I AM one of nature's hoarders; very little gets binned at our house if I feel there is the remotest chance of something having a future use, no matter how slight. Which is why a recent rummage on my desk at home unearthed one of those dual-purpose pledge cards, so much in evidence in the winter run-up to the 1997 General Election.
Not only were these credit-card sized pieces of plastic excellent for removing ice from car windscreens, they were even better for removing the last veneer of doubt from wavering electors in terms of the key Labour priorities for the incoming government.
There was every reason why one of the five pledges on the card related to the NHS (in terms of shortening waiting lists). Health was then (and still remains) one of the top three issues which concern the electorate and thus influences how they cast their vote.
So when next May, you heard it here last, Tony casts a final look at the achievements of his decade-long administration, there is a great deal of which we can all be proud. Waiting lists and times slashed, 110,000 more doctors and nurses, vast improvements in buildings and facilities, better results in cancer and coronary heart care, NHS budgets almost tripling in ten years . . . This welcome list could indeed go on and on.
However, there have been major NHS systemic changes in virtually every year for a generation. I had profoundly hoped in 1997 we would learn the lessons of the past, but sadly not. For instance, recently one of the very worthwhile changes made by an earlier Secretary of State was junked by the present one. Localised, efficient and accountable primary care trusts were just the latest casualties of ministerial merger mania.
Strategic health authorities are being regionalised. Patient and public involvement forums are set to be abolished just as they are becoming visible and effective. No-one, least of all me, is arguing for stasis and that masterly inactivity, with neither movement nor development, should be the order of the day. All we are saying is (to paraphrase 1960s protestors) give stability a chance.
When changes do occur, let them be evidence-based. If it is not necessary to change, then it is necessary not to change.
The continued disarray created among those delivering front-line health care is further compounded by two other well-established trends. The first is the rapid rise of the profit-driven private-sector leviathan. The other is marketisation ? a belief that competition and choice are superior to consultation and co-operation.
Private finance initiative hospitals are beginning to unpick in a rather embarrassing fashion, demonstrating that PFI is indeed prohibitive in cost , flawed in concept and intolerable in consequence for taxpayers, patients and health professionals.
Meanwhile independent sector treatment centres (ISTCs) are relishing a daft position where PCTs are being forced to sign up to contracts with them, even in places and specialities where there is existing spare NHS capacity.
As a result the ISTCs are being gifted lavish sums of public money, irrespective of contract delivery. All this at a time when some acute hospitals are seriously strapped for cash.
We are in danger of losing our way and our lead in health, one of our natural political strengths. The new Secretary of State for Health has much to bin next summer.
? David Taylor is Labour Co-operative MP for North West Leicestershire