The debate, held at a breakfast session in Dorking, Surrey, was chaired by Fiona Godlee, BMJ editor in chief. The attendants were Nigel Edwards of the King’s Fund and KPMG; Judith Smith, head of policy, Nuffield Trust; Gareth Goodier, a doctor and chief executive of Cambridge University Hospitals NHS Foundation Trust; David Bennett, head of the NHS trust regulator Monitor; Helen Thomas, medical director of Sentinel Commissioning Group in Plymouth; Penny Dash, a doctor and partner, McKinsey and Company; James Morrow, a general practitioner in Cambridgeshire; Clare Gerada, chair of the Royal College of General Practitioners; Simon Stevens, former adviser to Tony Blair and president of the global health division at UnitedHealth Group; Alastair McLellan, editor of the Health Service Journal, and Paul Corrigan who worked with Tony Blair and is now a management consultant and blogger.

Fiona Godlee: Welcome. This session is intended to look at what life will be like after the bill. Do you think it will be very different?

David Bennett: I shouldn’t think there will be huge changes. In many ways it’s about taking things that are being done today—whether you’re talking about pricing or the principles and rules of cooperation and competition—and putting them on a more statutory footing. In particular, putting them into Monitor or the [NHS] Commissioning Board.

Helen Thomas: I think after the bill it will be exciting to get a move on because we feel like we’ve been stalling, waiting for edicts to come down from the Department of Health that don’t come, or they do but we …