What does success look like?

Can you ever envisage yourself being delighted that a local hospital has been closed? Or a police station? It’s pretty hard to imagine.

But a truly successful NHS focused on early intervention and prevention would focus far, far fewer of its resources on acute care – because far, far fewer people would reach the stage where restorative rather than preventative medicine is required.

A truly successful care system would mean no elderly people in hospital because there was nowhere else for them to be cared for. Far fewer sent there as a result of falls or other preventable accidents.

And a truly successful crime strategy would prevent far more people from offending, meaning far less crime to be investigated and prosecuted.

These sound like good, if lofty, goals. But all would produce outcomes that would be very hard to swallow for the average Labour activist. Hospitals that are less needed would close. Acute care would be downgraded. We would pay less for that end of the NHS. Police Stations would close. We would pay less for the acute end of the criminal justice system.

None of this is to support the vandalism of the current government, who are doing all the closing without any of the reallocation of resources which has to come first. And not just first by a few months. This will take a generation to turn around.

Nor does it mean that all acute care can or should be driven from the system. It will still be necessary and for those with long term or acute conditions it will be essential. But imagine if we could add slack to the system by healing so many users before they fell into need? How much better would that be both for those never reaching the acute stages of illness, and for those with a system properly dedicated to specialising in the needs that remained.

We are not there. We are not anywhere close to being there. To get there would take a cultural shift of such huge proportions it is hard to imagine our getting there. Despite the obvious benefits, getting there would be a long hard task. longer than a parliamentary term.  And the money would have to be balanced across both systems as the changeover took place. A big bang would leave too many people currently in acute need with nowhere to go. As we are seeing from the rising waiting lists and falling standards the Tories are giving us now. No, this would be an expensive investment in a far distant future. Something no time limited politician is likely to be keen to sign up for.

But is is worth remembering to take a step back and look at what success really means. To think about the consequences of not changing the way we interact with the state when it comes to health, social care and crime. Because at the moment, success means beating the Tories off as they try to demolish our national health service. Hospital by hospital we fight the good fight and ensure that care is still provided wherever we can. It’s a good, brave and valid fight. And I have enormous admiration for those who fight it.

But it is not the only fight. The trickier one is to fight for a truly successful future model of preventative healthcare. The trickier one is to look to that time when those same campaigners can celebrate the closing of a hospital as the successful end result of vastly improved health outcomes.

Less people needing care is also what success looks like. We should remember to remember that.