Liberal Democrat leader Nick Clegg announced changes to his party’s health policy, including an endorsement of the principle of allowing patients to ‘top-up’ aspects of NHS care. This could mean choosing to pay for drugs not approved by the National Institute for Clinical Excellence

Speaking at the Kings Fund think-tank, Mr Clegg also announced that Lib Dem policy will set new mandatory maximum waiting times, after which if NHS provision is not available, patients would have the cost of private sector treatment met by the NHS.

New progressive agenda
Clegg told delegates at the meeting that the contempoirary question for progressive politicians is “how can we move beyond centralising agenda, to a quality public sector with better, fairer outcomes without the many errors of the last decade?”

He proposed that Lib Dem policies are based on three principles: that the role of the central state should be pruned so Whitehall can ensure universal access and high standards; that a radical devolution of power to communities will move control to those who best know how to use it; and to empower individual public service users to make their own path based on their own needs.

Changes in practice
In practical terms, Clegg said, “this would mean national policy must move from central targets to a small number of key entitlements”. Citing an example of “horrifying” waiting times for mental health services of up to three years in Portsmouth, Clegg stated that “where a health commissioner – the primary care trust (PCT) - fails to deliver care within a time limit specified, they will be legally obliged to pay for anywhere that can provide it: public or private.”

He also indicated that PCTs (the local NHS administrative unit) would be democratised with direct local elections to make them accountable to their communities: “PCTs would become accountable local health boards, not structurally reorganised, but democratised, with their spending decisions acountable, transparent and open to scrutiny”.

The Lib Dems’ proposed financial changes extended further, to the ability of patients to ‘top up’ their care and buy more expensive drugs or longer-lasting artificial joints while retaining the right to NHS care. At present, patients seeking private treatment are regarded as opting out of NHS treatment completely and invoiced for any NHS care they require as part of the treatment.

Clegg also indicted his party’s interest in giving patients with long-term conditions individual budgets to buy what care they choose, either within or outside the NHS, as has been trialled in certain areas for social care needs.