After three years editing HSJ I am still struck by the NHS’s antediluvian attitudes to the private and voluntary sectors. It does not want this mirror held in front of it.

In debate over opening up healthcare provision to alternative suppliers, the words “private sector” are spat out, not spoken; the voluntary sector is ignored.

Demonising an opponent is a crude but effective way of avoiding debating the real issues, such as quality, patient experience and cost.

The party manifestos paint vivid pictures of an NHS which is patient centred, community based, preventive and productive. It will not achieve this on its own; too much needs to be achieved too soon.

Shibboleths that constrain NHS thinking need to be confronted. Old ways of working will often need to be scrapped. That will require the disruption brought by fresh ideas from companies and charities.

This is just part of the solution; innovation from within the NHS will contribute more than outsiders to its renewal. But to meet the challenges ahead the NHS should take the best ideas from wherever it can find them.

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