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St John’s Hospital inBath was established in 1180 to provide healing and homes by the bubbling spa springs for the poor and infirm. The charity is still there 830 years later: a much valued health and care service for the elderly. This demonstrates our country’s great charitable tradition in health. The Government’s desire to put citizens and patients first is both core to the current health reforms and a guiding mission for the country’s great charities and social enterprises. The words of the Health Secretary,Andrew Lansley, "no decision about me, without me", are our driving passion.

We have a dual role. to deliver health services, undertake research and provide care and compassion to those most in need; and to act as an advocate and adviser. We are sometimes a challenger of the health establishment and always a doughty champion for patients.
For these reforms to be a success we must ensure a much stronger role for the third sector. That is why we strongly support the policy of "any willing provider". The previous Government was profoundly mistaken in pursuing a policy of the NHS as "preferred provider", which implied that services from our sector were less valued than the State’s. In fact, through a big expansion of the role of charities and social enterprises in providing care, we can provide more cost-effective and citizen-focused services.
This is not about privatisation. What matters is what is delivered, not who delivers it. This must be at the heart of health service reform.Charities can offer a better deal in so many ways. In 2008 the NHS spent just over 0. 05 per cent of its healthcare budget through charities. In other words this is a virtually untapped resource waiting to be use
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To me, competition in the NHS meansBritish RedCross volunteers being able to help more people to adapt to life at home after a lengthy spell in hospital, so preventing the need for readmission. Those who get this support are often aged over 65 and have experienced a fall. Volunteers bring them home, settle them in, advise neighbours or relatives of their return, check on pets, help to prepare a meal and make a further visit to ensure that they are safe and well. Such schemes can save the typical NHS commissioner up to ￡1 million a year.
Competition in the NHS would also mean an environmental charity such asBTCV running more "green gyms", which give people a physical workout while taking part in environmental projects. So far, more than 10,000 people--often referred by GPs--have taken part.An evaluation found that the positive impact on mental and physical health, not to mention the acquisition of new skills, means that the State saves $153 for every $100 it invests. On top of that, it has a positive impact on local communities and the environment.Do we want less of this or more I suspect that for most of us the answer is obvious.
Those who rely most on the NHS are the vulnerable, the very people charities were set up to help, precisely because they were being let down by the status quo. If groups such as the RedCross andBTCV can do a better job than the NHS, we should let them.
Promoting wellbeing and preventing ill health have for too long been neglected aspects of the NHS’s role. These reforms rightly put emphasis on public health. Giving a role in health back to local councils is long overdue. The new health and wellbeing boards may provide the opportunity to get more resources behind public health as well as, for the first time, giving elected councillors the chance to scrutinise NHS resources. Preventing diabetes through better education, diet and exercise is always a better approach than picking up the costs of a growing number of people with diabetes.Charities such asDiabetes UK, working with councils and GPs, are critical to achieving that.
Of course there are challenges in introducing reforms. Of course proper funding is crucial. We want to ensure that there