Wes Streeting, the Health Secretary, is launching a "national conversation" about the future of the NHS. He can sit around any dinner table or join any online chat group to hear that debate going on all the time, invariably accompanied by horror stories about poor, late or non-existent treatment.

Mr Streeting is not unaware of these shortcomings since he has already declared the NHS to be broken. He now proposes a 10-year plan to rectify matters, but seems remarkably bereft of specific proposals that would turn his ambitions into reality. Merely stating things will happen, without setting out how, is becoming a characteristic of this government.

One idea is to harness new technology to improve the nation's health. Mr Streeting wants millions of us to wear "smart" watches that can monitor blood pressure, sugar intake and cardiovascular function. Many people already own similar devices, but the Health Secretary wants to distribute them on the NHS, presumably to those unable to afford them or already on benefits.

Who qualifies? Do you have to be an existing patient or is this about preventative care, in which case why not give them to healthy people? New technology and AI are not panaceas but cannot be dismissed any more than X-rays or brain scanners should be rejected. If they work, all well and good. Yet "smart" watches smack of a gimmick, giving the impression of something better, like smart motorways or smart meters, which were anything but. Moreover, the biggest problem with the NHS is access to treatment, whether primary or hospital care. People would not be impressed if their smart watches highlighted an ailment for which they could not secure a consultation for months.

Also, despite its massive purchasing power, the NHS runs up excessive bills for equipment that costs less elsewhere. We can only imagine how much the smart-watch initiative will cost the taxpayer. Is the Budget about to pump billions more into a system where spending has long been out of control?

Mr Streeting said: "We will rebuild the health service around what patients tell us they need." What they need is an NHS that is efficient, ­­well-run, responds quickly to demand and has easily accessible primary care, without having to wait for many hours in A&E. The question he needs to ask is whether this is possible within a system whose parameters were laid down in 1948 and have changed little since. Will that be part of his national conversation?