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This is the danger of Cameron making off the cuff policy announcements to serve the purpose of short term image gain. If 52% want to see a more insurance based system, even when none of the parties have actively made the case for it, what level of support would such a policy have if we consistantly and clearly made the case? We have an opportunity to make health a strong issue for the Conservative Party, but now this will be so much more difficult thanks to Cameron ruling it out.

The NHS is the real soft spot in Labour at the moment, and if we're clever we'll come up with a way of attacking it and proposing a sensible alternative.

Hence why it's a shame that Cameron ruled out the patients passport. But it's not the end of the world - there's still plenty of alternatives we can use to improve the NHS. Let's just hope we get it right this time.

its good to see voters open to the case for NHS reform, its about time something was done.

here's an idea. why dont we introduce a "health grant" paid out of taxes. basically, split the health budget up and give everyone an amount which they would then use to purchase compulsory health insurance and pay for visits to GP's. it would have to be enough to cover these costs. to encourage efficiency and lower costs people could keep any of the health grant that they didnt spend on paying for the insurance and doctors visits. the government would have to set the minimum of what the insurance companies should offer so no one is left without access to the treatment they need (probably the minimum standard could be what the NHS currently offers). when someone needs an operation, they can phone the insurance companies who will organise it for them with a hospital. the hospitals (state or private) would compete for patients. the state hospitals could be made independent or even privatised and anyone could set one up.

the advantages of such a system would be it would introduce efficiency, keep it free at the point of use, abolish waiting lists and encourage investment into the NHS. All of this would be welcome by the public if it is argued and presented right. this is the way to get all the advantages of private healthcare, yet free.

This is just the sort of chance the Tories need to propose radical reform - replacing our NHS with a less statis European system. There is the necessary public support, is there the sufficient willpower? If Cameron blows this chance then his critics will have been proved correct.

Well spagbob how on earth are you going to put those ideas over on the doostep, I dont know the answer but we need to keep it simple and straight forward.
i do agree however that with David Cameron ruling out just about everything it does not leave us with much scope.

Surveys are interesting, but they do not necessarily reflect the nation's views. Some may support the principle, but that does not mean they would vote for it in practice. The NHS is a very emotive issue, and Labour love defending it. Personally I liked the patient's passport idea which gave support to those who were willing to help themselves - a very Conservative idea [or used to be].

The NHS is an emotive issue & since we rejected the form in which it was set up - centralised, nationalisation of charitable independent hospitals, local authority hospitals - an issue where Labour has always been able to portray us as anti.

Cameron rejected one proposal - that we have a patients passport - but he specifically ruled in that we believe in a mix of public & private provision (see Built to Last).

So we need to start from what the objectives of any policies should be:

A national health service free at point of use - the basic premise that a health service should serve all UK residents across the UK and it should be free in terms of clinical treatment.

A world class health service - on key indicators such as cancer survival rates the UK is not up with the best. In infant mortality while UK is near the top we are still behind the best in Europe.

A patient centred health service - organised around patient needs. My GP practice was a one man practice and he made it a rule that he put patients first. If you needed a blood test the practice nurse would do it then and there or within a day. Now we have a new multi-doctor practice and the new GP contracts, blood tests need to be booked in advance & now it can be three weeks.

I'd add another one - less central government interference. The NHS has gone from the Tory re-organisation, through Labours first term changes, through consolidation into large hospitals and now a re-launch of local provision. The re-organisation of PCTs has wasted about £1.5bn - other re-organisations probably higher amounts.

There is no magic bullet that will solve the problems of such a large organisation - Patients passports, trust hospitals etc don't deal with the key issue which is the NHS is too large to manage and especially too large for central governments to direct.

So lets take this opportunity to build a policy that doesn't say there is one thing we can do but looks to a variety. Let's listen to doctors & nurses, to patients. We looked at Sweden, France, Germany, Australia etc.

