Yesterday was a sad day for the NHS, but the Tories have already been introducing changes for the last 18 months or so. Thousands have already lost their jobs which has meant restructuring was already underway. I agree largely with what SJ says, although I do hope he is wrong that the Bill (or at least some of it) is irreversible. These changes are huge and, as such, can only be introduced gradually. For example, private sector involvement, whether you think it is a good thing or a bad thing, will not increase overnight - it's likely there won't be any significant rise for a number of years. And now matter how much some people refuse to admit it, there is no buy-in from the professionals that work within the NHS, which will inevitably affect implementation. At this point in time, the Labour Party is pledging to repeal the Bill if it was re-elected. Of course, no one knows when this will happen and politicians have been known not to keep their pre-election policies ;-) but it is conceivable that Labour could regain power in three years time and could repeal some aspects of the Bill in that Parliament.