Theresa May has announced she's pulling the plug on the NHS life support machine

In the heady, post-referendum haze of a few weeks ago, I, like many others, ascribed Theresa May with a degree of guile and political acumen that I'm now beginning to question.

We've seen the almost complete rout of the previous cabinet and removal of any significant ministerial post with ties to the Cameron regime.  This has been topped off with a raft of seemingly bizarre cabinet postings, none more freakish than giving the job of Foreign Secretary to a self evident buffoon with all the diplomacy skills of a hyperactive 5 year-old mainlining Sunny Delight.

At the time I saw those appointments as part of an ulterior agenda that would simultaneously rescue us from the worst outcomes of Brexit, whilst shielding May from the increasingly shrill demands coming from the far right. She seemed to be playing a very clever game.

If that was the case, that game plan has comprehensively unraveled. What originally appeared to be method now reveals itself to be more like madness. Her no-nonsense attitude looks more like a no-idea shambles. In short, she's winging it, and we're in a nose dive with her.

Indeed it's become apparent that her approach to her premiership is rather more reckless than considered. Maybe she's lost her nerve, or perhaps she's realised where her power base lies.  Whatever it is, we're seeing a far more reactionary regime beginning to emerge.

No wonder then that she refuses to give a 'running commentary' on her approach to the Brexit negotiations. It's clear that she has no strategy to square the circle being asked of her - that of staying within the single market and restricting free movement of people within the EU. Better then a tap on the side of the nose and a knowing look. Nudge nudge, say no more, squire!

Yet it's a conundrum with no solution, and faced with this dilemma, she's simply focused on one aspect of what she sees as her mandate.  Like a schoolmistress dealing with someone she's caught smoking behind the bike sheds, she's going to let us see the results of our own stupidity. She'll make us smoke the whole pack and invoke 'hard Brexit', taking us out of the single market with no idea of how she'll plug the economic gaps that will create. Presumably then we'll see another Tory PM exit stage left, off to a life on the lecture circuit and a few well paying non-execs.

As if that wasn't worrying enough, we're now witnessing a similar attitude towards public spending. In the same way that she expects to extricate us from Europe with scant regard for the consequences, she now seems to be applying an equally blasé attitude towards public spending. In particular towards the NHS.

It now emerges that during a woefully under-reported meeting last month with the Chief Executive of NHS England Simon Stevens, she effectively shut the public purse on the fingers of those trying to support our over-stressed health service.

Regardless of the fact that NHS demand is increasing by at least 3% per year, she told Stevens that there will be no more money for the NHS after the £10bn that was theoretically pledged before last year's General Election. In that one pronouncement she has assured the deliberate and purposeful destruction of the NHS.

Despite claims to the contrary by successive Tory PMs and Health Ministers, she's finally nailed the Tories' bloodied colours to the mast. The NHS will no longer be supported by her government. I suppose she should be applauded for her honesty.

Even before the election there were stark warnings from NHS managers that the service would face a £30bn shortfall by 2020.  After much cufflink twiddling and prevarication, George Osborne finally found an extra £10bn down the back of the treasury sofa when it looked like his party may actually lose.

Later claims that anything up to £15bn has been injected into the NHS by the Tories are hotly disputed amidst warnings that the Government is deliberately using misleading figures - as if the merest thought of doing anything so underhand would ever consider the faintest possibility of crossing their minds.

The BMA has since highlighted the fact that the Department of Health’s budget to fund healthcare in England will only have gone up by £4.5bn by 2020-21 compared to the current financial year, well below the £10bn extra the government pledged, and well below the £8bn demanded by the NHS Five Year Forward View plan.

Simon Stevens, who was known to be complicit in David Cameron and George Osborne's creative accounting on the NHS, has recently earned the displeasure of both May and Hunt after questioning their interpretation of the funding figures quoted in Westminster and beyond.

He was also sent away from Jeremy Hunt's office after being told by the Health Minister that his claims to need up to £16bn to maintain services were "mad".  He later told the public accounts committee:

The government would record it as £10bn. The health committee recorded it a little differently. There is an apples and pears issue there.

However you slice it, there still remains a £22bn black hole in DoH finances that Theresa May has now acknowledged. In doing so, she has demanded that NHS bosses should close the gap by way of operational savings - otherwise known as cuts.

In a manner so cavalier they may as well be wearing feathers in their hats and leading a spaniel, both Theresa May and Chancellor Phillip Hammond pointed to their own experience at the Home Office and the Ministry of Defence where they presided over big efficiency savings without "whinging about it".

Perhaps it's simply that I don't have access to the same quality of mind-altering drugs that May and Hammond appear to be imbibing, but I can't think of many cases where cuts in either of these previously fabulously wealthy government departments would be likely to cause suffering and death on a scale we're probably about to witness in our hospitals and doctors' surgeries.

Sorry to whinge Theresa, but amidst a recruitment crisis in the health service at both hospital and GP level, as well as continued pressure being applied to ambulance and paramedic services, social care, mental health services and A&E, I don't think there are many areas of fair comparison with the number of immigration officers on duty at Heathrow or how many Trident submarines we'll finally decide to build.

Perhaps May is going to use the £350m a week we were promised by Boris and his former bestie Michael Gove to fill the gaps left by her newfound miserliness.  Equally probably, I'll wake up tomorrow with the magical ability to sh*t gold bars and they can use those.

Not only is this another move by a Prime Minister out of her depth and divorced from the reality of those she claims to be representing, it's also her pressing the fast forward button on the ultimate fate of the NHS under Tory rule - an undermined and under-funded service driven into the wall before being sold off to private providers.

Regardless of the monumental cognitive dissonance displayed by every Tory MP and supporter who lays claim to a reverence of the NHS as a sacred institution, the overall aim of this government is to see us all forced into a system very much like that in the US.  Conservative ideology dictates that we should all be responsible for ourselves with only basic care provided by the state. For those in greater need, with chronic conditions, long term pain or life threatening conditions it will be a case of 'can't pay – won't treat'.

The end has been nigh for years now, but with May's latest announcement it'll be greatly accelerated.  Soon, like our American cousins, we'll all be one serious illness away from bankruptcy, with no one there to help us. That outstretched doctor's hand won't be one of caring concern, but one demanding the last few pounds in your bank account.

This is how the final endgame will play out. Not with a single announcement or a date on a calendar. The death of a thousand cuts will be meted out to our NHS by health trusts in secret meetings, lifted on the shrugged shoulders of fund managers and voiced in politician's promises as empty as a closed children's ward.

The question we all need to ask ourselves now is: are we going to stand by and watch Theresa May pull the plug on the NHS life support machine, or will we stand up and ensure a better prognosis while we all still have the chance?