The New Year has brought the opening salvos of the general election campaign, which is expected to be held in May.
This week, the Conservatives published the first chapter of its draft manifesto - on health. They’re going to publish it chapter by chapter and are calling it a draft because they say they want public response before finalising it.
The manifesto starts by making a commitment to keeping healthcare free at the point of use and available to everyone based on need not ability to pay.
The Tories claim that despite a massive increase in spending on the NHS, the gap in health outcomes between the UK and the rest of Europe has widened. They also accuse Labour of top-down, bureaucratic mismanagement that has undermined NHS staff and skewed priorities.
They’ve pledged to protect health spending and claim their reforms will be based on decentralisation, accountability and transparency.
A patient-centred NHS
1. The Conservatives have pledged to scrap all of the politically motivated process targets.
2. Make detailed data about the performance of trusts, hospitals, GPs and other staff available to the public online.
3. Put a focus on health results, particularly cancer and stroke survival rates and reducing infections.
4. Enable patients to rate hospitals and doctors according to the quality of care.
5. Enable patients to choose any healthcare provider than meets NHS standards.
6. Put patients in charge of their own health records, with the ability to choose which providers they share them with.
7. Open up NHS provision to include new private and voluntary sector providers.
8. Allow GPs to hold patients’ budgets and commission care on their behalf.
9. Devolve decision making to cut the cost of NHS administration by a third and transfer resources to the frontline.
10. Create an independent board to allocate resources to different parts of the country and make patient access more equal and based on need.
More accessibility and accountability
1. Deny hospitals full payment for a treatment which leaves a patient with an avoidable infection.
2. End mixed-sex accommodation and increase the number of single rooms in hospitals.
3. Reform how drug companies are paid so that any cost-effective treatment can be made available through the NHS, with drug providers paid according to the value of the new treatments.
4. Provide access to a doctor or nurse when the GP isn’t open. Stop the closure of A&E wards.
5. Give mothers choice over where to have their baby and allow new providers to deliver maternity care. Introduce local maternity networks to improve access to services.
6. Introduce a new dentistry contract that ties newly-qualified dentists into the NHS for five years.
7. Remove the rules preventing welfare-to-work providers and employers purchasing services from mental health services.
Improve public health
1. The Department of Health will be renamed the Department of Public Health to give prevention more priority.
2. Provide separate public health funding to local authorities. Extra resources will go to the poorest areas with the worst health outcomes through a new ‘health premium’.
3. The Conservatives will provide £10m a year funding beyond 2011 to support hospices in their work with children, and introduce a new per-patient funding system for hospices and providers of palliative care.
4. Give patients with chronic or long term conditions access to a single budget that combines their health and social care funding.
5. To protect people having to sell their homes to pay for residential care in older age, everyone on retirement will have to pay a one-off insurance premium of £8,000.
Reactions to the manifesto
Anna Dixon, acting chief executive of the King’s Fund, said: “Although there is much in the draft manifesto that chimes with current government policy - more foundation trusts and more choice for patients, for example - the document signals a number of areas where Conservative and Labour policy diverge.
“An independent 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 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.
“Whichever party forms a government after the next election, they will inherit an NHS facing the toughest financial challenge in its history. Whether or not current spending is protected, demand will continue to rise and the NHS needs to figure out how to do more for less without compromising safety or quality.”
Norman Lamb, shadow health secretary for the Liberal Democrats, said: “The NHS is facing enormous shortfalls in funding over the next few years yet the Tories continue to promise extra health spending without any details of where the money will come from.
“The time has come for David Cameron to be honest with the British public. If the Tories want to pledge extra spending on health in some areas then they must admit that without extra funds it will lead to cuts in frontline services elsewhere. And if they plan to remove all central targets how do they intend to prevent a return to the waiting lists of old?
“The sad truth is that David Cameron knows his health policies don’t add up. How else do you explain the sudden U-turn today on their flagship single room’s policy?”
Dr Peter Carter, chief executive of the Royal College of Nursing, said: “Having the right number and balance of skilled staff is the key to delivering quality care and in improving people’s health. Specialist nurses also play a vital role in improving care for people with long-term conditions and we are calling on all parties to support patients having guaranteed access to these specialists.
“We are encouraged to see signs that show the Conservatives intend to take a firm stance on public health and health inequalities but we are disappointed to have not heard more about issues such as tackling alcohol abuse. Specifically, we would have liked to have heard a firm commitment for a single mandatory code to better regulate the drinks industry.”
Tags: Health policy, Patient choice
