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Alan Milburn - out of touch and out of government. Outdated ideas that the market will solve everything in a year where markets have almost brought economies to the point of collapse. Does he seriously believe that fragmenting services amongst a multiplicity of providers is going to drive up quality? Many staff won't put up with it. They'll walk. They are not economic units subject to the flows of the market. Staff dont work in the NHS to get rich; they do so because they have a pride in the NHS and share its values. So why shouldn't NHS providers and NHS staff have first opportunity to improve or deliver new services? Co-operation should come before competition. Only if that fails should other solutions be considered. Cost wise this makes sense as well. The NHS remains best value for money compared to other national health systyems partly because it is not burdened with the administrative bureaucracy of managing a market. Andy Burnham is moving this debate in the right direction. Alan Milburn is yesterday's man.