David Cameron's declaration of love for the NHS will leave a few traditional Tories fuming. But it makes political sense.

Labour have claimed that his new approach is a "headlong retreat". It is true that he has abandoned policies such as private medical insurance, and the patient passport. But neither of these was especially coherent, or appealing to voters. By the last election, they were dead in the water.

The facts are that for all the bluster of Patricia Hewitt, the Health Secretary, Labour health policies today owe more than a little to the market-oriented approach of Margaret Thatcher.

It makes perfect sense for Mr Cameron to tuck himself in the slipstream, allying himself with the Labour reformers while warning that Labour itself will not have the courage to stick with its reforms when the going gets sticky.

The Government’s health policy incorporates patient choice, payment by results, and practice-based commissioning - all fairly arcane concepts to the average inhabitants of a GP’s waiting room.

But choice is a mainstream Tory idea - opposing it simply because it is government policy would be childish. Mr Cameron will argue that there should be more choice, more quickly. Consumers, in the Conservative book, always know better what is good for them than bureaucrats.

Payment by results simply means that hospitals will be paid by what they do. It enables private hospitals to be seamlessly incorporated into the NHS, so long as they can match NHS prices. That makes the NHS a broader church, which suits Tory predilections.

And practice-based commissioning is simply GP fundholding by another name. Fundholding was invented by Kenneth Clarke, one of the more creative Conservative secretaries of state. It gave GPs the funds to commission (buy) operations in NHS hospitals.

Derided by Labour as divisive, it has now been reinvented, made universal, and given a new name. Mr Cameron could hardly oppose it.

His real difficulty, given that Labour has gone for reforms far bolder than the Tories ever dared, is to give his policies distinctiveness. That may prove impossible, but Tony Blair has done well by adopting Thatcherite policies and pretending they are his. There seems no reason why Mr Cameron could not pull off the same trick.

The main victim of his new policy is the abandonment of the patient passport, invented by Liam Fox, now Tory Party Chairman. It was defensible, but barely, and John Reid, Labour’s ideological bovver-boy, gave it a hard time at the last election.

The idea was to enourage NHS patients to take themselves off to private hospitals by paying half the cost. The Tories said that this would ease queues. Labour argued that it would simply hand money to those who already intended to go private.

Electorally it never cut any ice, but gave Mr Reid plenty of fun claiming that the Conservatives were planning to privatise the NHS. The claim was nonsense, but by the end nobody could be bothered to argue the case. Even Dr Fox fell silent.

There is one hostage to fortune in Mr Cameron’s speech. He appears to have ruled out any form of financing other than by general taxation. This could be a mistake.

Nearly 60 years’ experience of the NHS has shown that taxpayers are seldom willing to provide enough to make it work. The past few years are an aberration, in historical terms.

What Mr Cameron must hope is that reforms will make the system so much more efficient that it also becomes more affordable.

That is a reasonable hope - there is huge scope for greater efficiency and productivity. But if it doesn’t, ruling out alternative ways of supporting it could prove a misjudgement.

Times Recommends

• Postmen: We bind the nation together
• Tewkesbury: when the memories flood back
• Cast Offs actress: I’m happy that my face fits