Andrew Lansley promises (1) transparency, (2) greater trust of NHS professionals and (3) payment-by-results

Tim Montgomerie

A major report into hospital performance uncovers huge variations across the NHS. Nineteen hospital trusts, according to the Dr Foster hospital guide, have "alarmingly high death rates". The Observer reports some of the other findings:

• Almost 10,000 patients suffered an accidental puncture or laceration.
• More than 2,000 had post-operative intestinal bleeding.
• More than 13,000 mothers suffered an obstetric tear while giving birth.
• Some 30,500 patients developed a blood clot.
• 1,300 patients contracted blood poisoning after surgery.

In the same newspaper Andrew Lansley sets out the three key planks of his plan to correct Labour's record:

(1) Transparency will mean no hiding place for under-performing hospitals: "A new culture of openness and transparency will transform patient care. Everyone – patients, the public and other clinicians – will be able to see just how well a particular organisation, team or even an individual is performing. This will create a huge incentive for ever higher levels of quality and patient safety."

(2) Freeing professionals from distracting targets: "The NHS consists of many highly skilled, dedicated and motivated people. We will free them from central control while holding them to account for the quality of care they deliver. Soon, GPs will be responsible for designing and paying for local health services, working with their colleagues across the NHS to get the best results for their patients."

(3) Payment-by-results-not-processes: "Our plan to deliver a payment system linked to the result of treatments will encourage hospitals to improve the quality of care they deliver for patients – like our 30-day readmission tariff – and should help drive up even higher the standards of care in hospitals."

Just speaking on Andrew Marr the Health Secretary summarised his approach as national standards twinned with freedom for local NHS professionals to decide how to deliver those standards.

He confirmed last week's story that the Department of Health is considering plain packaging for cigarettes. All packets would look the same, he said, if the reform went ahead with only the brand's name distinguishing the product. 18,000 lives are lost every year by smoking, he said, and he was determined to reduce the number of young people who started to smoke.

Jonathan Isaby reported last night that Mr Lansley is considering a minimum cost for alcohol. He confirmed that he was working with retailers and local government to stop alcohol being sold as a loss-leader at below price. This kind of action was necessary, he insisted, to reduce growing health inequalities.

He also confirmed a Mail on Sunday report that he wants to make it easier for women to breast-feed at work. The Health Secretary believes he can achieve this without increasing the regulatory costs that are stretching small businesses to the limit. The UK's breast-feeding rate of 46% is below the international average.