Footage on TV of the Labour Party conference in Brighton has had a haunted and almost surreal air. Where once the hyper-activity and jostling of the influence-purchasers added to the members' mix of the ambitious and the faithful, now the sense of the faded, the prime-past is prerfectly aposite for a seaside town out of season. Ennui. The empty seats in the hall for even the bigger-beast speakers thus far have the mute eloquence of tombstones.

Yes, we know that Brown is going to make a commitment on access times for diagnostic testing for cancer. It is a good policy.

Yet there are more pressing issues for discussion in policy terms. Andy Burnham's announcement at the Kings Fund that extant NHS providers are to get 'preferred provider' status has brought The Quiff Of Doom back from the boardrooms of his consultancies.

Alan Milburn has hit out at this policy volte-face. As Nick Timmins reports in that FT story, our assumptions that "the unions have had their pound of flesh" have been proven correct: Timmins reports that "the documents – agreed with the health service unions and sent to Brendan Barber, Trades Union Congress general secretary, before being issued to the NHS – were hailed as “a significant policy shift” by Mike Jackson, senior national health officer for Unison, the biggest health union".

And so to the speech
The mandatory delay is announced to be only 15 minutes. And some wit has chosen Sit Down by Madchester also-rans James as the pack-the-hall accompaniment music. Ho ho and indeed ho.

Video-montage on the history of the Labour Party hits all the Labour erogenous zones: women's votes; Battle of Cable Streeet; the NHS; anti-apartheid. "The history of Britain is of fighting for the right things against the odds ... Here's to the fighters, the true Brits, the ones who came from behind, who never gave up". It is moving the hall very effectively.

Ooh! It's Sarah Brown-time. This could be good. Hall are on their feet. A video presentation is to follow - and she talks about his faults: "he's messy, noisy, he gets up at a terrible hour, but I know he gets up and goes to bed thinking about the things that matter. I know he loves our country and I know he will always, always put you first". She tells how he will always make the time for people and friends .. and that;s why he's the right man for Britain". She also points out that it's a hard job.

Blimey. The music to launch the video is Move On Up by Curtis Mayfield.

Brown looks really happy, for a considerable change. "It is the fighters and believers who change the world ... we've changed the world before and we're going to change it again. Fight. Not give in, not walk away ... fight to win for Britain".

Listing New Labour achievements, waiting times and the 2-week-to-specialist cancer guarantee are part of the long list of "the Britain we're building together ... the change we choose".

"It's been a difficult year ... Alastair, you're doing an absolutely brilliant job ... I'd say you were the best Chancellor the country has ever had, but the press would report it as 'Brown snubs Brown'. There's also a nice joke about questions on the "special relationship ... Peter Mandelson and I are doing just fine".

He goes over the financial crisis - the saving of the banks, which "benefited the hard-working majority and not the privileged few". The economic stimulus - ditto. Saving jobs - ditto. His oposition is 'hard-working families' against 'the few'. Let's hope no-one calls his rhetoric Chrchillian!

On that nice Mr Cameron, and markets' morals
Onto the party politics - "only one party thought it was best to do nothing - only one party with pretentions to government made the wrong choice - the Conservative Party ... the only thing consistent about them is that they are consistently wrong all the time.

"The opposition might think the test of a party is the quality of its marketing but I say the test for a government is the quality of its judgement. The Conservative Party were faced with the economic call of the century and they called it wrong. And I say a party that makes the wrong choices on the most critical decisions it would have faced in government should not be given the chance to be in government".

"Conservative policy would return us to the lost generation and ther cardboard cities of the 1980s.

"what let the world down last autumn was not just bankrupt institutions but a bankrupt ideology. What failed was the Conservative idea that markets always self-correct but never self-destruct. What failed was the right wing fundamentalism that says you just leave everything to the market and says that free markets should not just be free but values-free. Bankers had lost sight of British values. When markets falter and banks fail, it's the squeezed middle who are hit the hardest - the milions of people who do their best and their bit and who in return want their families to get on and not just get by".

Brown locates his values as those of "the millions of people who do their best and do their bit and in return simply want their families to get on not just get by. It's the Britain that works best not by reckless risk-taking but by effort, by merit and by hard work. It's the Britain that works not just by self-interest but by self-discipline, self-improvement and self-reliance. It's the Britain where we don't just care for ourselves, we also care for each other. And these are the values of fairness and responsibility that we teach our children, celebrate in our families, observe in our faiths, and honour in our communities". You can, he offered, define these as working-class or as middle-class or as family values, but "these are the values of the mainstream majority - the soul of our party and the mission of our government. These are my values"

Brown also talked of the importance of free education and healthcare to his "independent and self-reliant" family, noting that "my parents could not easily have afforded to pay for operations on my eyes. So I come from a family for whom the NHS was quite simply the best insurance policy in the world. For us the NHS has not been a sixty year mistake but a sixty year liberation."

