October was one of those months - the big news just kept on happening and the growing crisis gripping the NHS has become more and more obvious.

To make matters worse, an architect of Labour's costly market-style "reforms," former Blair adviser Simon Stevens, has now been appointed to replace Sir David Nicholson as chief executive of NHS England.

For nine years he has been a high-flying director of the biggest US health insurer UnitedHealth.

The rapid descent into market chaos seems set to accelerate further.

The pace was already hotting up. Early in the month, the NHS Confederation threw down its "challenge" to politicians, demanding they sign up to support swingeing and unpopular local cuts and "reconfigurations" in hospital services in the run-up to the 2015 election.

The Confed warns that unless they do so, and unless MPs stop defending their local hospitals and start attacking their own voters' services, the NHS stands little chance of making the massive cutbacks needed to bridge a growing gap between the miserable frozen budgets set by George Osborne and the rising pressures and demand.

The current "challenge" of saving £20 billion by 2015 - for which most savings have so far come from effectively cutting the pay of over one million NHS staff - is to be followed by an even steeper "challenge" of saving another £30 million by 2020.

In case you are wondering where it went, most of the money "saved" so far has been clawed back by the Treasury, not reinvested in the NHS.

The Confed threat was followed by the medical director of the obscure new London Area Team of NHS England, Dr Andy Mitchell, who emerged from the shadows to claim that London's hospital services were "unsustainable" and that swift action was needed to close half its A&E units and many of its maternity and children's services.

On closer examination it was clear that Mitchell was concerned first and foremost with finances, since his warning was that action had to be taken to prevent London's NHS running up a £4bn deficit by 2020. He went on to argue that the capital's trusts could "not afford" to staff wards safely.

This blunt statement at least cut through the usual rigmarole in which NHS bureaucrats seeking to drive through cuts insist time and again that the cuts they are proposing are "clinically led."

In this case the only real clinical element was it was a doctor insisting on the need for financial balance and for services and patient to be cut to fit the budget.

This comes alongside the continuing claim by the government and a rag-bag of so-called think tanks and professional bodies that the NHS has to close A&E units "to save lives" - although these arguments stop dead in constipated silence when the question arises of how the remaining A&E units, and the hospitals to which they are attached, could possibly cope with the additional tidal wave of seriously ill patients who would be brought from ever-greater distances needing treatment and beds. There is clearly no spare money to rebuild and expand on the scale required.

In Worcestershire, where hospital beds average 99 per cent occupied, cash-saving plans are seeking to close beds and services in Redditch and Bromsgrove to centre them in Worcester.

There is no serious consideration about journey times and problems for elderly and low-income patients who would be forced to make ever-longer journeys to access care.

Instead we are constantly told about the services available to those with the most trivial needs, who would still be catered for locally in "urgent care centres."

There are constant blustering assertions that hospital care could be replaced by community-based care - but on closer examination there is little, if any, evidence that this can be done or that there are any real plans to do it where hospitals are scheduled for downgrading or that proper community-based services are any cheaper than existing hospital care.

In place of concrete plans for expanded community services, all we get, everywhere, is fine words, aspirations and wishful thinking - that's not much use to deal with tens of thousands of poorly patients.

Meanwhile we have been told that hospital budgets will lose another £2bn per year from 2015, which will be carved out of NHS spending and allocated to social care, where budgets have been brutally slashed by desperate councils facing Osborne's 28 per cent cuts.

A stark reminder of the limits of community-based care came with some warnings last month that year upon year of cutbacks in mental health budgets had reduced beds to dangerous crisis levels.

This is after years of transforming many services from hospital to the community.

There have been days this year in London, and even in the whole of the country, in which there have been no mental health beds at all, either in the NHS or private sector, available for those with serious needs.

Many other days have seen patients in distress dispatched after long delays on lengthy journeys to beds in other cities, many of them hundreds of miles from their homes and family.

Despite the headlines and crocodile tears from ministers, the squeeze on mental health continues.

The competitive market in health care has also gone badly wrong, with the Competition Commission now wading in to block trust mergers and reconfigurations, private hospital firms forcing Monitor to investigate where they are not awarded contracts and clinical commissioning groups ludicrously blocked by the Health and Social Care Act from meeting together to plan services.

Meanwhile patient "choice" and competition could be wiped out by a new private monopoly in Cambridgeshire, where the clinical commissioning group is pressing ahead with a hugely complex plan to put whole pathways of care out to tender.

The existing, successful NHS provider is no longer among the bids - raising the grim prospect of Virgin scooping up a monumental five-year £800m contract.

In Bedfordshire, too, the clinical commissioning group is set to hand a similarly complex £120m contract for musculoskeletal services to a privately led consortium which includes a company owned by almost half of Bedfordshire's GP practices.

As the fragmented, divisive, wasteful competitive market system set up by the Health and Social Care Act began to display its nonsensical side, Jeremy Hunt tried to smuggle through even more draconian legislation to allow "special administrators" to carve up local services as well as bankrupt trusts - in a clause tagged onto the Care Bill in the House of Lords.

Even if he gets his way, it will come too late to rescue Hunt from the embarrassment of losing his appeal against the court ruling that prevented him rubber-stamping the closure of most services at Lewisham Hospital.

And increased powers for the administrator would not help force through the closures in north-west London, some of which have been delayed by the Independent Reconfiguration Panel.

The IRP found that there were no convincing plans for community and other services to replace the closure of A&E and services at Ealing and Charing Cross Hospitals - and ordered the A&Es to be "sustained" until alternative services were in place.

Desperate NHS hospital managers have begun hoping for the public to turn their backs on the NHS to allow them to drive through unpopular cuts.

A shameful article by the the Foundation Trust Network chief executive Chris Hopson in the Health Service Journal - and echoed in a wretched Guardian article - celebrated the first small signs of weakening public affection for the NHS, as ministers, the BBC and the right-wing press delight in stories of poor care and service failures.

An opinion poll had found fewer people (60 per cent) supporting the view that "the NHS is a symbol of what is great about Britain and we must do everything we can to maintain it" and a larger minority (30 per cent) have been bludgeoned by the right-wing media into believing that "the NHS was a great project for its time but we probably can't maintain it in its current form."

By most readings, that's still a substantial majority behind the NHS despite all the bad headlines.

We are still many, they are few. Let's fight on, while there's an NHS to defend.

John Lister is director of Health Emergency.