Tories Pledge ‘Independent NHS’
The Tories have pledged to hand day-to-day control of the NHS in England to an independent board, part of efforts to make it more autonomous. Members would be chosen by the health secretary and would be accountable to ministers, the party says.
They would commission services while centralised targets, such as those on waiting lists, would be abolished. Health Secretary Patricia Hewitt has ruled out a similar plan, saying the NHS was too vast to be run by a board.
The proposals set out on Wednesday form the party’s first detailed and concrete policy pledge on public services. It is expected to be the first of several policy pledges announced over the next few weeks.
The Conservatives believe the NHS should have more autonomy but should also be made more accountable through strengthened health watchdogs and new patients’ groups. Board members would be appointed on the advice of an appointments commission, and would include financial, commissioning and clinical directors.
They would allocate funds to primary care trusts and oversee the commissioning of NHS services, in line with objectives agreed with the health secretary. And all government targets would be scrapped.
Shadow health secretary Andrew Lansley said: “Top-down targets – all they do is meet a need for political grandstanding and damage patient care. The NHS board which we propose will give a high degree of independence which represents patient and public interests.”
In the foreword to the document, the Tories pledge to end “pointless upheavals” and “increased bureaucracy”. And they say the plans will secure the “long term stability of our NHS” by giving NHS professionals more opportunity to exercise their judgment and expertise.
Under the proposals, GPs’ pay would be linked to the quality and success of treatments they provide. But Mr Lansley said there would be no change to the GP contract introduced in 2004, allowing them to opt-out of out-of-hours care. “That day has gone,” he said.
Other proposals include making the NHS more accountable, by creating more powerful patients’ watchdogs and requiring all primary care trusts to publish annual improvement plans. The Tories would also set up a new national organisation, Healthwatch, to represent patients and would enshrine 10 “core principles” of the NHS in legislation.
It is thought prime minister-in-waiting Gordon Brown had considered an independent board to run the NHS, but last week Health Secretary Patricia Hewitt appeared to rule that out.
On Wednesday, health minister Andy Burnham said an unelected board should not be made responsible for allocating £90bn of taxpayers’ money. And Labour chairwoman Hazel Blears, a deputy leadership contender, said: “The Tories’ plan to scrap waiting list targets eans only one thing: longer waits. This, at the very time when the public aspires to shorter waits, more say, and more personalised services from their NHS.”
She added: “Their proposals for an NHS board sounds like a return to the days of nationalised industries. You can’t run a £90bn-a-year enterprise like the NHS as though it were British Leyland.”
And for the Lib Dems, Norman Lamb said the board itself would represent more centralisation of power. “The Conservatives have spent a lot of time over the past year campaigning against reconfiguration of hospitals, closing hospitals down and so on,” he said.
“And yet under their model, these sorts of decisions would be taken by a remote, central quango and local people would have no say over the future of their cherished local hospitals.”
The NHS Confederation, which represents 90% of NHS organisations, welcomed the Tories’ commitment to a tax-funded NHS. Chief executive Dr Gill Morgan said she was pleased there was no ” violent change of direction or major reorganisation” as the NHS needed stability. She added: “The shift from a culture of targets to a focus on outcomes for patients is also a step in the right direction.”
The British Medical Association welcomed the proposals for an independent NHS board. But it said GPs’ pay was already linked to the success of treatments and it would need to be persuaded of the need to extend it further.