It may not have been pretty, but Labour gave new life to the NHS

The greatest success is that Labour secured the service’s future. As former chief executive Nigel Crisp reminds us, in the mid-90s hospitals and equipment were crumbling, waiting lists totalled over a million and ideological opponents from the right were arguing that the state could no longer sustain universal healthcare.

In the mid-90s the right was arguing that the state could no longer sustain universal healthcare

Now the Tories go into the election determined to seize the mantle of “the party of the NHS” - unthinkable under Thatcher in the 1980s.

Demolishing waiting lists was achieved by force of political will. It was a core promise to voters in 1997. But it was supposed to be paid for in part by “releasing £100m saved from NHS red tape”. That was forgotten. Instead, in a move typical of Tony Blair’s rejection of old left insecurities, he marshalled the private sector to clear some of the operations backlog and frighten the NHS into clearing the rest.

The market was back, but foundation trusts and the independent sector have yet to make competition an effective tool for driving quality up and cost down.

The loathed target culture improved services such as cancer diagnosis but too often overrode clinical judgement. Chief executives discovered failure to hit targets was career-terminating, while clinicians and managers talked of a culture of bullying. This helped precipitate Labour’s most spectacular mistake - stuffing the pay packets of staff while losing their respect. Consultants’ car parks glistened with the latest in motoring comfort but the drivers felt ignored and marginalised. GP pay bulged but relations with ministers soured. Productivity slipped. So much money, far too little achieved.

But the capacity is there. While the savings now required are the biggest and most sustained in the service’s history, it has more staff, better facilities, more clinical and management expertise and more ambition.