Cameron pledges to replace NHS process targets with an outcome-led approach

David Cameron and Andrew Lansley have been at the Royal College of Surgeons this lunchtime to launch their Green Paper on health. Click here to download the pdf. These are the six main points that Cameron made:

European levels of spending, but not European levels of healthcare: "Tony Blair sat on Sir David Frost’s sofa and committed the Labour government to matching European levels of health spending. Today, that pledge has been delivered. But despite all this extra money – all that extra spending - we still have some of the worst health outcomes in the whole of Europe... If we improve the NHS so it meets the international average, we could save an extra 38,000 lives a year. If we improve the NHS so our results are comparable to the best countries in the world, we could save over 100,000 lives a year."

Building on existing reforms: “Foundation hospitals won't go, they'll stay - and we'll improve them. Commissioning by GPs is right - we'll make it really mean something... actually giving GPs real control over their budgets... Patient choice is essential and we'll make it actually work - we’ll let patients choose any provider that meets NHS standards at delivers at NHS costs."

Scrapping top-down process targets: "Superficially, some of these targets may look sensible. After all, no one wants to wait a long time to be seen in A&E. But because they push healthcare professionals to make decisions purely to ‘tick boxes’ rather than because they’re beneficial to the health of their patient, too often the result is worse patient care and a worse health outcome... Labour’s targets are all about chasing good headlines – and nothing to do with the clinical needs and the health of patients. So yes, to make sure our health outcomes are among the best in Europe, a Conservative Government will scrap all centrally-imposed process targets."

Measuring long-term outcomes: "We will harness the power of information and publish the details of healthcare outcomes. So we'll measure cancer survival rates, instead of recording the number of radiotherapy courses delivered per month in a particular oncology unit. We'll measure how well patients are after treatment, instead of timing how long someone’s in an A&E bed. And we'll measure how many people lead active lives whilst suffering from chronic lung disease, instead of recording how many records GPs have updated into information systems."

Information revolution: "This is about concentrating not the 'how', but the 'what' about concentrating not on what politicians care about, but on those things that people really care about... No more five-minute chats in your GP’s surgery picking a hospital based on its waiting times and availability. But the power – the ability – to really compare and contrast different care providers on the things that really matter to you and are easily understandable – survival rates, after care service, patient satisfaction."

Healthy competition on outcomes: "Care providers can actually focus on innovative approaches to getting the right outcomes for their patients and giving real value for money to the taxpayer... It goes without saying that by making outcome information readily available, we will introduce an element of healthy competition between different care providers. They’ll be able to see what works and what doesn’t – what different practices are doing to achieve result and how they can learn from them."

Comments

[Patient Passport Fan]

Janet Daley:

"Mr Cameron and his health spokesman Andrew Lansley have clearly decided that the NHS producer interest is not to be threatened. So they will remove the more fatuous Labour targets and replace them with ones that medical staff may prefer. They will give in to the BMA lobby by undermining any move toward polyclinics (which might have revolutionised access to primary care in Britain's cities). And most important, they will fail to provide any real mechanisms for patient power. In other words, they will effectively rule out genuine healthcare reform."

[J Hutchings]

Bearing in mind that there are now four separate NHS's and that the NHS's for Wales Northern Ireland and Scotland are under the direction and control of their respective country's representative parliaments and assemblies

( although they are happy to take English money to fund their NHS's at a level far better than the British government allows England )

presumeably Mr Cameron is referring to the English NHS , a point which he skirts around " If we improve the NHS ---"
a point which nearly all the British media and political class are still skirting around - 10 years after the Scotland Act 1998- which brought an abrupt end to the previous unitary British state and the British NHS.

In future years historians will marvel at the wondrous capacity for self deception of the political class and the media.
The people are not so stupid. They know something has changed profoundly. They need leadership and clarity. This deliberate dodging the isuue does not do it.

And thats the Royal College of Surgeons of England, by the way.

[Jake]

Bearing in mind that there are now four separate NHS's and that the NHS's for Wales Northern Ireland and Scotland are under the direction and control of their respective country's representative parliaments and assemblies

( although they are happy to take English money to fund their NHS's at a level far better than the British government allows England )

presumeably Mr Cameron is referring to the English NHS , a point which he skirts around " If we improve the NHS ---"
a point which nearly all the British media and political class are still skirting around - 10 years after the Scotland Act 1998- which brought an abrupt end to the previous unitary British state and the British NHS.

In future years historians will marvel at the wondrous capacity for self deception of the political class and the media.
The people are not so stupid. They know something has changed profoundly. They need leadership and clarity. This deliberate dodging the isuue does not do it.

And thats the Royal College of Surgeons of England, by the way.

[BrianSJ]

Patient choice is essential and we'll make it actually work - we’ll let patients choose any provider that meets NHS standards at delivers at NHS costs."
or delivers at higher cost if the patient pays the difference? or the GP pays the difference on preventative cost-avoidance grounds?
Meeting NHS standards...hmmm

Why don't they read John Seddon, and the evaluation research literature, and come up with something better than outcome measures?

[Old Hack]

Many patients would enjoy better outcomes if the NHS accomodated copayment towards treatments, particularly cancer.

With Darzi steaming down the track at us and the rationing of healthcare becoming more prevalent the Conservatives are going to have to do better than just tweak outcomes.

The sooner we grasp this nettle and start to think practically about this rather than cleaving to the socialist dogma that hamstrings healthcare in the UK, the better.

[John F in Aberdeen]

What needs to be tackled is the national insurance payment.

Since the age of 15 when I went to work I have had to pay this every week. It was supposed to take care of my Health needs, unemployment benefits and pensions.
I,m now 57 and today I can see what a big con that was, and still is, with for example people having to pay for hip replacements, old people having to sell their homes to pay for care etc.

I agree with a form of compulsion to pay for health care and pensions but people should be given a choice,, a government one like Nat Insurance, or private schemes.

Now lets suppose a person chose a private healthcare scheme like BUPA instead of Nat Insurance, then the way is open for not only your health needs to be met in the UK but you would have the ability to go to a BUPA hospital overseas. People are doing this at present however not only do they have to pay for this, their Nat Insurance payments are subsidising others.

Last year I needed a lots of dental work, I couldn,t find any NHS or private dentists in Aberdeen, so I went to Pattaya in Thailand ( I was going on vacation anyway) and got all my teeth removed plus a full set of new dentures fitted and the cost,, 120 pounds,,, around 700 pounds cheaper than the UK plus the dentists standards in Pattaya were first class and very attentive.

Conservatives should be the party that supports choice thus giving people the choice between relying on the state or making their own provisions and taking advantage of the global market in healthcare for their individual needs.

[Hardcore Conservative]

How are they going to “measure” outcomes?

You will probably need to keep the army of bureaucrats and pen pushers.

As for “polyclinics” there are some advantages to these centres IF they offer a one stop shop of seamless healthcare and are readily accessible around the clock, the reality, however, is that no one really explained where we are going to get the staff from to run these places.

[David Sergeant]

Cameron's comments on the NHS are particularly prone to people making very robust observations that rarely seem to relate to what Cameron actually said.

To-day is a good example.

[johnC]

I have just received my online NHS birthday card from CCHQ. Why are we expected to celebrate this monument to socialist waste and inefficiency ? When is the party going to admit that the NHS is the problem, not the solution, and no amount of tinkering around the edges is ever going to make it work ?