Jeremy Hunt has released the most significant shift in medical service provision for decades. It will have a greater impact on the service than Modernising Medical Careers had a decade ago and a more positive one too.
It is right that the UK trains as many doctors here as possible. An ageing population means we need more doctors than ever and their communication skills must be excellent. Poor language skills have been tolerated for far too long and diversity has provided a fig leaf for a poor record on delivery.
No one expects 25% of MPs to come from India or Poland, nor for that matter fire officers or policemen. It must have something to do with how they are trained and rewarded. Caps on training have to go, clawbacks for medics who leave the UK early likewise are right and very fair.
The strategy is long overdue and desperately needed. So too are the doctors working today in the NHS. We need every single one and more. Migration has always been a choice for the NHS but it's vital we always choose first to ensure enough doctors of quality are available and for every doctor to feel welcome, valued, praised, and respected. There cannot be a choice between having UK or foreign doctors.
In a digital world what happens at conference doesn't stay there. While it is welcome that remain campaigners embrace Brexit, their new-found zeal could be tempered. Introducing doubt over whether doctors from abroad can stay is unwise, unfair and above all unnecessary.
There is a shortage of medics across the board, especially in primary care and urgent care. We are not in a position to consider sending doctors away from the UK, and in any case so many have permanent residence or indefinite leave to remain there's no chance of it.
We are going to need all the trainers we can get, motivated and positive and not looking over their shoulder for those keen to show their new found patriotism. We aren't doing too bad in the NHS really. It's not easy and never was. There are some shockers working in hospitals when it comes to quality of English, both from the EU and from Asia. They are few in number though. These long standing issues come from domestic policy failure and of inflexibility from Brussels. Only some of that will expire with Brexit.
Fine rhetoric butters no kippers who remain deeply suspicious of the PM's intentions. Harsh words are another matter. To quote a very accomplished and personable consultant, a diabetologist no less, these words burn and they burn in a way you can't understand until you've made your home abroad and you're then told to go "home."
Clarity last week from the PM is welcome but the question will not go away for those in frontline service who watch from the operating theatre coffee room, watch the conference on the news and ask, "Are they really thinking, what we think they are thinking?"
Conservatism cannot afford this doubt to linger. For so many foreign doctors conservatism is their political home and so is Britain.