The only way Britain can afford the resources to improve health outcomes, says shadow health secretary Dr Liam Fox, is to unravel the unsustainable NHS 'monopoly' by encouraging mass voluntary take-up of affordable, user-friendly private health insurance.
The resurgent private sector would then 'augment', rather than compete with the NHS, providing simple, non urgent, insurance-funded treatments to release NHS capacity and allow it to focus resources on urgent specialties such as heart disease and cancer.
Dr Fox wants to see the NHS driven by clinical priorities, with guaranteed waiting-time targets and uniform standards of quality and service across the country.
The strategic aim is to ensure healthcare resources are focused on the people who need them most.
What this does not mean is privatisation, he said last week after the first Commons health debate of the new session. He is against NHS privatisation but in favour of public-private partnerships, 'mixed provision' and 'the best of both worlds'.
There are times when Dr Fox's 'commonsense revolution' sounds - and to suggest this would irritate him no end - impeccably Blairite. Not that this has deterred Labour's spin doctors, who paint Dr Fox as an arch-privatiser who would destroy the NHS.
He also looks impeccably Blairite. Dr Fox is personable, well groomed, speaks with a Scottish accent and likes to suggest he carries no ideological baggage.
'On health I like to think the values I had in my medical training are the values I bring to healthcare policy. I don't regard it as some ideological crusade, ' he says.
The choices, he believes, are simple:
either more public money is spent on the NHS, which the Treasury would veto; or NHS funds increase at current growth rates, 'which will condemn us to a system whose health outcomes are considerably poorer than comparable European countries'; or extra resources are raised through voluntary private health insurance - the Conservatives' Big Idea.
But as Big Ideas go, health insurance is currently a bit of a damp squib. It has a minute share of the healthcare market, and the public shows no sign of wanting to buy it in any quantity.
Dr Fox admits that he does not have private health insurance because the products on offer are so unattractive.
So how does he want to stimulate demand for it?
'I want to revolutionise the availability of private healthcare products. I want far greater competition in their industry and far more products available than currently exist.
'I want people to get them through mutual societies, through friendly societies, through their trade unions.
There are some excellent private medical facilities open to trade union members and that offloads a great burden from the NHS. I want to see that encouraged.'
He adds: 'It's not an alternative but an augmentation to the NHS and that's the crucial part. I want it to be an increase in capacity, not competition.'
Dr Fox insists that tax relief may not be necessary to tempt the punters. 'I think we should be in a situation where private companies offer products that are cheap enough, flexible enough and good enough for people not to require any tax incentives to have them.'
But is he not trying to ratchet up demand for private care artificially by presenting the NHS as a failure?
Health secretary Alan Milburn has taunted Dr Fox for talking down the NHS, calling him and his colleagues 'Dr Gloom and the Doom Merchants - like some failed 1960s pop group'.
Dr Fox counters: 'What I want to see is a health service where people are sure that if they require serious treatment when they have clinical urgency then the NHS will see them in a guaranteed minimum time.
'I think it's absurd that people will take out private health insurance to cover them for heart disease or chemotherapy, which are services which should, because of the conditions they cover, be made urgently and quickly available on the NHS.
'If people choose to have their lumps and bumps done more quickly by spending some of their already taxed income then I don't have a problem with that.'
Another Conservative Big Idea is giving power back to clinicians. The Patients' Guarantee, to guarantee waiting times for all treatments, would allow doctors to reorder waiting lists to put those who need urgent treatment at the top and those who can wait further down.
This would effectively float regulatory and accountability mechanisms out of Whitehall into the professions.
The medical royal colleges would develop protocols to ensure standards of treatment were the same 'across the board', while the policing of standards could be done by the Academy of Royal Colleges.
'The vast majority of doctors want to be left alone by politicians to get on with treating the patients in the way their experience and education dictates, ' says Dr Fox.
'Only the most paranoid of politicians would see doctors as the dark forces of conservatism.'
See politics, page 21.
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