At the point of delivery

Gordon Brown has delivered a New Year's message to the National Health Service. We are promised

a new constitution of the NHS setting out for the first time the rights and responsibilities associated with an entitlement to NHS care.

This is an ominous development. What can the word responsibilities possibly represent in this context other than a threat that those who adhere to what are deemed bad habits may be refused (or receive reduced) NHS care?

We live in an age of stultifying orthodoxy in which Ministers of the Crown fall over each other to issue us with guidance on - and pass judgement on - any number of issues that are none of the Government's business.

If we let 10 Downing Street foist the principle on us that, for apparently trivial example, people who smoke or are fat are failing in their responsibilities to the Health Service, and that in return the Health Service's responsibility to them is commensurately reduced, then we will have abandoned something precious.

What would there be to stop a future administration of a different ideological stamp deciding that, say, people who became infected with HIV for want of taking responsibility for precautions were in breach of their contract with the NHS and thus ineligible for care?

Loads of potential examples spring to mind. It is a bad idea.