Markets not targets will be used to improve performance With the United Kingdom general election less than a year away and opinion polls showing the Conservative Party well ahead of the Labour Party, there is increasing interest in the opposition’s health policies and their implications for the NHS. The broad direction of the Conservatives’ thinking has been set out in a series of policy documents published in the period since David Cameron’s election as leader of the party in 2005.1 At the heart of this thinking is continuing support for a universal, comprehensive, tax funded NHS, alongside plans that are both different from and similar to those pursued by the Labour government. One of the principal differences concerns the Conservatives’ commitment to distancing politicians from the day to day running of the NHS. This aim will be achieved through the establishment of an independent board made up of the NHS chief executive, his senior colleagues, and lay people serving in a non-executive capacity. The board will lead the management of the NHS within a framework of objectives set by the government and will report to parliament. The creation of an NHS board is intended to enable the Department of Health to concentrate on public health issues in support of the stated aim of focusing on health outcomes rather than centrally imposed …