Cameron pays price over cuts

Yet, while the Conservative leader swatted away Labour leader Ed Miliband’s opposition with contemptuous ease, Mr Cameron masked the financial consequences of the decision to water down these proposals. While it is open to question whether the changes will lead to more effective policies, a financial imperative lies at their core – and the Prime Minister cannot deny this.

The reason that a whole tier of NHS bureaucracy needs to be stripped away is to accrue sufficient savings to take account of an ageing society.

If these changes are delayed, the shortfall will have to be discovered elsewhere – or Ministers will have to impose an even more demanding spending settlement.

Likewise, the signal by Mr Cameron that Justice Secretary Kenneth Clarke will have to water down plans to give shorter sentences to those offenders who plead guilty, straight away, to their criminality – a measure that could have saved £100m.

Again, this money will have to be found from other sources after Mr Cameron bowed to public opinion rather than the wisdom of those respected criminal justice campaigners who indicated that the policy would spare many victims the harrowing ordeal of facing their assailant in court.

Yet, while £100m is, at face value, a relatively small sum compared to the size of the overall budget deficit, these amounts will quickly add up if the Prime Minister halts any changes that attract considerable opposition.

And, while the respected International Monetary Fund endorsed the coalition’s deficit reduction plans this week, it also signified that the Government needs to find scope for tax cuts to kickstart the wider economy.

This, however, becomes even less unlikely with each volte-face announced by Mr Cameron as a result of critical headlines – or unfavourable poll ratings. Coalition or no coalition, the PM’s policy execution needs to become far more sure-footed.