The 60th birthday of the NHS presents a great opportunity to review what health means in a modern society. The world has changed so much in the last 60 years; and these changes if they are harnessed present a great opportunity to create a truly 21st Century service.

A major change has been in the improved capability of individuals to obtain and use information. Empowering patients by increasing their ability to engage in this service is an essential step in the right direction.

There is a growing awareness, across all parties, of the challenges that the service faces as it copes with rising population and consumer demand. The service faces fundamental issues arising from a number of factors including changing demography, advances in medical technology and increased expectations on the part of patients. These changes necessitate a paradigm shift: the focus of the service needs to change from outputs to outcomes.

A new report by the think tank Reform published yesterday argues that despite this widespread recognition of these increased demands, the current Government has explicitly rejected the type of structural reform that is needed to transform the service. While the Government has recognised, as early as the 2000 NHS plan, that empowered patients will demand a new type of service, current ideas will fail to deliver this. The landmark review of the NHS by Lord Darzi, commissioned partly to address these issues, continues to put forward recommendations that will direct care from the centre.

The Liberal Democrats have embraced many of the themes essential for a reformed system – personal empowerment, greater local autonomy and a desire to root out embedded inequalities. They have also expressed support for ideas such as the extension of direct payments, which are essential in giving greater control to users of the service. These ideas are a great basis on which to develop and transform the service.

An essential step that should be considered by all parties is an economic constitution which will promote a new drive for value. The commitment to ‘public value’ in the BBC charter could be an interesting model for the NHS.

The NHS is close – frustratingly so – to a very positive future. The key step is to empower people to get value from the vast amount of funds already in the system. There are already some local moves towards low cost programmes to bring about better services and better communication quickly. But currently these initiatives remain small, due to the massive financial commitment to traditional types of care. An economic constitution would drive them forward. It would give full rein to innovation in each of the clinical areas highlighted in the Darzi Review.

Over the next few months Reform will be following on from this by looking to create a blueprint for the future of the service. We would greatly appreciate contributions and ideas for the type of service that you would like see the NHS become over the next ten years. Please see Reform’s website – www.reform.co.uk – for more ideas on how to get involved in our work.

* Helen Rainbow is Senior Research Officer at Reform, a leading market-liberal think-tank.