'The system Mr Cameron is proposing would produce a health service reflecting local wants, not needs'

Conservative leader David Cameron billed the party's health policy unveiled last week as a white paper. In truth sections of it were distinctly yellow - the thrust of much of what he said in terms of driving power closer to frontline services is already government policy.

In a speech to the NHS Confederation which was businesslike but lacking spark (see 'Cameron pledges end to politically driven targets'), he pressed many of the right buttons: an independent board to keep the politicians out of day-to-day management, no more structural upheaval, increasing year-on-year spending, and an end to politically driven central targets.

But among the numerous aspects of the policy which require more detail, Mr Cameron's attitude towards service reconfiguration needs to be examined.

In his interview with HSJ this week (see magazine, pages 18-19, 28 June), he points out that GPs often oppose the reconfiguration of services and closure of hospitals, and therefore it might be better to give them more power to deliver 'a health service that reflects local needs'.

While there have been few prizes so far for winning hearts and minds over changes, pandering to local protests by undermining attempts to take a strategic view of how services should be provided is not the answer. Saying the GP knows best is simplistic and simply wrong. The system Mr Cameron is proposing would produce a health service reflecting local wants, not needs. This policy is flawed.