Brown finally begins to reveal his blueprint for health reform

Two themes are emerging: access, and the degree of central and local control exerted over the NHS (see ‘Private slowdown expected as service prepares for Brown’).

Mr Brown has declared improving access to be one of his priorities. Even after a decade in power he admits Labour still has much to do.

Walk-in centres, electronic prescriptions, blood pressure checks at pharmacies and a wider role for NHS Direct have all been pushed on the campaign trail. And GP services are in his sights. The prime minister in waiting has stressed the need for access to services outside normal consulting hours, and data revealing a 23 per cent increase in earnings for GPs in 2004-05 should be enough to see them at the top of the list when the new ministerial team looks for higher returns on NHS spending.

Mr Brown has, at least for the duration of his premiership, buried the idea of an independent board to run the NHS. By his own admission Labour has a long way to go to convince the public that the vast sums invested in health are delivering adequate returns; it would have been astonishing if he had come into power planning to relinquish much of his ability to drive through more reforms, notably in GP services.

But he has firmly endorsed local autonomy through mechanisms such as foundation status.

There is a third theme on which Mr Brown has been less forthcoming - the role of the private sector. Under Tony Blair and adviser Paul Corrigan, private firms were not just used but actively seen as desirable in pursuit of greater choice.

There are indications that Mr Brown is far cooler; he sees private firms as important players in increasing capacity to reach demanding targets such as 18 weeks from referral to treatment, but does not see an expansion of private provision as an objective in itself.

The mixed economy is here to stay, but the ground for the private sector may start to feel a little less fertile.