I am publishing tomorrow’s blog now, as the Health Secretary has just spoken to Conference and this provides some of the relevant detailed background for those writing about it.

In response to those of us who have asked how the new Secretary of State will ensure the extra money directed to the NHS will be used to raise the quality of care, improve access and get the waiting lists down, Mr Javid has announced a review of NHS and Care  leadership.

He has appointed General Sir Gordon Messenger and Dame Linda Pollard to conduct a review into how efficiency and innovation can be improved in the NHS and how regional inequalities can be reduced. As Health now has a massive £230 bn budget, absorbing all of our Income tax, CGT, Inheritance tax and Stamp Duty it is indeed to time to review how it can be better spent and to ask what another £12 bn can  bring that £230 bn cannot achieve. I wish to explore this in a few pieces and pass on my thoughts to the Secretary of State. I would have preferred the terms of the review to have been more narrowly focussed on quality and cost of care.

Let us begin by asking what can we expect of the two lead characters appointed?  I wish them both well and acknowledge they have had successful careers in public service. May they be wise and insightful in this task, stepping outside the frequent public sector wish to claim all is well and turn most arguments into one about how much extra money is required .Often the need is  to remedy defects in the way the base  budgets are spent.

General Sir Gordon can draw on the talents, bravery and discipline our soldiers show, and their ability to improvise and respond quickly when on active service. He was decorated for his personal bravery in leading troops in action. I hope he has also learned from some of the failings of MOD and senior army management. There is a long history of big budget overruns and delays when buying equipment. The use of the rank of Lieutenant Colonel paying around £80,000 a year for 1510  senior officers in a service of 82,000 armed personnel  does not look like slim management. There are 590 more  officers of ranks above Lieutenant Colonel  to fill the main national management roles.

Dame Linda Pollard can draw on the example of the bravery, hard work and versatility shown by the front line NHS workers handling serious covid cases over the last year and a half. The Leeds Teaching Hospital she chairs  was last rated as  Good by the Care Quality Commission. It did, however, receive criticism for safety which needed improvement. It failed to meet performance standards for referrals to treatment – i.e. too many people waited too long. Its emergency readmission rates were above the national average meaning more remedial treatments were needed. Its staff cost per unit of work were lower than average but its non staff costs higher. I would be more reassured about her advice were Leeds to have an outstanding rating for safety and quality of care, and were it not to have issues in getting waiting lists down.

The media did not seem to report any of this, saying the review was an attack on waste and wokery. It is not quite what the announcement says. I do think the Secretary of State needs to sit down urgently with the leading CEOs running the NHS in England to get them to identify what they need to do to get waiting lists down, the prime current objective. Of course this also entails performance criteria for quality of treatment and cost. His own performance monitoring system which is very detailed by CQC should help him decide which of the senior CEOs are  good, which need to be mentored to improve  and which if any need to be removed for continuing poor results.

It is true NHS spending is up by £1200m a week over the last two years, well ahead of £350 m illustration on the side of the Brexit bus as we save on our contributions to the EU.

Its also true we developed and rolled out a new vaccine ahead of the EU approving and importing US vaccines, thanks to the flexibility Brexit provided.

Meanwhile we await more Brexit wins. When will the government abolish VAT on green products like heating controls and insulation which the EU made us tax?

When will they ban industrial trawlers of over 100 metres length to safeguard our fishery and help our domestic  industry?

When will they abolish the Ports Directive and introduce our new Freeport’s?

When will they restore the Merchant Shipping Act struck down by the European Court to help rebuild our merchant fleet?

When will we get a new Agriculture policy which redirects subsidies to stimulating more domestic food production?

There are many more Brexit wins which the government should bring forward. I spoke about these yesterday.

The stage is set for a post Covid recovery. Adopting a Conservative approach to liberty and prosperity is the best way to promote the greater happiness of the greater number.

Anti pandemic policies damaged incomes and jobs and removed many freedoms. The first task is to restore all our lost freedoms so the quarter of our economy that was effectively closed down can flourish again. The successful vaccination programme should give us the scope to relax, leaving it to each individual to judge how much exposure they want to others given the risks.

The second task is to make the case anew for work as the best means to banish poverty and improve life styles and chances for  families. Conservatives have done more than the socialist inclining parties to advance prosperity, because we recognise it comes primarily from enterprise and effort by  millions of people and hundreds of thousands of businesses.  Markets generate choice and opportunity. Profits reward those who venture their capital and put in their effort, and help pay for the new investment employees and consumers need . Prices fluctuate to  bring forward more supply where needed or to reduce output where the popularity of the product or service is waning. Governments must allow price systems to send their signals.

Markets are not cold impersonal enemies of the many . They are the way we all have choices of what to buy and where to work. All humanity participates in the market. Of course Conservatives believe that the state needs to step in to help those in need, to support the ill and disabled, to prevent monopoly exploitation or market abuse. Conservatives believe in the rule of law to keep people using markets honest. We also know that public sector monopolies that charge customers  also need taming to avoid poor service, high cost and no choice that we used to get from nationalised industries.

