When Tony Blair took up residence in Number 10 few could have predicted that he would seek to rest an important part of his legacy on profound changes to the National Health Service. In fact, it has become something of a personal crusade.

True, Labour had come to power saying it would ‘save the NHS’. But in the context of the accompanying slogans in 1997 this was a conservative claim. It implied that Labour would return to the principles and organisational assumptions on which the NHS had been founded in 1946, assumptions that derived from the apparent success of a centralised state in the Second World War. There was no admission that the service was massively underfunded compared with health systems in similar economies. New Labour accepted the Conservative spending plans for its first two years as a way of convincing voters that there would be no increases in rates of income tax. Many economists were proud of the NHS's low spending, including my mentor at the LSE, Brian Abel-Smith.

Yet Blair ended his second period in office:

• with health care spending well on its way to matching the high health spenders in Europe;

• with the government implementing a significant change to the way in which health service providers were rewarded – the aim was to give patients more power; money would follow the patients who would make choices about which hospital or service provider they preferred, again a model more familiar in Europe;

• with adult care services for elderly and disabled […]