Ten years ago this week, Tony Blair told the country that it had 24 hours to save the NHS. Now that the remainder of his premiership can be measured in days, what can be concluded on whether he delivered on that bold claim?
On Monday the prime minister delivered what will almost certainly be his last speech on health(see news stories on NHS independence and Tories & Lib Dems criticism); he used a King's Fund debate to set out his case. As the think tank's chief executive Niall Dickson pointed out, the success of Blair's reforms will be measured in their sustainability. Mr Blair clearly agreed - time and again he emphasised that however controversial when introduced, the main planks of his reforms were here to stay.
Indeed in many cases a reversal is difficult to envisage. The funding model is not in question by any party (which is why an organisation like Doctors for Reform, with its calls for the end of tax funding, seems off the pace).
The reduction of waiting lists has gone far beyond what was envisaged in 1997, driven by competition and choice. The use and open publication of meaningful information to drive performance and inform patients is now roundly accepted.
Foundation trusts have proved their worth. The quality and outcomes framework has, unlike payment by results, delivered on its name.
The twin roles of the Healthcare Commission and the National Institute for Health and Clinical Excellence are firmly established.
The absences from the list of lasting successes are notable. The national IT programme was Mr Blair's personal crusade; and although the vision holds true, the delivery has been poor, perhaps fatally so. Effective action on public health - with the shining exception of the ban on smoking in public - has foundered. The compact with the professions is unresolved, indeed in pieces.
Although Mr Blair did include practice-based commissioning as part of his lasting legacy, it was on shakier ground. The percentage of GPs who have signed up, and been paid for doing so, does not reflect how well the policy will actually work. His former health adviser Simon Stevens argues this week that PBC is likely to fail, partly because GPs are so well incentivised to act in other ways and partly because the quality of primary care in some areas remains poor.
The same applies to payment by results where, even if the premise holds true that hospital trusts are paid more transparently for their activity, there are too many unintended consequences for it to be deemed successful in the long term. It will need to be revised markedly to survive.
Will an NHS split from government be counted as part of his legacy? Not directly. Mr Blair poured cold water on the concept of NHS independence - water distilled by his former health adviser Paul Corrigan, who openly detests the idea.
The prime minister bluntly indicated that the kind of 'tough decisions' he had made in the last 10 years would have been dodged by a so-called 'independent' board actually in thrall to special interests (whether he had his fellow speakers from the BMA and RCN in mind was not clear).
The big decisions in the NHS are political, he stressed, and politicians are best placed to make them. Indeed a familiar complaint from those same politicians is that when the NHS is given freedom to make its own choices, it freezes. In truth there is learned behaviour on both sides that needs to be countered.
So in this context, what of Mr Blair's claim? The truth is that the NHS - battered by reorganisation, hungover from the spending spree, unsure of the future - has been saved. That truth is the legacy not just of the prime minister but of the staff at all levels that have made the journey with him, including currently unpopular health secretaries. And very soon all the talk of legacy will become history and a new chapter will begin.