Political philosophy
He made an attempt to define a clear ideological blue water between the main parties: "too much government can make people powerless. But too much government indifference can leave people powerless too.

"Government should never try to do what it cannot do but it should never fail to do what it needs to do. And in a crisis what the British people want to know is that their government will not pass by on the other side but will be on their side".

"Markets need what they cannot generate themselves - markets need morals. We will pass a we will pass a new law to intervene on bankers' bonuses whenever they put the economy at risk. And any director of any of our banks who is negligent will be disqualified from holding any such post".

The big changes
Brown moved on to the model for a new more responsible society and more accountable government. "The new mission is for New Labour to realise our passion for responsibility and fairness in these new international times ... the first Labour government of this new economic age.

"Our new economic model for a strong economy is founded on three guiding principles.
That in future finance must always be the servant of people and industry and not their master.
That our future economy must be a green economy.
And that we must realise all of Britain's talent if we are to lead and succeed.

"The best way finance can serve our country now is to help ensure that the inventions and innovations pioneered in Britain are developed and manufactured in Britain. So we will create a new national investment corporation to provide finance for growing manufacturing and other businesses; our £1 billion innovation fund will the back the creativity and inventions that are essential to the economy.

"And I want the Post Office — to play a much bigger role, bringing banking services back to the heart of people's communities. And our economic future must be green.

On tax and spending
Deficit-cutting will become law in a new fiscal responsibility act. Brown contrasted the Conservatives' deficit reduction plans with Labour aims to improve front-line servcies. He promises to cut costs; see "realistic public spending settlements"; raise tax at the top (already announced - more to come?) and 0.5% on NI in 2011 (also already announced). He lists the inheritance tax cut and others as "the change they choose".

Health-adjacent and NHS-specific policy
Brown noted that 75% of GP practices already open out-of-hours, and promised that in the next five years everyone will have a right to see a GP at evenings or on the weekend. He also mentioned the restoration of the pensions link to earnings, and promised to increase the minimum wage annually in every one of the next five years; likewise child benefits and child tax credits.

"We will give local authorities the power to ban 24-hour drinking. Drink banning orders should be imposed, pubs and clubs to pay for cleaning up neighbourhoods and make them safe". Cah. What cowboy's been in power for the past decade-and-a-bit?

"there is huge debate around the world today about how countries can manage health care. Countries from every continent look to our NHS for inspiration. And this summer didn't we show them – we love our NHS.
We can sometimes talk about the NHS purely in statistics – purely about the record numbers of doctors and nurses and operations and treatments under Labour. But it isn't about the figures – it's about the individuals who get help.

"I got a letter from Diane, a mother from Rugby who wrote to me saying her life had been saved because the NHS used its extra investment to reduce the age for breast cancer screening. Before she would have had to wait until 50 – and her surgeon told her that if she had, she'd probably be dead. But thanks to the changes we made, Diane was diagnosed early, treated early, and was back at work within three weeks. When she wrote to me about us lowering the screening age she said "this may seem small in comparison to all the other issues you deal with, a small thing to do but it probably saved my life."

"And so I say to you today; Labour fought for the NHS, you fought to save and invest in the NHS, and because you did, you are saving lives every day. You should be very, very proud. Because if you've changed one life you've changed the world.

"And because we know that our investment in breast cancer screening works and early intervention saves lives, I am proud to announce that we will go much further. We will finance a new right for cancer patients to have diagnostic tests carried out, completed and with results – often same day results — within one week of seeing your GP. That is our early diagnosis guarantee, building on our current guarantee of only two weeks wait to see a specialist.

"And so with three major steps forward – early diagnosis, early treatment and our historic investment in research for cancer cures, we in Britain can transform cancer care; and our ambition is no less than to beat cancer in this generation. That is the change we have chosen; change that benefits not just the few who can pay but the mainstream majority.

"For a few days this summer Sarah and I worked helping in a local hospice near our home and I say now that the care and compassion shown by volunteers and staff must be matched by greater support for this work of mercy.

Health and social care back together
"And in our times there is a new challenge that no generation has ever had to face before. We have an ageing society and new rightful demands for dignity and for support in old age. And so we need social care for our elderly which is not subject to a post code lottery, but available to all – to the hard working majority, and not just the few who can pay.

"And so we will say in Labour's manifesto that social care for all is not a distant dream, that to provide security for pensioners for generations to come – we will bring together the National Health Service and local care provision into a new National Care Service. That is the change we choose. And we can start straight away.

