NHS report gets tough on political parties

"The NHS is safe in my hands" has become something of a mantra for the Prime Minister David Cameron.

But the man who wants to succeed him has staked his chances on persuading the public that it isn't.

Ed Miliband claims the service won't exist in its current form if there are five more years of Tory Government. So who's right?

The King's Fund, an independent health charity, has been assessing the Coalition's record on health reform and its findings make damning reading.

The Fund concludes - along with almost every doctor or nurse I've met - that the upheaval wrought by the government's NHS reforms has been "damaging and distracting".

Andy Burnham, shadow health secretary, has responded promptly saying, "Labour warned David Cameron that his reorganisation would damage the NHS and we now have independent authoritative evidence that is what happened".

But the criticism of the Coalition's Health and Social Care Act is toughest on its timing.

One thing no one is debating is the surge in demand the NHS has had to deal with amidst a chilly climate of austerity.

Here's Chris Ham, the King's Fund chief executive:

Those reforms were the work of David Cameron's first health secretary, Andrew Lansley.

While you would struggle to extract something as tangible as an expression of regret from the Department of Health, there is a tacit admission that lessons have been learnt.

But in the face of a report that criticises the Coalition's reforms for leaving unwieldy structures and fractured leadership there is defiance too.

The Department of Health is quick to point out that without the vast reorganisation there wouldn't be the positive developments, the report also notes.

The King's Fund praises the closer involvement of GPs in commissioning - essentially buying services for their patients - along with local authorities taking on responsibility for public health.

Not surprisingly the Conservatives are more than ready to use the report to sling some mud back at Labour, who stand accused of planning their own top-down reorganisation of the NHS by attempting to better merge health and social care.

A spokesperson for Health Secretary Jeremy Hunt said: "The independent assessment highlights why both the public and the health sectors should be wary of Labour's plans for upheaval and reorganisation".

The truth is there is a fair degree of consensus among the three main parties on the future of the NHS - all are promising extra cash and a more coherent partnership between our hospitals and the local authorities that provide social care.

But, however pressing the need to free up beds currently blocked by the frail and elderly, it will be a brave politician who moves on too sweeping a scale

Change will need to be driven locally, or at least look that way.

As the King's Fund concludes: "Politicians should be wary of ever again embarking on such a sweeping and complicated reorganisation of the NHS."