Today, a new NHS has been born. While some warn of creeping privatisation and the 'gradual erosion of the public service ethos', others (mostly ministers) believe changes introduced under the Health and Social Care Act are 'unavoidable' and will ultimately benefit patients.
Meanwhile, nurses just have to get on with the job at hand, a job that has been made more difficult by the constant questioning of their compassion for patients.
Not only are frontline staff contending with NHS reform, but with changes prompted by the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. In last week's Oral statement to Parliament: the government's response to the Francis report, health secretary Jeremy Hunt outlined plans to introduce a new regulatory model under an independent chief inspector of hospitals, working for the CQC, plus a statutory duty of candour for healthcare providers.
He also announced plans for NHS student nurses to spend a year working on the frontline as healthcare assistants.
While his speech was peppered with talk of Ofsted-style ratings, much less was said about nurse to patient ratios or staff morale. Also omitted was the much hoped-for (but costly) promise to regulate HCAs on a statutory basis. And there was the usual, predictable emphasis on acute care with minimal reference to the community.
Mr Hunt spoke of the appointment of a chief inspector of hospitals and a chief inspector of social care. However, ministers are still 'looking into the merits of' appointing a primary care inspector.
The health secretary hopes the Francis report will become a catalyst for positive change. He aims 'to create an NHS where everyone can be confident of safe, high quality, compassionate care'. To do this, he must listen to staff, invest money in change and shift his focus to community settings where the bulk of patient care is predicted to take place.