Patients to get more choice in health shake-up

Conservative Health Secretary Andrew Lansley yesterday unveiled the most radical package of NHS reforms seen in decades, promising to "put patients right at the heart of decisions about their care, and clinicians in the driving seat on decisions about services".

Announcing his health White Paper in the House of Commons, Mr Lansley confirmed plans to cut out swathes of NHS management and give 80 per cent of the organisation's 100bn budget to family doctors, who will work together in consortia to commission local services.

Mr Lansley pledged to slash management costs almost by half over the next four years, freeing some 20bn for front-line services. At least a third of the NHS's numerous quangos would be scrapped, he said, with the White Paper warning of "significant" job losses.

Labour's system of top-down targets, such as those relating to A&E waiting times, will also be abolished, while hospital and mental healthcare trusts will be freed from the state sector to become not-for-profit companies, with more control over their own budgets and work practices.

Health ministers and Whitehall will also be given a reduced role over running the NHS, with a new NHS Commissioning Board established to oversee standards and local councils given responsibility for public health.

Labour condemned the proposals as "a huge risk", saying more than a decade of progress in the NHS would be "thrown up into the air" by removing experienced managers. And Shadow Ministers and unions warned the shake-up would lead to a significant privatisation of the NHS, with the new GP commissioning bodies free to buy in private services.

But the White Paper confirmed previous Conservative pledges that overall spending on health would be protected and that the NHS would remain "a comprehensive service for all, free at the point of use".

Mr Lansley said: "The sick must not pay for the debt crisis left by the previous administration.

"But the NHS is a priority for reform too. Investment has not been matched by reform. So we will reform the NHS to use those resources more effectively for the benefit of patients."

He told MPs that increased patient choice over how and where they receive their treatment would improve both satisfaction and outcomes.

"We will introduce more say for patients at every stage of their care, extending the right to choose far beyond a choice of hospital. Patients will have choice over treatment options, where clinically appropriate, and the consultant-led team by whom they are treated. And they will have much greater access to information – including the power to control their patient record."

Doctors and other healthcare professionals cautiously welcomed the proposals last night, though health charities voiced concerns that GPs had little

experience in commissioning services.

Nigel Edwards, acting chief executive of the NHS Confederation – which represents over 95 per cent of NHS organisations – said the changes would mean a huge upheaval.

"It is hard to stress just how radical this is," he said. "The NHS will look much more like the gas, electricity or telecoms market than it will the monolithic state bureaucracy we have come to understand."

MAIN POINTS

Patients get more control over treatment

GPs handed 80bn to spend on local services

A third of NHS quangos scrapped

"Significant" job losses as management costs halved

Labour's top-down targets dropped