This Bill is the right remedy for the NHS Reforming the National Health Service is as necessary as it is difficult. As our population ages, demand for health care will increase, but the tax base from which it is paid for will not expand at the same rate: in fact, it will diminish. In 1960, health care consumed less than 4 per cent of Britain's GDP. We now spend close to 10 per cent. Within two decades, that figure might rise to 15 per cent - a rate of increase that is obviously unsustainable. That's why every political party knows that NHS reform is necessary. If we want to prevent the costs of health care from crippling the economy, we have to find ways to ensure that the service achieves better outcomes for lower costs. The introduction of greater competition should save money, as will the elimination of an entire tier of management. Both are essential to the Health and Social Care Bill. But the project to reform the health service has become embroiled in controversy to a degree that threatens the project. Partly that is the result of the opposition of doctors" and nurses" groups. The British Medical Association yesterday voted to ballot its members on industrial action over pensions, even though GPs" retirement benefits are among the most generous in the country and many family doctors are earning well over £100,000 a year, while providing a more limited service to patients than before. "Producer interests" of this kind are behind much of the hostility to the reforms. But these vested interests are not the only source of opposition. People in Britain are deeply attached to the health service and its noble ethos. Many fear that any change proposed by the Conservatives will lead to a system in which health care is provided solely on the basis of a person's ability to pay, where those who cannot afford hefty medical bills will suffer. That is nonsense. But it is powerful nonsense. Unfortunately Andrew Lansley, the Health Secretary, has failed to engage sympathetically with these concerns. This is, perhaps, an understandable response from a man who has for many years been absorbed in the intricate details of the reforms. But his approach has proved damaging. He has not merely alienated the doctors and nurses, he has also disappointed members of his own party: the letter from Tory MPs that we publish today supports the reforms but pointedly fails to endorse him. No one is better placed than Mr Lansley to pilot his reforms through Parliament. But once the Bill has become law, it may be time for the Prime Minister to consider replacing him with someone who is better able to convince the public of the wisdom of the changes. This task needs someone with rigour, steel and the human touch. The issue of NHS reform has once again become toxic for the Tories. We admire Mr Cameron's determination to stick by his ministers, and his refusal to give in to pressure from the Lib Dems to weaken reforms based on greater competition and consumer choice. The Conservatives have already given far too many concessions to their minority partners in the Coalition. But it would be foolish for the Prime Minister to allow loyalty to a colleague to jeopardise a Conservative victory at the next election. That, unfortunately, is what may happen if Mr Cameron insists on holding on to Mr Lansley as Health Secretary for too much longer.