THE government's plans to overhaul the NHS, unveiled today in a White Paper, promise a bonfire of the red tape that the Tories' internal market created and savings of £1billion that will be ploughed into front-line patient care.

That, if it is achieved, can only be an improvement.

For it is true that the competition that the last government's reforms brought to the health service has resulted in an explosion of bureaucracy.

But, though changing the NHS's structure and scrapping the market, the government is not ripping up the Tory reforms altogether. For the purchaser-provider split which they introduced is to remain.

Much of it will be in different hands, however, and how well this works will be the real test of Labour's shake-up.

Instead of health authorities and the fundholding GP practices buying health care for patients, the bulk of purchasing power - up to 90 per cent of it - will be handed to local "collectives."

These will be made up of groups of GP practices covering about 100,000 patients.

One promised bonus of this is that the fundholding system will be phased out and end the two-tier system through which fundholders' patients were able to jump the queue for hospital treatment.

Meantime, patients will be less interested in who runs what in the NHS and more in what it delivers.

And their first judgment of the reforms and promised extra money will be on what they do to cut the soaring hospital waiting lists.

And for all the radicalism of the government's shake-up, they may have to wait a while yet to wait less.

For it is noteworthy that health minister Alan Milburn, boosting the reforms today, could only offer the cautious promise that waiting lists will be shorter "come the next election."

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