I actually think that CMD has a pretty good idea of the real world, he just doesn't come across that way. He has more experience with the NHS than most people would ever want to, but still gets portrayed as the NHS killer.
Milliband would be far more credible if he ditched the union support altogether, and stopped aiming all the evils of the world at the door of business. Labour should be smarter than that now, which is why Blair was so successful in the first five years.