First some caveats.
My personal position on developing reform in the NHS is that I want to work through and carry out reforms within its basic principles. I am the same age as the NHS. I accept that there will be others that come after me that will want to change this, but as of the 2010 election a higher proportion of people supported these principles than ever before and I see that as one of the successes of the last Government.
So for me reform is within the idea that the NHS will
- be paid for out of money collected through national taxation.
- provide equal access for all in England to services that will be free at the point of delivery.
These were the principles that guided NHS reform between 2000 and 2007 and I would want them to be the principles that guide NHS reform for at least the next ten years. Letâ€™s not forget that reform so far has created greater satisfaction with the NHS than ever before.
Why is this important? These statistics mean that as far as the NHS is concerned the middle classes have decided that it is not worth buying themselves out of it and will therefore add their voice to the shouts for improvement. The NHS, in practice as well as in theory, provides universalism.
Part of the aims of any reform programme must be to improve on that by the year 2020 since it is that support that ensures politically the prolonged life of the NHS
And my first issue is vital to that support.