At worst, Labour looked conservative and swayed by producer interests in its final stage in government and early years of opposition. Today, Andy Burnham positioned the party as a powerful agent of change, based on the vision of ending fear of old age.
In so doing, he avoided some of the mistakes made by the coalition, producing green paper thinking for consultation, not white paper policies for government. Refreshingly he was also clear on the implications of public finance: without change, the NHS will be overwhelmed.
There are some big shifts in policy. Out goes competition, which Labour used to good effect in government. Out too goes the purchaser-provider split, only just implemented. In comes a clear national entitlement to health and social care and integration with single budgets and single organisations.
Many questions of detail remain. Burnham promised not to restructure but to work with the organisations he inherits. Quite right. Yet repealing the Health and Social Care Act will remove the statutory basis for those organisations, so Labour will be accused of promising another top-down reorganisation.
Health and wellbeing boards will commission across health and social care, with clinical commissioning groups as advisers. That would make CCGs some of the most expensive advice in the country.
The big questions are these: how will Labour end the social care funding crisis, without which integration will fail? How will poor quality monopolistic providers be challenged to improve without competition? And where is the beef in terms of productivity? Integration is an excellent goal but its potential for savings is often overestimated.
At last we have seen real vision from Labour and it will excite many. But the real challenge is in the detail of implementation, as Andrew Lansley found to his cost. The consultative policy review has the time to get that right.
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Neil Churchill is the chief executive of Asthma UK. This article is written in a personal capacity
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