The Conservatives have fired their salvo in the battle to prove they are the party that can deliver a patient-centred NHS.
The party launched a 10-step plan to put patients 'at the heart of the NHS' at its conference in Blackpool this week, echoing sentiments made by prime minister Gordon Brown at the Labour conference last week.
In his speech to the conference, shadow health secretary Andrew Lansley gave a clear sign of the party's desire to win over managers.
He said: 'You can't deliver the healthcare people need if you don't listen to patients and trust the doctors, nurses and managers whose job it is to care for them.'
Yet the party was keen to emphasise that it is not afraid of reform.
It put centre stage a pledge to renegotiate the GP contract so family doctors take responsibility for commissioning out-of-hours care, another area also given priority by the prime minister.
Mr Lansley told HSJ this was needed to make up for the failure of primary care trusts to provide out-of-hours services and the knock-on effect on hospitals and GPs. He said: 'PCTs in too many cases have simply looked at the cost of out-of-hours services and not focused on quality.' Family doctors were better placed as they could 'mesh' the services together, he added.
The party made two other primary care proposals: allowing people to choose a more convenient GP, for example near work; and a single telephone number for all non-emergency care to replace out-of-hours numbers and NHS Direct.
The party reiterated its pledge to scrap top-down targets and set up an independent NHS board, and this week also pledged to 'establish clear NHS care entitlements through commissioning guidelines'.
Mr Lansley acknowledged the need for a 'clear statement of what the NHS is setting out to do' but acknowledged this created a 'tension' between central and local control. He said: 'In some cases [the commissioning guidelines] will be quite directive because there will be sufficient evidence.' Patients denied treatment in spite of the guidance 'might arrive at the point where they want to seek a review by a court on the decision', he said.
The party also endorsed individual budgets for patients with long-term conditions - and letting them 'top up' care with their own money. 'We are not going to block people using individual budgets as they wish,' Mr Lansley said, adding it would be 'completely inconsistent with the philosophy to tell them what [they] can or cannot do alongside that'.
The party pledged to keep small maternity units and offer mothers choice - a word he said had 'disappeared from the Labour lexicon'. '[On] a lot of these things, [and] competition generally, I just don't know what the Labour Party's policy is any more,' said Mr Lansley.