The National Health Service is an important expression of our national values as a caring and compassionate society. It impacts, from birth and through health and sickness to death, upon the life of quite literally every person in the country and we should be eternally grateful for the fact that it exists and for the dedication of all of those who work within it.  That is why the coalition government has guaranteed that health spending will increase in real terms in each and every year for the lifetime of this parliament.
 
That said, it is also the case that if we are to keep pace with the development and availability of modern technologies and treatments and drugs and if we are to promote excellence through research and innovation then we have to make sure that every last available pound is directed towards patient care.  That does not mean removing essential local management and secretarial support staff from the equation but it must mean an end to centrally controlled micro-management from Whitehall.
 
The Health and Social Care Bill, now before Parliament, does not represent change for the sake of doctrinaire change as some have tried to suggest.  It is a very genuine and determined attempt to shift the power away from quangos and towards General Practitioners as the patients` expert guides through the health system with the power to commission the care that is needed at the best price and from the best possible provider. If, as is promised, the costs of NHS administration are to be reduced by a third and if that released money is transferred to support doctors and nurses on the front line then that one action will go a very long way towards removing postcode lotteries and delivering an NHS that is based not upon any ability to pay but upon treatment that is free at the point of use and available to everyone.
 
During the past year I have had huge cause to be thankful for the care that I have received personally following the fracture of both Achilles tendons and I have also had the opportunity to observe the health service  experiences of my own family through the birth of my granddaughter and the illness of my Mother. I have witnessed great expertise and commitment and I have also seen at close quarters the frustrations of Managers and Medical staff who know that given free rein and the room to innovate they could do still more.
 
I know that the 24/7 urgent care provision, the GP out-of-hours services and access to local general practice are of real concern to my constituents. I know that there are also concerns about the future, staffing and medical support  for local  birthing centres and maternity services.  I know that overseas doctors and nurses and ancillary staff make a contribution to healthcare without which the NHS would quite simply collapse but I also know that following some high-profile failures patients want to know that foreign healthcare professionals have satisfied robust competence and language tests before they practice in the UK.   I know that it is results that matter to people and that we have to improve still further cancer and stroke survival rates and to reduce hospital acquired infections . And I know that people want to be able to access the drugs and treatments that their doctors decide that they need without external interference and control.
 
All of that, and much more, does depend upon the new structures and freedoms that the Health and Social Care bill promises to introduce.   No change is ever introduced without proper challenge, without some upheaval  or without understandable uncertainties and anxieties . But it is all too easy to use “too far” and “too fast” as an excuse for leaving things to muddle along as they are. If we are to deliver the 21st century world-class NHS that the resources we are spending can buy then the changes contained within the bill must be made with courage.  Thank goodness those who are going to have to drive these initiatives, the local General Practitioners and clinicians,  are generally enthusiastic and eager to roll up their sleeves and to get involved. As the secretary of State for Health, Andrew Lansley, said on the eve of the publication of the bill, “A National Health Service, nationally funded will deliver local care at arm’s-length from politicians” That alone, surely, has to be good news!

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