Are ambulancemen a kind of helmetless fireman – because they answer 999 calls? Or are they a kind of car-borne nurse – because they get the sick to hospital?

The shadowy answer to this question took the ambulancemen off into an overtime ban in mid-September. They said they were firemen by another name. Kenneth Clarke said they were nurses on wheels. The differences was worth several thousand pounds a year to them. It is the sort of difference that tends to make people vote Yes in strike ballots.

It is also the sort of row that has increasingly marred the Welfare State. Years ago, Richard Titmuss, one of the patron saints of the Welfare State, said that we must always ask whether the money was going to those who needed the help; or whether it was going to those who were supposed to give the help. The interests of ambulancemen, or nurses, or doctors, or social security officials, or teachers, are not – unfortunately – identical with the interests of their clients.

It is a pity they aren’t – because it would make running the Welfare State so much simpler; just as it would be simpler if ambulancemen fitted neatly into one category or the other. Sue Townsend’s agreeable pamphlet, subtitled Why Britain Needs a Welfare State, would lose its charms if