The Conservative Party has finally showcased its proposals for the National Health Service, which, it says, are designed to scrap the current target culture, reduce red tape, increase patient decision-making power and foster future growth.
The Tories have joined ranks with those calling for less political interference in the running of the Service in favour of handing over control to an independent board, as set out in a policy paper unveiled by Shadow Health Secretary Andrew Lansley yesterday.
It also proposes: handing over budget control to GPs so that they can decide how the money is best spent in their practices; linking doctor salaries to patient outcomes, and penalising via pay cuts when services under-perform; and providing patients with long-term illnesses special ‘budgets’ to purchase care services, amongst other things.
Speaking at paper’s launch, Mr Lansley described a current environment of low staff morale, patient disillusionment and the government’s refusal to take responsibility for decision-making, and he called on incoming Labour Prime Minister Gordon Brown “to adopt the Conservative blueprint.”
A long-term constitution
“The NHS needs a clear, long-term constitution: one which entrenches NHS core principles - and we commit to that; which stops the pointless organisational changes - we will do that; which takes decisions close to patients - we promise that; which lets healthcare professionals use their judgement in providing care to patients; which gives patients personal choice and control over their own care, and gives the public locally a voice over service quality and service planning,” he said.
“We need a service where the Government and Parliament set the framework, determine the overall resources, agree the objectives and outcomes which need to be met, but don't try to interfere in the day-to-day decisions about patient care."
The NHS Confederation welcomed the Conservative’s “commitment to the values of the NHS and a tax-funded system,” and its chief executive, Dr Jill Morgan was pleased that the proposals shyed away from any significant change of direction. “The last thing the NHS needs is more reorganisation and upheaval,” she stressed, adding: “We need a period of stability.”
With regard to an independent NHS, she said that while the Confederation was behind a more autonomous NHS, its members are not convinced that an independent board is the answer, and “some form of political involvement is unavoidable in a service that spends over £100 billion of public money.” Furthermore, she said that some people are worried that an independent board may actually lead to more covert politics. “What NHS leaders want is genuine autonomy with decisions being made as locally as practicably possible,” she stressed.
BMA supports independence
And, unsurprisingly, the British Medical Association – a leading advocate of an independent NHS - has voiced its support for the plans. In a statement, the Association said is it “pleased that its call to value NHS staff and engage with health professionals and patients has figured highly in the Conservative party health proposals,” but Dr Jonathan Fielden, Chairman of its Consultants’ Committee, also warned of concern “at the continued emphasis on a ‘social market’ and enhancement of the purchaser-provider split.”
Last week, Health Secretary Patricia Hewitt rejected the notion of an independent NHS on grounds that, at four times the size of the Cuban economy, it is just too big to be controlled by a single board. But she has come out in favour of creating an NHS constitution, and handing over more power to healthcare professionals and patients, according to media reports. Mr Brown’s stance on the matter is still unclear.