In a time of cuts and "unprecedented" efficiency savings, questions about money are never far away for Andrew Lansley's groundbreaking reforms of the NHS.
By Alex Stevenson
Today marks the culmination of six years' work as shadow health secretary for Lansley. He is finally implementing many of the ideas which have underpinned much of his rhetoric during that time - scrapping targets, increasing choice, "liberating the NHS from the old command-and-control regime".
Lansley could never have anticipated the wider environment within which those reforms would take place. Yes, the Department of Health is spared the budget cuts of other departments. But there are still up to £20 billion of cuts scheduled for the next four years. There is much pain to come.
"The reality is there is no more money," the white paper says. "Difficult local decisions" will be required. Net cuts in terms of total staff are "inevitable" in the next five years. There will be "significant disruption".
At the same time,Read More »from Health white paper struggles to square the circles