Conservative MPs have released radical plans to hand day-to-day control of the NHS to an independent board.
Shadow Health Secretary Andrew Lansley has proposed that senior doctors should be placed in charge of local budgets with the power to decide how money is spent.
Patients will also be empowered to choose where they wish to be treated, whether in the public or private sector.
The Conservatives say their plans will reduce the amount of NHS red tape and give patients the power to make treatment decisions.
"We need a service where the government and parliament set the framework, determine the overall resources, agree the objectives and outcomes which need to be met, but don't try to interfere in the day-to-day decisions about patient care," says Lansley.
He promises that there will be a clear divide between those who commission NHS services on behalf of patients and those who provide hospital and community health services.
He says this will ensure that the NHS is not "controlled by vested interests."
He adds: "Labour's obsession with targets is a triumph of ideology over experience. Targets haven't delivered. For every target met – and many haven't been met - there are many other aspects of care which have deteriorated.
"Tony Blair's amibition was to spend as much as other countries in Europe; our ambition is for our health outcomes to be among the best in Europe."
"I agree that the current system is too target driven which forces trusts to allocate resources inappropriately for local needs. I work in both acute and community care and am very aware how the acute trusts are financially penalised for failure to meet targets - so they fiddle the figures and I don't blame them. Jobs are at stake here, all because of ill thought through policy. I do worry about the Conservatives' committment to adequate funding though. No one party has my 100% support. Give the NHS back to it's staff" - Name and address supplied