And the conference will hear other ministers' proposals for an NHS constitution, like the BBC charter. But the government has already introduced root and branch reform of the health service. Just what has been the impact, and is it fair to say the NHS is in crisis?

First it was deficits and now there is the first national strike in the NHS for nearly 20 years.

And the worst may be yet to come, with the new NHS boss, David Nicholson, warning hospitals may be stripped of many of their key services.

Predicatably, the government says it is all part of its plan to reform the way care is provided.

Ministers say they want to see more people treated in the community and out of hospital so it is logical to see services such as emergency care centralised in fewer hospitals.

The opposition are having none of it, scenting blood, they claim the government has lost control.

So what is the truth?

'Fast enough'

Henry de Zoete, of centre-right think tank Reform, believes the problem, if any, is that the government is not going far enough, fast enough.

"In many ways we believe the government has got to be bolder if it is to get this right.

"Increasing use of the private sector, more market-based reforms and hospital reconfiguration is the right way forward, but ministers should not be too shy about it."

But the experiences of health bosses in Greater Manchester illustrate the difficulties the NHS faces when it takes the bull by the horns.

They have announced that one of the four hospitals run by the Pennine Acute Hospitals NHS Trust is to be stripped of services, such as A&E and emergency surgery.

In doing, so they will create what they are dubbing the country's first "locality hospital" concentrating on social services and mental health.

The final decision is expected by the end of the year, but it has already attracted a lot of criticism locally, especially since the NHS trust is facing a

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And the conference will hear other ministers' proposals for an NHS constitution, like the BBC charter. But the government has already introduced root and...