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Labour stakes its reputation on NHS Plan part II

Published on 06/07/04 at 10:46am

The government has unveiled a plan for the second half of the 10-year period covered by the NHS Plan, claiming that the war on waiting times will soon be won, and that patient choice is now central to improving the service.

Labour's unveiling of the NHS Improvement Plan, subtitled Putting People at the Heart of Public Services, was pre-empted by the Conservative Party's launch of its vision for the health service, differentiated from Labour by incentives to opt-out of the NHS into private healthcare through a 'patient passport' scheme.

Despite plans for expanded use of private contractors in fast-track surgery centres and increasing the number of foundation trusts, Health Secretary John Reid told the Commons the government was committed to the founding principles of the NHS.

"The comprehensiveness, and above all the fairness, of the NHS are qualities that are already admired throughout the world with a few possible exceptions and we will retain them," he said.

The next general election could be as much as 18 months away, but both parties are now preparing to make the future of the NHS one of the key battlegrounds, and the issue of patient choice will be one of the most central themes.

The government set out its vision in the new document saying: "From the end of 2005, patients will have the right to choose from at least four to five different healthcare providers. The NHS will pay for this treatment.

"In 2008, patients will have the right to choose from any provider, as long as they meet clear NHS standards and are able to do so within the national maximum price that the NHS will pay for the treatment that patients need.

"Each patient will have access to their own personal HealthSpace on the internet, where they can see their care records and note their individual preferences about their care."

Bodies representing NHS professionals have expressed concern and scepticism about the new emphasis on patient choice.

Just ahead of the Improvement Plan launch, the NHS Confederation, which represents health service managers, warned the government not to focus exclusively on solutions for headline-grabbing secondary care.

Chief executive Gill Morgan said:  "It is important to give people who need surgery a say in when and where it takes place. But with 17.5 million people living day in, day out, with long-term conditions, it is vital the choice debate does not become exclusively preoccupied with hospital care."

A poll of Confederation members found that 77% of NHS leaders feel the current health debate ducks many of the difficult decisions facing local NHS organisations, with the majority claiming postcode variation in services was legitimate when based on local choices, and that "not all hospitals will be able to provide all services in the future".

Prime Minister Tony Blair and Mr Reid made a point of visiting a practice in North London as well as University College Hospital to launch the new plan, and also made it clear that the role of primary care would continue to grow.

The new plan contains little new for primary care, largely pulling together previously announced plans for the roll-out of US-style chronic disease management across the country - the new post of 'community matron' giving a name to the healthcare professional for co-ordinating primary care disease management.

One significant innovation not included in the programme is plans for the return of practice-based commissioning and budgets - a strong echo of GP fundholding of the 1990s, and a system long advocated by the NHS Alliance.

Key NHS Improvement Plan pledges:

  • Waiting times to be cut to 18 weeks maximum from GP referral
  • Average waiting time to be nine to ten weeks by 2008
  • Patients to be given greater choice of hospitals
  • Greater access to primary care services, including those near the workplace
  • New post of community matron to co-ordinate treatment of long-term conditions, with Expert Patient programme rolled-out nationally
  • Up to 15% of operations and diagnostic tests carried out by private sector by 2008

Related feature:

Giving patients more choice

The government's efforts to provide more patient choice in the NHS will open up opportunities and threats for the pharma industry. But is it reality or just rhetoric?


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