If you are fond of a bit of torture and imprisonment, today's your day.  St Valentine was captured, beaten, stoned and decapitated by the Emperor Claudius who believed unmarried soldiers fought more bravely than married soldiers; he thought married Centurions would be preoccupied, worrying about what would happen to their families, should they die in battle.   

Valentine, a priest, married soldiers to their loves, in secret, against the Emperor's decree they should not.  Whilst in prison, through the power of prayer, he restored the sight of a blind girl and as he went to his horrible death, left behind a note for her to read; signed. 'From your Valentine'.

Love...  what is it?  We could borrow from Corinthians; "Love is patient, love is kind. It does not envy, it does not boast, it is not proud.  It does not dishonour others, it is not self-seeking, it is not easily angered... it always protects, always trusts, always hopes, always perseveres.

If the NHS needs a mission statement, substitute 'NHS' for 'love'... job done. 

However, wherever I go I hear people say; "The NHS has to change...." They don't say from what, to what?  From a tax funded, comprehensive, cradle to grave, free at the point of need service... to what?

When will these change-numpties realise; shifting where services are provided is not change... it is moving services.  Changing who provides a service is not change... it is altering who provides a service.  Changing criteria or restricting access isn't change... it's shifting criteria.  Moving funding isn't change... it is redistribution or more often a cut.

The changers will say the NHS has to change because there are too many patients and not enough money.  That's no reason to change.  The NHS is value for money, popular, resilient, robust and fuelled by vocation and commitment.  All reasons to build on it, be more efficient, increase funding and keep people healthier longer.

Being more efficient is not 'change'.  Being more efficient is 'doing more of the good stuff'.  There is plenty of good-stuff but no mechanism to share it; instead we dump on people struggling to deliver good stuff.  That is worth changing. 

Increasing funding isn't a blank-cheque to inefficiency; it is a passport to invest-to-improve.  Hanging a 'Nil by Mouth' sign on the front door of the NHS won't make it fitter and slimmer; it will emaciate it.  There is no mechanism for voters to support an increase; none of the main political parties offer it.  That is worth changing.

Keeping people healthier for longer means asking when Public Health England are going to join in, get off the bench and run onto the pitch.  It means sorting out a realistic curriculum for school kids to learn useful healthy-life skills and making sure people have decent homes and secure jobs.  That is worth changing.

Change the way the NHS is paid for?  Maybe part taxes and part insurance or top-ups?  Take your taxes out of right pocket, insurance out of your left, it's still the same pair of trousers.  The politically motivated, financially illiterate need to realise; it doesn't reduce health spend as a percentage of GDP, doesn't save money, it just shifts costs.

Care closer to home?  There is little evidence CCH is better and no clear evidence that it is cheaper.  Putting all your best stuff in one place and making it easy for people to get to works for Tesco's.  Maybe you mean care in the home (much more expensive?), or telemedicine (Needing serious capital investment?).  Be careful to count the cash before you count on change. 

GPs could to do more?  You'll have to double the number of GPs, end the patchwork of +8,000 corner-shops run by an independent army of the awkward squad.  You'd better hurry.  It looks to me like Off-Sick is intent on killing them off.  Do you want better Trust Boards?  Then you'll have to sack half of them and franchise the others to run the remaining hospitals.

Do you want safe care?  Then you'll have to mandate and pay for safe staffing levels and find a Chief Nurse with the cajones to demand it happens.

Real, top-down change can be pitiless, painful and a journey that is much more agonising than you'd think.  Does the NHS 'have to change'?  Certainly it is a troubled organisation, ill at ease with itself.  Perhaps we can't answer that question because we just love it too much.