Mark Coote: We are right to back the basic tenets of the NHS, but that doesn't mean it should escape critical reform

Mark Coote is Conservative candidate for Cheltenham.

Since we’re in the death throes of this Parliament, and everyone knows there has to be a General Election by early June, it was inevitable that the pre-election guns would be fired as soon as New Year festivities were out of the way.

I’m very glad David Cameron seized the pre-election initiative on two counts: firstly by focusing on the NHS and secondly by travelling to my county of Gloucestershire to engage with local residents on local healthcare issues and other important concerns.

I work as a Director for a well-known cancer charity and NHS surgeons saved my life in September 1991. I have much to be grateful for. When I most needed it, the NHS was there for me and my family. Having spent literally months of my young adult life in NHS hospitals, and been treated by some of the most specialist health professionals anywhere in the world, I have been incredibly lucky. Some of the people for whom I dedicate my working life have been less so.

Hardly surprising then that Cameron’s message that enshrines the basic tenets of the NHS as being free at the point of use and available to everyone based on need resonates with me with particular piquancy.  This is a cornerstone of modern Conservative philosophy and, without any apology at all, our key and compelling priority.

But of course the NHS is far from perfect. Constant re-organisation has sapped the innovative outlook and appetite of clinical staff. Overbearing Department of Health target-setting has distorted clinical priority and created dreadful healthcare inequalities. Numbers of managers in the NHS are rising three times as fast as the number of nurses. The postcode lottery of healthcare is well-documented, as is the escalation of hospital-borne infections and filthy wards – often mixed sex. Hospitals in the main might provide heroic results against the odds, but given the public money invested in the system, the least patients should expect is dignity, cleanliness and proper nutrition.

I volunteer regularly on the cancer wards at Cheltenham General Hospital, joining an enthusiastic army of local dedicated volunteers. We make beds, prepare food orders, clean patient bays, mattresses and run errands. I wonder what the nursing staff would do without us; so many of the chores were once undertaken by nurses, or were when I was an inpatient in the 1980s and early 1990s. So it’s not a perfect regime, and we are luckier in Cheltenham than in many other towns.

I applaud David Cameron’s commitment to protect health spending in real terms, but also his focus on critical reform. Decentralisation, accountability and transparency must be key priorities and the draft manifesto for change – the very first announced in this pre-election campaign – is the right clarion call.

When I visit my Nephrology Consultant and see him battling with the NHS computer system recently launched, late and over-budget, I gain a glimpse of the waste, inefficiency, frustration and management gobbledegook top health professionals and their support colleagues have to tolerate. It is depressing to witness, and little wonder the prospects of early retirement beckon for these people dedicated to public health and at the top of their game.

I want to change all this, not just for my own doctors but for all those who care for everyone else who need better outcomes in healthcare. At the point when we most need the NHS, it must be there to support us.

If there was any single reason to venture in to national politics, it is this.