This is from Anna Dixon's blog at the Kings Fund:

"The other factor likely to make implementation more challenging is that the reform proposals themselves dismantle the very apparatus used in the past to get things done in the NHS – targets and performance management by strategic health authorities and primary care trusts. A reliance on choice and competition and the motivations of professionals and clinicians to drive the changes is a gamble."

This sums up my attitude: "choice and competition" will not improve the NHS in the short term and in the medium, term it is likely to make the service worse for many people as competition closes down under performing hospitals. Ms Dixon concludes:

"If the proposals are to succeed, the government needs to engage and motivate clinicians and managers to work effectively together. They ultimately will lead change across local health economies and deliver improvements in quality and productivity. It is unlikely that managers, who face potential redundancy, and clinicians, who are being given new responsibilities without any increase in pay, will feel ‘liberated’ by the government’s plans. Instead, the government runs the real risk that these structural and organisational changes will distract from the real task of clinically led service change"

 It is almost as if Lansley's plans are designed to fail. I wonder who would step in to provide healthcare in the UK if that happens?

Andrew Lansley is the Dr Beeching of the NHS.