comment Best way to tackle rising demands on NHS is to see 10-year plan through

News of the increased workload faced by ambulance service trusts this summer will add to a widespread, growing and uneasy sense within the NHS that something should be done about the apparently ever-growing demand for health services (news, pages 6-7). Now even the prime minister appears to believe his own government's propaganda about record levels of public investment in the health service, and wonders, along with the Daily Mail, why it appears to have done so little to improve matters (politics, 19 August).

The danger, as Tony Blair returns rested from his holiday sojourn, and eager to set the agenda for the remainder of his first term of office and beyond, is that many of the seductive 'somethings' whispered in his ear could turn out to be as ill-conceived as Margaret Thatcher's own presidential- style intervention more than a decade ago in the wake of a series of 'shock horror' news stories. Downing Street's influential health adviser, the shadowy Robert Hill, would do well to remind his master that Mrs Thatcher's frustrated bid to break the NHS log-jam cost her then social services secretary and favoured son, John Moore, his career in government, led to the break-up of the Department of Health and Social Security and produced the internal market.

The fact of the matter is there is no crisis which demands radical action. There is, as there always has been, a mismatch between the growing demands that people make on the health service and the service's own increasing ability to deliver them.

The NHS has a claim on increased resources if it is to rise to meet those demands. But for as long as people read about scientific advances and new 'wonder drugs', the health service will always lag behind expectations. And boring though it may be for an activist politician like Mr Blair, the '10-year modernisation programme' that health secretary Frank Dobson talks so much about must be given time to deliver results which can be properly evaluated.

The National Institute for Clinical Excellence, the government's potentially far-reaching primary care reforms, and even NHS Direct, are not instant solutions. Even two-and-a-half years into the lifetime of the present parliament, Mr Blair and New Labour remain sufficiently popular that the prime minister can - and should be - prepared for the long haul.