Johann Hari: There are still reasons to choose Labour

Another election campaign, another festival of apathy-inducing trivia. John Prescott's penis has loomed larger over this local election campaign than the issues that will affect people's lives for the next five years. Local councils are responsible for the 400,000 elderly people living and dying in Britain's care homes. They are poised over the next few months to make decisions about whether to reduce the funding for these homes or not. (Or, to put it something other than cold council-speak, they are going to decide whether to slash a few pounds from council tax and leave more old people crying and caked in their own faeces for longer, or to increase taxes and try to provide decent care). But have you heard this issue discussed? Have you, as a voter, been helped to figure out whether Labour, Tory or Lib Dem councils will care better for your granny?

The Today programme's interviews with representatives of the three main parties have served up cretinised brain-pulp. For example, John Humphries spent three minutes of an 11-minute interview questioning David Cameron about his bike, suggesting at great length that he buy a bigger basket to fit his papers into. I don't mean to single out Today. We have all failed to help electors meaningfully participate in their democracy - it's just more shocking to see the BBC toss its brain into a blender.

The Labour government is clearly going to get a kick in the ballots today, but the people who will pay for it will mostly be elderly people in ever-more-disgusting care homes. Broadly, Labour councils tax more and spend more on the elderly, asylum seekers running for their lives, and council housing for the poor. Broadly, Tory councils cut taxes and services for these people. (Lib Dem councils are more variable, sometimes tacking to the right, sometimes to the left). The result of refusing to turn out to vote Labour in most areas will be to allow Tory and BNP councillors in to sandpaper public services down.

But people are not in the mood to hear this. They are angry with the Government for a thousand good reasons: the disasters in Iraq, the disrespect for civil liberties and more. But where this hardens into a churlish oppositionism that refuses to acknowledge any progress, where it turns into a vandalistic desire to tear down the Government without any worry about what comes next, it becomes a betrayal of people more vulnerable than you. Sometimes this the-Government-never-does-anything-for-us mentality reaches an absurd level. In the year Tony Blair introduced gay marriage to this country - the last step in implementing the entire gay rights agenda - two of the major gay publications, Gay Times and Boyz, named him as their "Villain of the Year".

The response of nurses has been just as self-defeating. If a leftie had predicted in 1997 that spending on the NHS would literally double (paid for out of hefty tax rises), waiting lists would fall so hard and fast that many private clinics would go bust, and British nurses and doctors would become the best paid in Europe, they would have been accused of being a deranged fantasist. It has happened. We are there. Yet still Patricia Hewitt is barracked by the very Royal College of Nurses she has just awarded an inflation-busting pay rise to.

The conference's cries and boos were a perfect symbol of the point-blank refusal to see any progress that is rippling across this country, even as the progress washes into your own bank account. The glorious principle of an NHS free at the point of use, paid for out of general taxation, is under real threat. The right-wing press is determined to trash it and the Cameronistas are privately convinced of the case for private health insurance. The RCN have handed these enemies of the NHS a massive propaganda boost. Now they can say: "You have doubled spending on the NHS and it is still in rebellion! It can never work!"

Yet when Cathy Doughty, the nurse who famously told Patricia Hewitt with a snarl that she was a "brave lady" to attend the conference, was asked exactly what she is so angry about, she offered two things. The Government has imposed a maximum four-hour wait in Accident and Emergency, and Cathy now has to do "even more serious cleaning" where there is "a serious infection". That's it. Was it really worth kicking the NHS when it is already under attack from the right for that, Cathy? Is your solution - "if only they gave us more resources" - not being tried, just a bit?

Don't be a Cathy Doughty. Don't forget that while there are real reasons to be furious with the Government, there are real reasons to respect them too. And please, don't take your anger out on old people festering in our care homes when you go to vote today.

j.hari@independent.co.uk