We need to manage the costs of health provision but in 1980's that seemed to be the main purpose of our policies - lectures on what we could afford, how we could ration healthcare. We seemed to care more about tax cuts than improving the nations health. Some of us still seem to think the message should be Labour is spending too much rather than that Labour has failed to improve the services to acceptable levels, it's wasted billions through ill thought out targets, re-organisations and short tem planning.

So in our policy let's start by saying what we expect a world class health service to deliver, what we can do to support the professionals in achieving that, then how we will remove barriers, increase choice, reduce waste etc. Lets have a policy which starts from the premise that the NHS is something we want to make a success, that we might radically change how it does things but we believe in a publically funded, free at point of use service.

I keep getting told on here that voters are so attached to the NHS that they could never abide a different system. Well this poll appears to vindicate my position that that is simply not true. And remember, this poll is the opinion *before* people are presented with the evidence of how much better other systems of healthcare perform over our own.

Why has Cameron ruled out a European-style system again?? Is it *really* because he believes the NHS works best?

DC has ruled out very little - he dropped a policy and stated a direction that was politically sensible. We have too much baggage to offer in our our first term anything like introduction of a European system. But we can offer less central direction, letting hospitals / trusts make decisions based on clinical priorities and other small but effective changes.

We can simulaneously influence the direction of discussion both through the policy group and through other conservative think tanks/groups. But we need to have the Kings Fund for example supporting us, the BMA saying we have good ideas - because we need to win the trust of the people that the Tories are to be trusted with the NHS.

DC has ruled out very little

No, he and Letwin have ruled out a huge amount between them, including any remodelling of Health service financing and provision on continental lines.

Oliver Letwin's comments as Director of Policy have also ruled out any any radical thinking in these areas.

But we need to have the Kings Fund for example supporting us, the BMA saying we have good ideas

But if we're afraid to ever articulate any ideas beyond upping funding, that's never going to happen.

I am living abroad at the moment and I am paying private health Insurance. It is expensive.

Cameron should say very little about his plans for the health service.

Why give Labour and the media a stick to beat him with, he would never win the argument they would pull him to bits. But that does not stop him being radical on health if he is elected to form a government.

I think it would be better for him to make the case for change only when he is elected.

I do agree with Anna K. We should know by now what slippery efforts Nulab are. One category we absolutely HAVE to get rid of, and its those twits so wonderfully portrayed in Casualty. The idiot manager with his lighting up board and his stop watch. He does exist, (or she) costs the NHS a lot od wasted money, does no one any good at all, makes damn good doctors and nurses want to either retire early, or bop him/her on the head. What are they FOR for chrissake? I noticed the difference idiot managers made to Health visiting, when we started getting them. It was usually the ones that couldnt hack the front line work that applioed for, and got the management posts. Interviewed well, ghastly in operation, then of course, you couldnt get rid!!

Why not transfer the NHS, State Schools and LEA's to Private Companies Limited by Guarantee, require that they raise all their money by charging for services and have a Low Interest Loans System repayable at a certain proportion of the earnings of the patient\parents of the pupil\pupil if over school age.

>>>>have a Low Interest Loans System repayable at a certain proportion of the earnings of the patient\parents of the pupil\pupil if over school age.<<<<
that is for costs incurred up to a certain limit beyond which the loans would not cover, the patient\pupil if over school age or parents if the client was under school age would be responsible for repaying the loan.

It seems to me that it is the two women - Annabel Herriott and AnnaK that have made the most pertinent and 'down to earth' comments. 'Why give Labour aand the media a stick to beat him with, he would never win the argument they would pull him to pieces'. And Annabel's 'idiot managers', no matrons or ward sisters with bite, just posturing and probably overpaid managers.

Its far too early for definite policies to be aired even if there are some in the pipeline, they would only be 'nicked' if they seemed plausible or pulled to pieces.

There needs to be an acceptance that votes and winning the next election is the ONLY thing that motivates this government, EVERYTHING else is subservient to that. Every concession that is made, even bringing back some of the soldiers from Iraq, has that thought behind it, I think.

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