While any benefits from the changes to the NHS can at best be long term, the political costs are immediate

One year on from its adoption, Rudolf Klein argues that only one thing is certain about the Health and Social Care Act: it will be a vote loser for all parties in the coalition government. Predictions of disaster will probably not come to pass, nor will the changes be likely to make the NHS more effective and efficient. The Act may be the most dramatic example of a policy fiasco in the history of the coalition government, but it is not the only one.