A Conservative government would “reform the way drug companies are paid for NHS medicines, so that any cost-effective treatment can be made available through the NHS, with drug providers paid according to the value of their new treatments,” according to chapter one of the party’s draft manifesto, which deals with the Tories’ reform plan for the Service, published this week.

The draft – which declares the Tories to be “the party of the NHS today”– emphasises that they are committed to protecting health spending in real terms, but adds: “that doesn’t mean the NHS shouldn’t change. When you’re more likely to die of cancer in Britain than most other countries in Europe – and when the number of managers in the NHS is rising almost three times as fast as the number of nurses – the question isn’t whether the NHS should change, it’s how the NHS should change.”

Setting out the party’s vision for a patient-centred NHS, the draft manifesto says the Tories will scrap all “politically motivated” process targets and “set NHS providers free to innovate by ensuring they become autonomous Foundation Trusts.” In government, the party would also “unleash an information revolution” in the NHS, by making detailed data about the performance of trusts, hospitals, general practitioners (GPs), doctors and other staff available to the public on-line.

Patients would be able to rate hospitals and doctors according to the quality of their care, and choose any healthcare provider that meets NHS standards. To give patients even more choice, the NHS would be “opened up” to include new independent and voluntary sector providers, if they can deliver a service that patients want, to a high standard and within the NHS tariff, and a “payment for results” system would be implemented throughout the Service.

GPs would be empowered to hold patients’ budgets and commission care on their behalf, and their pay would be linked to the quality of the results they deliver.

Moreover, to make sure the NHS is funded on the basis of clinical need, the Conservatives say they will create an independent NHS board to allocate resources to different parts of the country and make access to the Service more equal.

On access to medicines, the draft manifesto states: “British patients should be among the first in the world to use effective treatments, but under Labour they are among the last.” It goes on: “the current system lets Ministers off the hook by blaming decisions on unaccountable bureaucrats in NICE (the National Institute for Health and Clinical Excellence).”

This last statement has perplexed commentators, who wonder if it suggests the Conservatives are planning to allow government ministers to have some say in NICE’s recommendations as to the medicines and other treatments which should be made available on the NHS in England and Wales.

Commenting on the draft health document, Dr Anna Dixon, acting chief executive of health policy think tank The King's Fund, said that initiatives such an independent NHS board, changes to the way that drugs are approved and paid for and real budgets in the hands of GPs could significantly change the way in which the NHS operates, but noted that “more detail is needed before the impact of such policies can be properly understood.”

“There are also some issues which remain unanswered, such as whether a Conservative government would seek to maintain the current waiting times achieved by the NHS,” added Dr Dixon.