Some illnesses are more expensive to treat than others. While most people accept this fact, they do not like the idea that healthcare might be rationed according to cost, and react angrily to suggestions that certain interventions might “cost too much”.

The relative cost-effectiveness of different treatments can be difficult to pin down. The National Institute for Clinical Excellence, for example, assessed drugs for the treatment of dementia and rejected them on the grounds of excessive expense – a decision criticised by those who believed the potential cost-saving on carers’ time was not being evaluated correctly. This kind of problem occurs in all sorts of medical treatments, where the discrepancy between research findings and real-life outcomes are hard to measure.

Take angina, which, until the 1960s, was treated with drugs. Next came coronary artery bypass grafting (CABG), developed to supply the heart muscle with blood when its own circulation failed, usually due to plaque formation (atheroma) in an artery.

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Sometimes you really do wonder whether the Conservatives are remotely ready for government. The travails of the NHS’s £12.7bn project to create an electronic medical record for all are well known. The health department has just come up with its latest plan to rescue it.

Your guess is as good as mine about whether it will work. But it at least applies to the real world. At the Conservative spring conference at the weekend, David Cameron, the Tory leader, was talking about what he quaintly calls the “NHS supercomputer” as though this was some mighty black box sat in a field somewhere in the middle of England.

Not needed, he said, because “in this age of austerity, a web-based version of the government’s bureaucratic services like Google Health or Microsoft Health Vault cost virtually nothing to run”.

The Conservatives have clearly been listening to snake oil salesmen. Applications like these may well play an important part of patient controlled, and patient accessed, records. But the idea that either of these remotely amount to the patient administration system, appointment booking, test ordering and recording, digital imaging equipment, clinical coding, the decision support systems and the myriad other items needed in a hospital or GP practice to create a full electronic record in the first place is laughable. It really is not a choice between £12.7bn and “virtually nothing”.