The time has come for us to better meet our care needs so that we can better meet the needs of others.

The 20th century drew to a close with outstanding technology but redundant philosophy. The cart is driving the horse.

A clear philosophy is demanded to meet this fundamental social challenge which cannot emerge from disparate controlling interests.

We have a golden opportunity to evolve new structures which stimulate positive change for the benefit of all.

Socially oriented, mixed-economy models which create enthusiastic, cohesive, self-sustaining care cultures relevant to local contexts are the way forward.

Talk of services based on need is counterproductive unless infrastructures are inherently public-led.

This can only be achieved through commercially viable, ethical change agencies forging constructive partnerships across all sectors and boundaries.

Stakeholder, social companies genuinely owned by the public, for the public, constituted to evolve the care services we actually need through international co-operation.

Governments should state and encourage an agenda in which we can all have a stake in taking the initiative to improve all our lives. Whoever and wherever we are.

Tony Praill