Tories say they will scrap all NHS targets

Tuesday, June 24, 2008

The Tories have said they want to scrap all NHS targets. Leader David Cameron announced that if in power his party would abandon Labour’s ‘top-down’ approach to NHS targets and focus on major diseases such as cancer and stroke instead.

Launching a Green Paper which claims to set out how a Conservative government would create a health service that is "truly the envy of the world", Cameron said he wanted to improve healthcare outcomes such as cancer survival rates, after-care service and patient satisfaction by scrapping Labour's "bureaucratic process targets" and replacing them with outcome measures.

Cameron said it was time to concentrate "not on what politicians care about, but on those things that people really care about", adding: "No more pointless re-organisations – just building and improving. No more top-down process targets – but an information revolution to measure outcomes. No more talking about patient power – but actually giving it to them, through greater accountability."

In a speech to the Royal College of Surgeons, the Tory leader reminded people that he wanted to be "as radical in social reform as Margaret Thatcher was in economic reform" and his priority is health.

He said: "We won't get there through yet another massive structural reorganisation. The past decade has witnessed a series of restless changes which, to the NHS itself, have felt like a series of frontal assaults, the latest of which is a national network of polyclinics imposed on local communities – and GPs – that don't want them. Instead, we'll offer steady, purposeful change with a clear direction. So we will build on and improve the NHS we inherit. Foundation hospitals won't go, they'll stay, and we'll improve them. Commissioning by GPs is right and we'll make it really mean something. Not Labour's phoney and imaginary budget-holding, but actually giving GPs real control over their budgets so they can re-invest savings and negotiate contracts with service providers to get best deal for their patients."

Cameron said the Tories would look to improve five-year cancer survival in excess of the EU average by 2015 while premature death from stroke and heart disease would be brought below the EU average by 2015 and for lung disease by 2020. He added that achieving average European standards in various disease areas could save 38,000 lives while performing at the highest levels could save 100,000 lives.

Then Cameron went for the government’s targets.

"What this Green Paper is all about is how we can improve our health outcomes by ushering in a new era of patient-doctor accountability through an information revolution. If the last ten years has taught us anything, it's that Labour has tested to destruction the idea that the NHS can be improved by more bureaucracy, more central control and more initiatives from the Department of Health. This approach is embodied no better than in the endless top-down process targets they impose on doctors and hospitals. 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. So we get the perverse situation where patients are kept in ambulances or in trolley waiting areas just so hospitals can say they've meet the centrally-directed four-hour A&E waiting time limit.

"This is crazy. 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. But don't for one minute believe the Labour lie that we're giving up on quality, that we're going to leave a vacuum of accountability.

"We've got a new approach. In fact, it's an approach so obvious and so simple you'll be astonished it doesn't already happen. In place of Labour's self-defeating top-down targets, 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."

Health minister Ann Keen responded: "David Cameron will tell anyone in the NHS what he thinks they want to hear, whether it is patients, GPs or NHS staff. Having opposed extra investment in the NHS, the Tories are now opposing reform that is helping to improve patient care. The Tories are proposing an end to longer GP opening hours, scrapping guarantees that have shortened waiting times and cuts on a scale that would put NHS investment at risk."