Landmark? Last chance? Election winner? Will today's national plan for the NHS fulfil the many hopes invested in it? Kaye McIntosh asks key players for their assessment

Due out today, Labour's national plan for the NHS is intended to remould the way healthcare is delivered in the UK. Health secretary Alan Milburn says it will be as important as the original 1948 settlement.

The money is apparently there - the chancellor promised the health budget will rise by 35 per cent in real terms over the next four years.

The ideas appear to be there - submissions from every pressure group imaginable have been thick on the ground and the government's modernisation action teams have not been short of suggestions.

But in the run-up to the next general election, will the plan save the government's bacon on an issue that has become a potential vote-loser for Labour?

HSJ asked the great and the good, from interest groups to former senior NHS executives, for their views.

extended roles for some. This is important, but not as important as training, developing, valuing and thereby retaining existing staff.

How much of the growth will end up in pay packets will be one of the great puzzles for historians of the future. Some, perhaps a lot, should.

The regulation of the professions will no doubt be dealt with. The professions are ready for change, but will the government find the right balance between public protection and professional responsibility that is founded on self-regulation?

When the dust has settled another judgement will have to be made. Has the plan piled another raft of ideas and innovations on an organisation ill-equipped to deliver them or has it invested in the infrastructure that makes things happen?

The ocean-going captains in the days of sail knew that attention to their ships' keel was at least as important to their performance as piling on a new sail. However, sail is attractive, keel is not.

Will Tony Blair have the same wisdom about the NHS? Will the investment secure the future of the NHS as well as his government?

Brian Edwards, professor of healthcare development, Sheffield University; former regional director, West Midlands and Trent regional offices:

'The national health plan is a landmark event in the history of the NHS.

The decision to hike up investment at the level planned is of enormous significance. This bold and decisive move is quite likely to ensure Tony Blair's place in history and the re-election of his government. In the long term the detail of how it is to be spent will fade but the short-term impact will be very powerful.

So how are we to evaluate and judge it? Will it eradicate preventable blindness, improve cancer survival, reduce deaths from surgery or save more low weight babies? Will it make a sizeable investment in research and development to secure new treatment options in the still unfashionable areas like mental health or arthritis? Will it propose steps to give the poor at least equal access to services?

For politicians these are tantalising but dangerous propositions. It's easier and safer to be proud of inputs than outcomes and concentrate on playing Lego with the organisation. In some respects the plan will look like a direct product of a series of focus groups - interesting and newsworthy ideas focused on patient access, NHS Direct, improved complaints procedures, better information and extended choice. Focus group product or not, these ideas are to be valued and respected. The NHS belongs to the community, not the health professions and managers.

The plan will also promise more staff in all the direct patient areas and Ruth Lea, Institute of Directors, head of policy:

'I remember Harold Wilson's 1960s national plan well. It completely failed to deliver its promises. When I noticed Alan Milburn had chosen the same title for his proposals, I winced. The title tempts fate. I hope it is more successful than its predecessor. After all, Alan Milburn's plan could not be more important.

But I have major concerns. Firstly:

funding. The national plan will be backed by huge increases in public spending over the next four years. By 2003-04 NHS spending will be nearly£69bn (around 6.4 per cent of GDP) and in real terms 25 per cent higher than in 1999-2000. But UK healthcare spend will still be significantly less than in, say, France and the Netherlands.

And there can be no promises of further largesse after 2003-04. I fear the huge increases are the last throw of a government which still seems to believe that we can realistically meet nearly all patient expectations through taxpayer-funded healthcare. I agree care should be 'free at the point of access', but at some point governments will have to grasp the nettle of restricting taxpayer-funded services to 'core' services and incentivising people to increase their own provision for health.

Second, how will NHS personnel cope with the centralising and prescriptive managerial and professional changes which will be imposed on them 'in return' for the extra funding?

NHS personnel are suffering from reform fatigue, and they can be forgiven for a corrosive cynicism which I detect in many employees.

And, third, how will managers deal with rapidly expanding budgets after some very lean years? NHS provision will still be restricted by serious supply constraints in both medical personnel and physical facilities, and a combination of rapidly increasing budgets with supply constraints is a recipe for waste.

No business can plan properly and flourish with rapidly changing fortunes. And the NHS is no exception.

