The last word on 42 months of change

This is my last HSJ editorial. Next week Nick Edwards, the magazine's deputy editor, takes over as editor while I move to become HSJ's editorial director.

I joined HSJ in April 2002, after 16 years writing about the construction and engineering industries. I expected a challenge, but nothing could have prepared me for the roller-coaster ride ahead.

Change - in truth too much of it - has been a constant. For HSJ's readers the pace of reform will have been very trying. As a journalist, charting the switchback ride of health service policy design and implementation has often been exhilarating.

I hope that HSJ of the last 42 months has struck the right balance between recording the ambition and achievement of the reforms and highlighting their inadequacies and contradictions.

As I leave the editor's chair, the various reform streams which began in 2002 (choice, payment by results, increasing diversity of providers) are coming to boiling point, while new ingredients provided by primary care reform are added to the mix.

In an ever-changing world, one thing is certain: the next three years seem set to be as exhilarating and trying as the last. l