There is a danger in the rhetoric of "modernisation", "participation", etc, of not understanding what it means, according to Mr Niall Dickson (social affairs editor for the BBC). Indeed, he asked, did it mean anything at all?
Mr Dickson told the conference that in 1948 the NHS had been launched into a world of deep rooted paternalism and patient deference. Like many other values in society, these were being eroded and, while the NHS had reduced the fear of the medical bill, it had shifted the focus to the doctor and disempowered the patient.
Today's patient, however, occupied a world of choice - instant choice - but health care, because it was delivered by a government monopoly, was anything but instant. Being free at the point of delivery was one of the NHS's greatest strengths, but also one of its greatest weaknesses. The service was struggling to adapt, hence the new NHS furniture, such as NICE, clinical governance and audit, and increasingly educated patients were being encouraged to take more responsibility for their own care.
But the Government was going for high profile goals which meant nothing and if the NHS could not adapt quickly enough, the middle classes would desert it, leaving the NHS as a safety net for the deprived rather than the comprehensive service which it had been designed to be.