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Mark is correct and his wider eastern experiences should make us reflect on what can be achieved. it must not be competition for ideological reasons but because it may be able to improve outcomes and increase choice. Why are NHS proffesionals so afraid of competition from providers other than themselves. If the NHS is as good as it believes it is it will win hands down by providing better outcomes and retaining surpluses for reinvestment. We all know that NHS reform is held up in the sameway as the print unions held up change to the newspaper industry. it needs a Mr Murdoch to drive change ensuring we have more choice and better services. the NHS needs more of Marks thinking turned into practice. An NHS for the age we live in not the age it was born in. Great to see enlightened doctors supporting reform in the Telegraph and Times .The reason we have a thriving newspaper industry is thanks to radical reform a lesson for the NHS.