25 June 2004
Patients' power to choose where and when they are treated will be expanded, no matter which party wins the next general election. Both Labour and the Conservatives put patient choice at the heart of their health strategy outlined this week.
As Health Secretary John Reid prepared to launch the NHS Improvement Plan on June 24 before addressing the NHS Confederation conference in Birmingham, Prime Minister Tony Blair and Tory leader Michael Howard traded blows – and bids – on what they see as the key election battleground.
Reid's five-year plan was set to pledge an unlimited choice of provider at the point of GP referral. Ministers have already pledged patients will be able to choose between four or five providers, including some in the private sector, by December 2005. Care would be free at the point of use.
The Improvement Plan, the follow-up to 2000's NHS Plan, was also due to promise further action on waiting times. The measurement of waiting times will start once patients are referred by their GPs, not when they are put on the list by a hospital consultant.
In a keynote speech on the future of public services on June 23, Blair insisted the government would improve users' experience of the NHS and other public services. He said the government would insist on 'modern services which maintain at their core the values of equality of access and opportunity for all'.
It would 'base the service round the user, a personalised service with real choice, greater individual responsibility and high standards; and ensure in so doing that we keep our public services universal, for the middle class as well as those on lower incomes, both of whom expect and demand services of quality'.
The Tory riposte is its Right to Choose policy, including a pledge to reimburse up to 50% of the cost of treatment if patients choose to go private.
They pledge to scrap all central government targets, together with the star ratings system, while foundation hospitals would get the enhanced flexibility to borrow and invest funds.
Howard, in his speech on June 23, said: 'Our policies will eradicate the inequalities that exist in our two-tier health service, where the rich get what they pay for and the poor have to shut up and take what they are given.'
But Niall Dickson, chief executive of health charity the King's Fund, was unimpressed. 'The Conservative proposals would mean the NHS subsidising large numbers of patients who would have gone private anyway,' he said. 'It's the relatively wealthy who are more likely to benefit and it undermines the concept of a service free for all, regardless of ability to pay.'
At the confederation's conference, service managers warned the politicians that they must not duck the difficult decisions facing local NHS organisations by concentrating on choice and personalised care.
A poll of 100 NHS chief executives in England, published by the confederation, found that managers' top priorities were improving public health, caring for people with long-term conditions and investment in primary care.
Chief executive Gill Morgan told the conference: '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.
'In the past, hospitals and waiting lists have dominated election campaigns. We welcome the fact that political parties have given greater recognition to long-term conditions in recent months. The real challenge now is to translate this rhetoric into reform.'
She added that the confederation had drawn up a draft manifesto in alliance with 15 patient groups. This sets out proposals to give each patient a personal care plan, as well as plans to invest in better diagnosis.
The survey found that more than three-quarters felt that the current political debate ducked the crucial issues facing frontline services.
PFjun2004
