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David Cameron sets out the next Conservative Government's five priorities for health policy

Picture 12 At his press conference last week, David Cameron said that all shadow ministers would be expected to set out a small number of priorities for their policy area.

Today see the publication of the party's five priorities in government for health and David Cameron has just given a speech in central London in which he outlined these five priorities.

He also called again on Gordon Brown to commit to protecting the NHS from any spending cuts, as well as seeming to re-iterate his previously made promise that Andrew Lansley will be Health Secretary if he forms a government next year:

"Nobody is better placed to bring about this change to the NHS than Andrew. He has an exceptionally detailed knowledge of his brief, a cast-iron determination to reform and improve the NHS and a deep understanding of what the health service and its values mean for this country."

Mr Cameron also referred to the priorities as relating to "a Conservative Department of Public Health", revealing that the Department of Health will be subtly renamed (a pledge which, I imagine, comes with not insignificant menu costs).

So here are those priorities:

1. Create a patient-led NHS where patients are in control of the care they receive

  • "We want to deliver an NHS where every patient has the power to design their healthcare to meet their own specific needs. And by introducing new providers into the NHS to meet those needs, we will increase innovation and improve the quality of healthcare on offer."
  • "We will allow patients to choose any provider – from either the public or independent sectors – to deliver care within the NHS so long as they do so to NHS standards and within the NHS tariff. We will also enable patients to choose the GP that is right for them."
  • "We will give patients control over their own health records, so they can take them to their provider of choice, and introduce personal budgets for patients with long term conditions."

 Immediate actions to be taken to achieve these goals

  • New ‘choice in commissioning’ guidelines will be issued, then the ‘choose and book’ system will be restructured to include new providers and provide greater choice.
  • Healthwatch will be created to act as an advocate on behalf of patients' interests.
  • A full consultation will be carried out on how to move to patient-held records, with a view to introducing them throughout the NHS.

2. Measure health outcomes and pay NHS providers according to their success

  • "A Conservative Government will measure the performance of the NHS providers by the health outcomes they achieve, like increased life expectancy for cancer sufferers and higher quality of life, instead of the processes they follow. And we will pay NHS providers according to their ability to deliver these improved outcomes."
  • "We will scrap Labour’s top-down process targets and instead start collecting and publishing health outcomes data, allowing patients to see which hospitals and doctors provide the most effective treatments and improvements in quality of life."
  • "We will pay providers according to the results they achieve, not just for the number of patients treated. We will reform drug pricing so that companies are paid according to the value that their treatments deliver."

Immediate actions to be taken to achieve these goals

  • Publish NHS Information White Paper followed by first full year dataset.
  • Phase out block contracts and link the NHS tariff so that it is more closely linked to the particular treatment and better reflects the complexity of the patient's condition, with the tariff being geared to delivering outcomes, not processes, and will increasingly cover the whole of a patient's spell of care.
  • Introduce new contracts that allow the tariff to be varied downwards if providers do not deliver the required standard of care and varied upwards where hospitals perform well.
  • Introduce consultation on moving to value-based pricing for treatments.
3. Put healthcare professionals in charge of delivering care
  • "Under the Conservatives, doctors, nurses and other healthcare professionals... will be able to make decisions based on clinical priorities and medical expertise, not political interference and we will decentralise power to the lowest possible level within the NHS so that providers are properly accountable to patients."
  • "We will take political interference out of the day-to-day running of the NHS by giving frontline NHS staff the power to make decisions about how to meet our key healthcare objectives, like increasing cancer and stroke survival rates."
  • "We will encourage all NHS providers to become more independent, and move towards a system where GPs are responsible for commissioning all forms of care on their patients’ behalf."

Immediate actions to be taken to achieve these goals

  • An NHS Autonomy and Accountability Bill will be enacted to put in place an independent NHS Board.
  • All NHS providers, regardless of sector, will be moved towards Foundation Trust status. Trusts and new providers, including the social enterprise and voluntary sector, will be encouraged to invest and innovate because their future success will be closely linked to patients' choices and the results that are achieved.
  • Frontline NHS staff will be empowered through the rationalisation of the quangos within the NHS and by cutting NHS administration costs by a third and focusing resources on the frontline.
  • The GP contract will be renegotiated, opening up the primary care sector to new providers, and giving real budgets and commissioning powers to GPs.
4. Focus government action on improving public health
  • "By creating a more independent NHS, we will be able to transform the department into a Department of Public Health."
  • "We will devolve public health budgets to local health commissioners and local authorities, and introduce a universal health visitor programme to improve the health of young families."
  • "We will work in collaboration with sectors outside government, to help individuals make healthy choices."

Immediate actions to be taken to achieve these goals

  • Rename the department as the Department of Public Health, publish a Public Health White Paper and deliver a public health strategy.
  • Introduce ring-fenced public health allocations to Primary Care Trusts and local councils.
  • Recruit and train 4,200 more health visitors and introduce minimum service guarantees.
  • Implement a range of measures to lead to improved exercise and diet and reduce alcohol abuse as part of a public health strategy.
5. Reform long-term care
  • "Conservatives will create a fairer system of social care and improve community-based care so that fewer people need to enter residential care."
  • "We will end the injustice of people being forced to sell their homes to pay for care costs by allowing homeowners, for a one-off fee, to protect their home from being sold.
  • "We will support innovative community-led care schemes that prevent people from needing care in the first place, and help keep people in their homes for longer when they do. We will target help towards older people who have falls or hospital treatment, and who need therapy or support to prevent dependency or readmittance to hospital."

Immediate actions to be taken to achieve these goals

  • A White Paper will be published, followed by a Bill, to create the Home Protection Scheme.
  • Schemes will be piloted including Telecare and Telemedicine, home adaptations, and schemes to build patients' ability to look after themselves after being in hospital, which will be followed by full roll out nationwide.
  • Budgets combining social care and health care funding for people with long-term conditions will be rolled out.
Jonathan Isaby


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