"Today more and more people see their parents and grandparents suffering from conditions like Alzheimer's and dementia, and they see their dignity diminish. And for too many families the challenge of coping with the heartbreak is made worse by the costs of getting support.

"The people who face the greatest burden are too often those on middle incomes, who have savings which will last a year or two, but then they will see their savings slip away. And the best starting point for our National Care Service is to help the elderly get the amenities to do what they most want: to receive care and to stay in their homes as long as possible.

"And so for those with the highest needs we will now offer in their own homes free personal care. It's a change that makes saving worthwhile, makes every family in this country more secure and is a much needed reassurance for the elderly and their children.

"This is the change we choose; change that will benefit not just the few who can afford to pay, but the mainstream majority".

Other bits
Plans are afoot to tighten the immigration points system, to favour the skilled. "We will reduce information for new biometric passport to no more that the present - there will be no compulsory ID cards in the next parliament".

More money for education and new training and apprenticeship schemes.

Much of the hall stood for a long ovation for the British military. Brown promised "all the equipment they need and the best support they can give". He's spending a lot of money here.

There will be a legal requirement to raise spending on development aid to 0.7% of national income. "Others may break their promises to the poor of the world. Britain never will".

MPs proved to have been financially defrauding taxpayers will be able to be recalled by voters if Parliament fails to act.

Hereditary Lords will all be going, to be replaced by something democratically elected.

Referendum on voting reform in next Parliament.

Get asking questions
Addressing activitists towards the end, Brown declaimed a clearly Mandelson-authored list of questions for voters to be primed with to ask Conservatives:
"If you're a family that's feeling the pinch – don't take it from me – just ask them the question. If you care about me, why is your first priority to give a 200 thousand pound tax giveaway to each of the 3,000 wealthiest estates?

"And if you're one of the millions of Britons who loves our NHS– don't take it from me – just ask them the question. If you care about us, why would you scrap the right to see a cancer specialist within two weeks?

"And if you're worried about crime – don't take it from me – just ask them the question. Why would you cut the Home Office budget by the equivalent of 3,500 police officers this year alone and then make it harder for them to catch the most violent criminals using DNA evidence?

"And if you care about a proud Britain – don't take it from me – just ask them the question. Why would you put this country's prosperity and power at risk by placing Britain at the fringe of Europe rather than at its heart?

Us-ism vs. them-ism
"there is a difference between the parties. It's the difference between Conservatives who embrace pessimism and austerity and progressives like Labour who embrace prosperity and hope.

"And this is a timeless difference in our approach. It's between those like them whose vision is limited to how things are and those like us who reach for the world that can be.
And isn't this the story of Britain at its best and the Labour Party at its best, that we are people who strive for and achieve great changes even when others say it is impossible?

"They said a free National Health Service was impossible, then argued it was unworkable, then said it was unaffordable, but in the last 12 years we have rebuilt it and it is now quite simply, for the British people, irreplaceable."

"I grew up in a family, a party and a country that believes no obstacle is so great that it can stop the onwards march of fairness and of justice. And so I urge you, as the poet said, dream not small dreams because they cannot change the world. Dream big dreams and then watch our country soar.

"We can build a new economy which tames the old excesses. We can meet and master the challenge of an ageing society with a National Care Service, we can in this generation be the first to beat cancer.

"We can transform our politics.

"We can do all these things and more if we think big and then fight hard. Since 1997 Labour has given this country back its future. And we are not done yet. We love this country. And we have shown over the years that if you aim high you can lift not just yourself but your country — that there is nothing in life which is inevitable – it's about the change you choose.

"Never stop believing in the good sense of the British people. Never stop believing we can move forward to a fairer, more responsible, more prosperous Britain. Never stop believing we can make a Britain equal to its best ideals.

"Never, never stop believing. And because the task is difficult the triumph will be even greater. Now is not the time to give in but to reach inside ourselves for the strength of our convictions. Because we are the Labour Party and our abiding duty is to stand. And fight. And win. And serve".

In review
Phew. It was quite long, quite policy-full and delivered much better, with some fire and passion, than I expected. A long standing ovation followed it. So what happened?

He has committed to spending a lot of money. It feels like a poker player with a bag-of-nails hand raising the stakes and hoping his opponents will fold. Expect lots of attacks on the costings offered: Andy Burnham, speaking to Jon Sopel on BBC News afterwards, suggested that the first-year costs of the National Care Service to DH budgets would be "about £200 million" to help those with the highest needs in their homes, which Burnham suggested would be about 350,000 people in England.

Setting the needs threshold is going to be interesting. One for NICE? Or the PCT?

For the NHS, the national minimum wage raise; diagnostic capacity; and a National Care Service= a lot of money to find. Expect sharp-eyed replies from sharp-eyed economists. And lots of use of the word "efficiency".