Your house as the NHS (please indulge my whimsy)

It is generally agreed that the Health and Social Care (H&SC) Bill represents the biggest shake-up of the NHS since its inception.

The NHS budget for 2011/12 is around £106 billion. Estimates of the cost of implementing the H&SC Bill range from the Government's £1.3 billion to Labour's £3.5 billion. For simplicity, let's say the cost will be around £2 billion, equating to about 2% of the annual budget.

Now imagine your annual household budget is £50,000. One day, three men, two wearing blue ties and one wearing a yellow tie, knock on your front door. They tell you that they are here to do urgent, expensive work on your house. It's going to cost you £1,000 (2% of your annual budget).

You didn't invite or expect these men. In fact, you were under the impression that the workmen in your area had recently agreed not to do any cold calling. You ask the men to explain what's wrong with your house. They tell you that your kitchen is outdated and inefficient, and doesn't match european standards. You patiently explain to them that that was the case a decade ago, but since then you've systematically upgraded your kitchen, and it's now fine. You're feeling charitable, so you invite them to come and have a look at your kitchen for themselves, but they don't seem interested.

They then tell you that your household energy efficiency is only half as good as that of a house in France. Again, you patiently explain to them that that was the case quite a while ago, but since then you have been busy making your house greener, with loft insulation and energy saving light bulbs. And in fact, the latest information indicates that your house has become massively more energy efficient, and is improving at a much faster rate than the average french house. You're even considering adding solar panels to your roof, but that's a decision that you'll make for yourself in your own time.

They then tell you that the increasing annual cost of your household bills means that you absolutely have to let them do major work without delay, otherwise you won't be able to afford your house. You struggle to understand their point exactly, but you do concede that a few years ago your household bills were increasing quite rapidly. Since then, you've switched some providers around, set up direct debits, and consolidated your gas and electricity supplier, so that now your household bills aren't increasing at the same rate that they were, and actually aren't particularly alarming in the context of your annual household budget.

Visibly frustrated, the three men tell you that you're not listening and that they're sorry that you don't understand what they're telling you. They say that they're going to go for a walk around the block, and they'll be back soon.

When they return, you decide to take a different approach. It's clear to you that they can't explain why you need the work that they are recommending, so you decide to ask what exactly they are going to do and how it's going to improve your house. Somewhat bizarrely, one of them tells you that it's about empowering you as an individual home-owner. Another tells you that it's about making sure that your house is better than your neighbours' houses, and that by competing with your neighbours, he guarantees that your house will always be very good (at this point, you can't help think about all the times your neighbours have helped you out and vice versa... lending power tools, babysitting, the list goes on). And the third tells you that it's about doing the work now to avoid your house collapsing, so that he then doesn't have to worry about your house in the future.

Your house... collapsing?!? Yowsers. But hang on a minute, you think to yourself... you're very house proud, and you've devoted lots of time and energy making sure that it's a good house. You've had friends and family help you out over the years, doing the usual DIY bits and bobs. You've even had builder friends come round and tell you that your house is really impressive compared to lots of other houses, particularly when you take into account how much your house cost you and how much you've spent on it.

And you also think about how this unannounced, unrequested door steeping started. You had to keep correcting the three men about the current state of your house and what the main problems were - you're no fool, you know that there are always things that can be done to improve your house (and anyway, whose house is perfect?), but they weren't what the men claimed were the fundamental, urgent problems. You realise that the men have got a real credibility problem, and frankly you just don't trust them.

Your mind is starting to reel... £1,000... for what exactly? And why? They tell you that you can't afford not to do the exact work that they are peddling (although even this is confusing, as the three of them have done a fair bit of bickering on your doorstep, and have actually changed quite a few aspects of what they say they are going to do). In contrast, you're wondering whether you can afford to do the work, particularly right now, what exactly the work is, and what it will achieve.

Soooo, the question is - what do you do, hot shot? What do you do?

Chris