The immediate need to is to get some tax rates down. Lets forget the National Insurance rise, the tax on jobs. Lets relax the IR35 rules so they do not stop people developing self employed businesses. Lets take VAT off domestic heating and insulation products.  Lets offer a tax boost to those who will substitute home grown food, home produced gas and home produced timber amongst other things for the large import bills we currently pay and all the extra energy cost of long haul transport.

Let’s help more people on their personal journeys with great education, better training , and easier access to buying a home and setting up your own business.

China has decided to suspend her not very demanding emissions targets as the country needs to keep the lights on. In a major reversal just before COP 26 the world’s largest producer of CO2 has had to urge full out production and purchase of coal to generate power. Any idea that the creator of 27% of the world’s manmade CO2 was about to reverse the growth in her carbon output has been forced out by the reality that she needs coal to keep the factories turning and the homes heated and functioning. In Germany the CDU is trying to keep coal alive until 2038, with the CDU government in the Rhineland approving new large strip mining activities, owing to the unreliability of wind power on the German system.

Governments keen to decarbonise need to recognise that their prime duty is to keep the lights on and the factories working. It is not a good look  to end up with emergency power cuts and the need to dash for coal to avoid disaster. Our very sophisticated societies, hospitals, schools  and homes rely completely on electricity to power them or to operate the controls, lighting  and communications. It is even more important now to have enough capacity for all conditions and eventualities.

I repeat my request of government that they make putting in more electricity capacity an urgent priority, choosing methods of generation that balance the current mix and provide resilience. I also want to see us produce more domestic gas and biomass materials to cut the costs and fuel use currently taken by importing LNG and wood pellet and to add to our options for power generation.

I reproduce below a piece I published recently on Conservative Home:

I’m all in favour of levelling up. Our country needs all the talent it can get. I want more people who have bought their own home, found a good job, built their own business, developed a passion for dance or sport or entertainment.

I want a society where snobbishness is a thing of the past and where the plumber is as valued as the accountant and a food delivery driver as much as a health worker. We need a reliable water supply and food in the shop every day. These are important tasks.

The recent battle to recruit a new army of truck drivers should be seen as a prime case where we need to level up. We have seen years of decline in the numbers of people wanting to be long distance and heavy lorry drivers. A lack of concern by some employers over facilities for breaks and overnight stops, coupled with relatively low pay and long periods away from home, has made it difficult to recruit younger people and women.

During lockdown the online retailers needed a massive expansion of van deliveries for their offers. They were able to attract drivers to smaller vehicles with more flexible hours and better pay. The closures and shortages across Europe reduced the numbers of migrants willing to work for less with poor conditions.

The UK needs to attract back the qualified HGV licence holders and early retired, those who have swapped jobs in pursuit of better pay, and train a new cohort of truck drivers. Large employers and government need to remedy the defects of the conditions with more lorry parks, with better facilities for breaks and overnight stops.

Pay needs to go up, as it did when tube drivers used their negotiating muscle to require the public sector to pay much higher rates for a job than an HGV driver gets. There should be a new respect for these drivers now people see how dependent their own lifestyle is on the timely delivery of everything from food to petrol.

Levelling up is about people as well as about place. Indeed, if enough people in a given town make a success of their business or company careers their extra spending power will bring the extra investment, new services and better shops people would like to see.

Conservatives should not try to define levelling up in Labour terms. They place all the emphasis on levels of public spending. Levelling up to them is more about place than people. Buy the town a new heavily subsidised tram system, put in more public sector community centres and provide new school and surgery buildings and the place will be levelled up. If only it were that cheap and easy. They stress the amounts of money rather than what we get for it.

Of course it is right that improving the quality of the public estate and helping with communications and connectivity can help. Any MP knows they have to argue the case for the new school or the improved road for their patch.

That is not the same as thinking if we just double the public sector spend lives will be transformed. To have a self sustaining wealthier community requires government helping the many. They need to reap better rewards from work and to get access to the qualifications and opportunities it takes to own your own home, have some money in the bank for a rainy day and to have a working life that commands respect.

It all begins in the schools. Inspired teachers can help every pupil find that spark, that thing they love and wish to excel at, that drive to be positive about life and its numerous chances. It requires discipline, as you only get good when you practise a lot.

Aims need to be stretching but achievable, built up as a child progresses. It moves on to the choice of apprenticeship or degree. Some break from academic education because they are already sure of their ambition to be sports people or entrepreneurs or performers whose path in life after leaving school requires their full attention to the chosen course.

Government can of course help. It needs to redouble its efforts to make it easier for people to set up their own business, and to go on to recruit their first employees. It needs to make it easier and more affordable to buy your own home. The attack on the self employed through IR35 was unhelpful, The new tax on jobs is a bad idea. Getting a mortgage is not easy. Government contracts could be made available to more smaller companies to give them a chance of getting one through break down of quantities required through multiple suppliers.

Where place and people come together is in planning decisions. Places the Government wants to level up need more homes for people with good jobs and businesses of their own. Many have more freedom over where to live now we are moving into a hybrid world of working. More people with good qualifications and earnings help boost a community and provide more demand for others to meet.

A relatively affluent community like Wokingham is not affluent through more public spending. We are at the bottom of the tables for public spending per head in the main services. We are well placed in the relative prosperity and good place to live tables because they keep on sending so much investment in expensive homes for people to live in who have levelled themselves up through qualifications and good jobs.