But why?
Today the prime minister spells out what, he says, is not true about his NHS reform.
It is not a revolution.
It is not opposed by doctors.
It is not privatisation by the back door.
It is not going to damage patient care.
Maybe - or maybe not. Each one of those claims is hotly debated.
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What's curious, though, is that David Cameron did not say why his reforms are needed - save, that is, for one mighty big claim. The PM says that without modernisation the NHS will be unaffordable. What he did not spell out is why.
The health service is being asked to find £20bn in efficiency savings over five years - a figure set by the last Labour government and without precedent. It's being asked to do so at a time when costs are increasing thanks in large part to the fact that people are living longer - the population aged over 85 is expected to more than double in the next two decades. What's more, no political party is proposing to increase health spending beyond the tiny - and disputed - real terms increase the coalition had budgeted for.
So, the government believes it must get more for less. Labour clearly believed that too. The question as to how they think they can do it is rarely spelt out.
The coalition hopes to cut the costs of bureaucracy by scrapping the quangos - Primary Care Trusts and Strategic Health Authorities - which supervise care. Their critics warn, though, that the costs of re-organisation may outweigh savings in the short term whilst private sector providers - once they have a significant slice of NHS business - may start to charge more not less than the NHS managers they replace. Only time will tell who is right.
Ministers believe that giving family doctors more decision-making powers will speed up the process of transferring treatments from expensive hospitals to cheaper alternatives provided closer to home in enhanced GP practices. Labour ordered the creation of more polyclinics to achieve the same goal. David Cameron used to attack what he called top-down bureaucratic decisions to close hospitals. Let's be clear though there is bound to be pressure for more hospital closures which will now be blamed instead on patient and doctor choices.
Finally the government thinks, but rarely says, that GPs will ration care - in other words decide what the NHS can and cannot afford. Those decisions are currently taken by unelected and unaccountable Primary Care Trusts or quangos like . In future they will be taken by large groups of GPs locally - with ministers again (they hope) getting less of the blame.
In other words, more for less must mean more closures and more rationing. That would be true however the NHS was run. The debate is whether the government's reforms will lead to more of it or less, and whether they will lead to decision making which is more or less in the interest of patients.