Published: 15/08/2002, Volume III, No. 5818 Page 30 31

The Blue Book on Health Edited by: Ed Vaizey Publisher: Politico's. ISBN: 1842750437.£10 (hardcover).

Reviewer Mike McManus Freelance journalist and former private secretary to Sir Edward Heath

How the times have changed.A year or so ago, one might almost have thought that the Conservative Party had never even heard of public services.Now a group of ambitious young Conservatives have begun a new series of policy primers with a collection of essays - not about the euro, but about healthcare.

I must declare an interest. I stood in Watford as the Conservative candidate last June and contributed a short essay to this book about the experience. I did not, however, see any of the other contributions until the book was at proof stage and I am genuinely impressed by most of them.

The Blue Book is described as being 'of the Conservative Party, but not run by it'.The series is intended to 'act as primers for those interested in aspects of the debate in a particular policy area;

to bring forward voices that the party should hear in any given policy area; and to show that Conservatives are open to new ideas'.

It helps, I think, that contributors are not required to be members, or even supporters, of the party - though, in this instance, most seem to be fairly well-disposed towards it.By and large, these essays do not offer a series of ruminations and reflections that all politicians would do well to take on board.

The degree to which common themes emerge is pretty remarkable.

First, almost every contributor agrees that two great national institutions - the NHS and the Conservative Party - are in grave peril, and that their destinies may be interlinked.

Second, everyone submits, in some shape or form, that far greater responsibility within the NHS needs to be vested not in politicians or bureaucrats, but in the professional practitioners at the front line.We need a greater reliance on clinical judgements, which should not be so heavily obscured or distorted by political priorities from on high.

Third, greater diversity is needed within healthcare.There are various suggestions for ways in which 'patient power'could be increased. Institute of Directors head of policy Ruth Lea suggests that citizens should have an NHS 'passport', and former health minister Gerry Malone proposes 'individual healthcare funds'.

Fourth, there needs to be organisational decentralisation.

This takes us right back to the foundation of the NHS, when the Conservatives opposed Nye Bevan's plans for a national health service because he insisted on subsuming the voluntary hospitals within a centralised system.As one writer points out, Labour itself has now recanted on this.

I was most struck, however, by the first and last contributions to the book.

In the opening chapter, former Conservative strategist and numbers man Andrew Cooper reminds readers, in no uncertain terms, that 'the common perception of Conservative attitudes to the NHS was a primary cause of the party's ignominious collapse to unelectability'.

In the end piece, Dr Kate Pickering, a GP and former parliamentary candidate, agrees: 'We have to establish ourselves as real believers in our NHS... at present we have no credibility... it is time to depoliticise and reprofessionalise [the NHS].'Most NHS employees whom I know would say a powerful 'Amen'to that.

This book will be read mainly by Conservatives - and, if they read it with open minds, it will do most of them a world of good. It will force them to face up to the difficult questions - over perception as well as reality - that they need to surmount before they will get back into government.

Personally, I hope also that it will help the Conservative Party to fashion policies on health that will commend themselves to the voters, and to healthcare professionals in particular.

It was a Conservative minister - Henry Willink - who first brought forward detailed proposals for a national health service. It is high time his party reclaimed that ground.