The text of the PM's speech is online here.

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A few quick thoughts.

1. That man can read an autocue with aplomb.

2. Nothing much new. Choice and competition are where it’s at.

3. A pause for bureaucrat-bashing? Maybe: “these managers do important and valuable work. But they’re not on the frontline”.

4. Big hints on a farewell to bail-outs and letting strugglers fail. Again, not new.

5. He used the stupid line about “Primary Care Trust commissioning is widely regarded as the weakest link in the English NHS … their ‘lack of clinical knowledge’ in particular. This is what top-down control is doing to our NHS”. If PCTs were clinically lacking, it wasn’t to do with their line management but their staffing and composition. Changing that means planning. Which is so last season!

6. He seems to want to do away with the purchaser-provider split: “I was sat in a surgery in Birmingham last week, listening to the doctor explain that he has world-class physiotherapists in the same building … but he can’t refer his patients to them because the current system stopped it. This is frustrating enough, but add to it to the lack of co-ordination and integration. Modern healthcare needs to be joined up, but we have a system today where different nurses and doctors sometimes have to start from scratch when they each see the same patient. We have a system where different elements of a patient’s care – primary or secondary – can occur in isolation to one another. This doesn’t just cause stress and inconvenience, it’s just not conducive to delivering the best quality healthcare possible”. Interesting.

7. It reminds me of nothing so much as the late, great Alan Watkins’ two-line summary of the 1997 New Labour manifesto: “Everything is terrible. We won’t change very much”.