Will Alan Milburn's national plan meet a kinder fate than Harold Wilson's? I hope it will. But I am not optimistic.

'Margaret My then, chief executive, New Health Network:

'The national plan must be a fresh start for the NHS - a confidence boost and catalyst for sustainable positive change. The NHS has never lived up to its full potential.

The original 1944 white paper had sound aims to give everyone 'the best medical and other facilities available. . . regardless of any factor irrelevant to real need'. Yet unacceptable variations in quality and access continue. At last proper resources are available - now the public wants to see a first-class service. Proper national standards are long overdue - realistic standards we would expect for our own family and friends - backed up with meaningful information so that success can be rewarded and problems addressed.

There is unfinished business renegotiating the historic compromises that made the NHS possible. And we have to find better ways of spotting, sharing and supporting best practice, rather than continually re-inventing the wheel.

Not everyone will find what they are looking for because the national plan has to be about the big picture - what the NHS is for, what its problems are, how they can be solved. And at its heart has to be the patient. How do we finally make the NHS people-centred so that every stage of the patient journey is looked at from their perspective? That requires a radical change in culture and a new kind of health professional.

There also has to be a change in the relationship between national government and local delivery. There is only so much a government can and should do - it is the people at the coalface, like the members of the New Health Network, who make change happen.

Professionals who are doing a good job need praise and those who are not need support. The government empowers and in return the professionals innovate. The national plan must not be seen as the beginning and the end of this process.

Peter Griffiths, chief executive, Health Quality Service, former NHS deputy chief executive:

'The plan needs to ensure there is a demonstrable link between the additional resources being made available and improved performance in terms of patient experience, staff experience, efficiency, effectiveness and access.

There needs to be considerable emphasis on the local determination of performance improvement targets and priorities, albeit that these are rigorously monitored externally.

The plan must also be explicit about what proportion of the additional resources are required to make good the financial deficit that many trusts and health authorities have been running.

The plan needs to set out how staff numbers will be increased, and in what categories and service areas. It needs to be explicit that investment in more staff is as much to do with providing more time to adequately meet present workloads, as much as forecasts for demand.

The plan should be regarded as the basis for achieving cross-party support in relation to the level of public financing to be made available, the broad priorities to be pursued and the means for the regular review of progress.

There are two possible scenarios - the first that it will herald a renaissance in the confidence, trust and enthusiasm that the public and staff alike feel for the NHS.

It will result in increasing crossparty support and the support of the professions. There will be a sustained and demonstrable improvement in the quality of service given to patients and an improvement in the working conditions for staff.

The NHS will slowly but surely be the subject of growing and positive commentary by the media, and its performance - as judged by the international league tables of developed countries' healthcare outcomes - will be significantly improved.

Alternatively we will look back at the plan as having signalled the last throws of the state monopoly dice. It will have been regarded as the basis of a widening divide between the political parties. Public expectations and hostile media commentary will not have been assuaged by the quantum improvement in the quality of service for individuals that was needed.

Increasingly individuals will turn to their own funds or private insurance to supplement their healthcare needs. The next 12-18 months will certainly give us more information as to which of these scenarios is most likely.

Nick Harvey, Liberal Democrat health spokesperson:

'The national plan is three years too late, but at last the government is serious about modernising the health service.

There has been proper consultation through the modernisation action teams. There is a belated commitment to invest the kind of money for which Liberal Democrats have been calling for so long. That is a start.

But the most difficult part of the process still remains. Alan Milburn will only be able to command the consensus he is seeking if he can prove that he intends to spend his new resources on the right priorities.

The plan needs to address scores of problems, but two are critical. The first is NHS capacity. Everybody knows that the shortage of staff has undermined the health service more than anything else.

The second is the attitude of the NHS towards its patients. Often, it appears to exist for the convenience of the providers rather than the health needs of patients. The national plan needs to change the culture of the health service.

We agreed with the recommendations of the royal commission on long-term care over a year ago that free nursing and personal care, on the basis of assessed need, should be provided to patients, with an extended amnesty on means-testing of housing to encourage rehabilitation.

The long delay has not diminished our calls for the government to tackle this head on.

Liberal Democrats have been arguing over the past three years for radical reform.We shall be watching the government like hawks to ensure that the national plan really delivers this.

Conservative health spokesperson Dr Liam Fox was unable to comment.