Politics is a funny thing. Or, rather, people’s expectations in politics are funny.

Yesterday morning, I confess, I woke up rather confused. There seemed to be lots of people rushing around claiming that the Lords were going to save the NHS. Crossbenchers, Lib Dems and, god help us, Lord Owen, were going to “go rogue” and shoot holes in the government Bill.

They didn’t of course. The Labour amendment to block the bill was defeated by 354 to 220 and David Owen’s more modest attempt to delay the bill was defeated by 330 to 262.

80 Lib Dems voted against Owen’s amendment. The crossbench vote split down the middle.

Shirley Williams – brave Shirley Williams, maverick, party-wrecking, straight-talking Shirley Williams (the leader of the Lib Dems in the House of Lords) – probably didn’t vote. I hope her conscience is appeased by her abstention for it does no other good.

Lots of people got angry when the dog didn’t bark. My Twitter stream was full of people letting rip with righteous fury.

I wasn’t angry.

This was a battle that was lost months ago.

It was lost when the Lib Dems settled for a “consultation period” – in which no one was consulted and no significant changes were made – rather than taking a proper stand against their coalition masters partners.

It was a battle that was obviously lost when the Lib Dem leadership blocked an attempt to have a proper discussion about the Bill at their conference and the party’s activists caved in.

I wasn’t angry yesterday because I knew the battle was already lost.

I know that there are loyal Liberal Democrats struggling to justify their party’s actions in the last year by blaming Labour and saying that the financial crisis makes cuts necessary.

But let’s be absolutely clear, the changes to the NHS aren’t about cutting costs. The NHS is one of the most efficient and cost-effective health care systems in the world. We get far more out of the system than we put in, even after Labour spent 13 years pumping money into the system at a rate so high that there were times (especially in the late 1990s) that the NHS struggled to spend it all.

The Tories aren’t cutting vast sums of money out of the system. When they say they’re increasing NHS spending year-on-year they’re partially telling the truth. They’re not raising spending enough to keep up with NHS inflation (which is always significantly higher than inflation in the rest of the economy) or to accommodate the cost of their reforms – but they are modestly increasing NHS budgets while others are being slashed.

They’re not cutting the money that will be spent on health services, but they are redirecting part of those public funds from the NHS to private healthcare firms. They’re opening the NHS up to be scavenged by profiteers.

So, as the quality of our healthcare begins to fall (waiting lists are already rising and services are being cut) the amount we pay will increase. And the difference will be creamed off by profit-making organisations.

The Lib Dems could have stopped this. The Liberal Democrats could have said “no” and killed this Bill that no one – not patients, not GPs, not nurses, not consultants, not NHS managers – thinks is a good idea.[i] But they didn’t when the Bill was in the Commons. And they didn’t at their annual conference. So quite why anyone was surprised when they didn’t stop it yesterday is, frankly, a bit beyond me.

So, yes the Tories are ultimately responsible for a piece of legislation that damages the NHS in fundamental and potentially very dangerous ways. Andrew Lansley, pushed by a handful of lobbyists, has introduced changes that no one voted for (because they weren’t in any manifesto, before the election the Tories said reform wasn’t necessary) and that no one wants or thinks will make healthcare better.

But it’s the Liberal Democrats who let it happen.

It’s the Liberal Democrats who have put their desperation to stay in the coalition ahead of protecting the single most popular and most effective public institution in this country.

I have heard it argued that the Liberal Democrats are determined to cling to power. But what is the point of being in power if you never use it, even when an issue ties together both fundamental issues of principle and straightforward practicality in the way that this Bill does?

This is not about clinging to power. It’s about clinging to office.

[i] Actually that’s not quite true, there is one group who think this Bill is a good idea. The private healthcare companies are all for this Bill, but they would be, wouldn’t they?

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