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Thank you and the other two editors for this excellent piece. Reform of the NHS in England is inescapable. But it is also clear that a new Bill is needed, and quickly.

There is a clear "Plan B". Kieran Walshe's editorial in BMJ today talks about it and Roy Lilley has been banging the drum about it for months. We have the way forward for reform marked out clearly in the recommendations of the two Future Forum reports, all of which the present government has accepted with alacrity.

These reports constitute pretty much all that needs saying about what sort of NHS England needs. It is built on an understanding of needs and engagement with users and carers, the public, clinicians and managers.

The longer we delay shifting course in this direction, the worse the problems with the present system will become. No amount of baying across the floor of the House of Commons can disguise that. The time for blame is long past. And keeping things as they are now is also a recipe for disappointment and probably also bankruptcy.

There is a strong narrative for change that is simply not being heard clearly over the party political noise. If we do not act on that soon, there is a danger of straying into the wilderness so far that we cannot find our way back to reality.