Conservative leader David Cameron will today tell the Royal College of Surgeons that by abolishing targets and focusing on survival rates, a future Conservative administration could save up to 100,000 lives a year.

Current national targets for the NHS in England include maximum waiting time of four hours in A&E; urgent suspected cancer referrals within two weeks; access to a GP appointment within 48 hours; and by the end of 2008 a maximum waiting period of 18 weeks from GP referral to the start of hospital treatment.

Critics have long argued that these targets are arbitary, without basis in evidence and distort clinical priorities. Supporters of targets have countered that the NHS has seen its first sustained major reduction in waiting times in its history.

Survival matters
Cameron’s new policy will abolish all ‘process’ targets, and focus instead on outcomes. He believes that a future Conservative government could thereby increase British cancer survival rates above the European average by 2015, and reduce avoidable premature deaths compared to other European countries. His figures will show that if the NHS were to match the international average performance on outcomes, 38,000 more lives a year would be saved. If results improved to match the best in the world, more than 100,000 lives would be saved.

Cameron will say, "despite all the extra money, we still have some of the worst health outcomes in the whole of Europe. Right now, England is near the bottom of the table when it comes to five-year cancer survival rates - far below countries like Sweden and Germany, and on a par with Slovenia and Poland.

"We have one of the worst records of diabetic control. And you're more likely to die from a stroke in England than in any other country in Western Europe."

The targets would be replaced by information on healthcare outcomes - such as average patient length of survival after cancer; active patient lives while suffering from lung disease; and the probablility of recovery after a stroke.

Last month, the Royal College of Nursing suggested that "pressure to meet the four-hour waiting time has had negative consequences for the quality of patient care. Three quarters of nurses say that patients were regularly admitted to inappropriate wards just to meet the target."

Government riposte
Health minister Ann Keen described the Conservatives’ plans as "inconsistent” and added: “Having opposed extra investment in the NHS, the Tories are now opposing reform that is helping to improve patient care. The Tories are proposing an end to longer GP opening hours; scrapping guarantees that have shortened waiting times; and cuts on a scale that would put NHS investment at risk."

And King's Fund chief economist John Appleby told BBC News: “I think everyone now agrees it is the right time to move away from the traditional targets. Outcomes are being looked at, but the problem is that you cannot say what the NHS is responsible for, as other factors such as lifestyle and genetics play an important role."