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Do we want a producer-centred NHS or a patient-driven NHS?

By Tim Montgomerie
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Debois-nick Nick de Bois MP (who has written for ConservativeHome on NHS reforms) has circulated a letter to all Tory MPs urging them to fight for the key components of Andrew Lansley's NHS reforms.

The most important component is, he says, patient choice:

"Patients should be able to be treated at any qualified provider. Patients should have every right to be treated at the best possible service, free of charge, on the NHS, if that service meets NHS standards and NHS costs."

Amidst all the confusing language that has clouded the NHS debate Nick de Bois provides an in-a-nutshell summary of what this healthcare reform debate is all about*. Do we want a producer-centred NHS or a patient-driven NHS? De Bois continues:

"If a provider is qualified to deliver NHS standards at NHS costs – and a patient, together with their doctor, wants them to be treated there – the Government should do nothing that stands in their way. Patients, together with their doctors, should have a choice over where to be treated. Without such a choice, there can never be an incentive to drive up standards in the NHS. However, vested interests will fight to restrict patients' right to choose. Therefore, Monitor must be retained as a regulator to ensure that patients' choices are not being restricted and ensure that their interests are not being harmed."

Download a full PDF of Nick de Bois' letter.

Andrew Lansley's reforms also get the backing of Lord Warner in an article for The Times (£).

Screen shot 2011-05-27 at 09.07.17Who's Lord Warner? He was Labour's Health Secretary from 2003 until 2006 and he concludes that Lansley rather than Ed Miliband has a better prescription for the NHS:

"It may well be the much criticised Mr Lansley who has the best appreciation of what the NHS needs if it is to survive and avoid crises that will lead to higher taxes, more rationing and even patient co-payments."

It's an excellent article that sets out how the NHS is based on a "failed business model — the 1960s district general hospital." It's well worth the paywall fee.

Tory MPs are finally fighting the "yellow b**tards" who oppose NHS reforms that they backed only a short time ago. I fear it's too late, however. George Osborne has decided that, unless significantly diluted, the reforms won't get through the Lords - where Shirley Williams has fought a brilliant campaign. What now needs to happen - and urgently - is the identification of new ways of delivering the goals of the Coalition Agreement even if it's too late to save every mechanism recommended by Andrew Lansley. We shouldn't be under any illusions, however: the NHS unions will fight anything that threatens their monopoly.

* [As Andrew Lilico noted yesterday this pro-patient language can be found on p26 of the Coalition Agreement].


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