When the trio of likely lads Cameron, Clegg and Lansley appeared recently at Frimley Park Hospital to launch the ‘Big Listen’ the staff looked like rabbits caught in the headlights. They were supposed to be there to tell the politicians what they felt about the reforms but instead they were the recipients of the Big Schmooze. And in truth it would take a brave nurse or theatre porter to stand up in front of the press and TV cameras and tell the Prime Minister what they really thought of their proposed health reforms.

So the first question is who is going to listen to whom? All the talk on the government’s side is of misunderstandings, repackaging, reassurance and a better presentation of ideas. It seems that it is we who have not been listening hard enough, and Mr Lansley’s only problem that he is not a natural ‘communicator’.

Andrew Lansley is not a listener. I’ve had the dubious pleasure of meeting him on two occasions, and can confirm that like many politicians he only listens to what he wants to hear. He is not interested in anti-market views, and most certainly believes his critics are simply wrong. The only reason he is having to grit his teeth and pretend to pay attention now is the formidable array of opponents to his legislation, and a stark warning from Sir David Nicholson that the ‘reforms’ will lead to chaos.

David Cameron, with his laissez faire attitude to his cabinet ministers, is waking up rather late in the day to the fact that the ‘reforms’ have provoked strong antibodies from the profession and the public. He knows only too well that a government that makes a mess of the NHS will be severely punished at the polls.

Andrew Lansley has had plenty of opportunity to listen. He could have discussed his proposals with NHS workers before producing them fully formed shortly after he had promised ‘no more top down reorganisations of the NHS’. But he didn’t. He could have listened to the 6,000 responses to the bogus ‘consultation’ exercise, but he didn’t and none of the major concerns was taken on board. He could have taken on board some of the 700 proposed amendments in the recent committee stage of the bill but he didn’t.

There is no reason to suspect that the Big Listen will be any different - a cosmetic exercise to bamboozle those who don’t understand the underlying purpose of the Bill and to stave off disaster at the forthcoming local elections. You only have to look at who he has appointed to lead the exercise to know that there is no serious intention to make significant change. And the recent leaked memo from Sir David Nicholson, claiming that certain elements can’t be changed, indicates that only minor surgery is contemplated.

The problem is not with Mr Lansley’s communication skills but with what he has to sell. There is no misunderstanding on the part of the opponents of the bill. We understand very well that all the elements of the bill that trouble people - Monitor, ‘any willing provider’, the draconian powers of the Commissioning Board, the flawed version of GP commissioning - are part of the long term plan. This is to change the NHS into a funder of healthcare, not a provider. The NHS will pay the bills but the care will be provided by competing organisations, initially including NHS institutions and the voluntary sector but increasingly by the private sector.

No amendments will alter this as the government will not be willing to compromise the core purpose of the legislation - they would lose the advantage of all the political pain they have had to endure. Talk of amendments misses the point - the whole bill is toxic. We don’t want reassurance or a better class of schmooze. We want the legislation to be withdrawn, as the BMA has called for already. I hope the likely lads are listening.