Labour Party Manifesto 2010 World-leading healthcare: a patient-centred NHS
The challenge for Britain
To build a better health service by protecting NHS spending and by shifting to more preventative and personal care, clear patient guarantees and greater care in the home. The Tories will not introduce the necessary reforms, would fail to guarantee access to services, usher in a care postcode lottery, and put the interests of patients second.
The next stage of national renewal
* Legally binding guarantees for patients including the right to cancer test results within one week of referral, and a maximum 18 weeks’ wait for treatment or the offer of going private.
* Preventative healthcare through routine check-ups for the over-40s and a major expansion of diagnostic testing.
* More personal care, with the right in law to choose from any provider who meets NHS standards of quality at NHS costs when booking a hospital appointment, one-to-one dedicated nursing for all cancer patients, and more care at home.
* The right to choose a GP in your area open at evenings and weekends, with more services available on the high-street, personal care plans and rights to individual budgets.
* Access to psychological therapy for those who need it.
The NHS embodies our values remain a universal health of fairness and social justice service, not a second-rate safety – for 60 years it has been the net. Only 15 years ago, the embodiment of what it means very existence of the NHS was to be British. We will always put in doubt. Now with sustained the NHS first. In an insecure investment and reform, the world, people need first-class NHS is delivering high-quality healthcare they can rely on. healthcare in safer and more Under Labour, the NHS will convenient ways.
But to safeguard the NHS in tougher fiscal times, we need sustained reform. To prosper in the future, the NHS will have to respond to the challenges facing healthcare systems across the developed world: new cures and breakthrough treatments, an ageing society, an increased number of people with long-term conditions, ever higher public expectations at the same time.
So we will be tougher in ensuring value for money, more determined in demanding the highest standards of care and in shifting rapidly to preventative care. Above all, the interests of the patient will come first.
No longer passive recipients of care, patients will be active partners with enforceable guarantees, real choice, and direct control over services.
These changes are essential to maintain the principle at the core of the NHS: of care provided on the basis of need, not ability to pay.
Protecting the NHS and investing in the front line
In 1997, health spending as a share of national income was the second lowest of all the major industrialised countries. The resulting failures were visible to all: long waits, outdated buildings, too few doctors and nurses.
Since then, investment and reform have turned around the public’s experience of the NHS. A generation of new hospitals has been built, entirely new services created, and long waits eliminated. We are undertaking fundamental changes to community services, tough decisions on pay, and a shift in care from the hospital to the community.
As we complete our once-in-a-generation programme of hospital building, we will refocus capital investment on primary and community services so that we rival the best healthcare systems in the world with our ability to identify disease early.
The reforms of recent years will allow us to do more than ever to release savings by cutting red tape and directing resources to where they matter most. We will scale down the NHS IT programme, saving hundreds of millions of pounds, and over the next four years, we will deliver up to £20 billion of efficiencies in the frontline NHS, ensuring that every pound is reinvested in frontline care.
Getting the most from NHS resources: sustained investment and reform
We will continue to press ahead with bold NHS reforms. All hospitals will become Foundation Trusts, with successful FTs given the support and incentives to take over those that are under performing. Failing hospitals will have their management replaced. Foundation Trusts will be given the freedom to expand their provision into primary and community care, and to increase their private services – where these are consistent with NHS values, and provided they generate surpluses that are invested directly into the NHS.
We will support an active role for the independent sector working alongside the NHS in the provision of care, particularly where they bring innovation – such as in end-of-life care and cancer services, and increase capacity. We will be uncompromising in expecting high standards from all NHS services – and in the coming period we will expect PCTs to challenge all services to achieve the highest quality.
Where changes are needed, we will be fair to NHS services and staff and give them a chance to improve, but where they fail to do so we will look to alternative provision.
Patient power will be increased.
Patients requiring elective care will have the right, in law, to choose from any provider who meets NHS standards of quality at NHS costs. And we will also increase year-on-year the payments made to hospitals linked to patient satisfaction and quality outcomes – up to ten per cent of payment.
Prevention and early intervention
The NHS must be as effective at preventing ill health as it is at treating those in need of care. Prevention and early intervention will be at the heart of our plans for a reformed healthcare system offering more for every pound we spend, significantly improving survival rates for cancer, heart disease and strokes so that we are among the very best in the world.
We all have a responsibility to look after our own health, supported by our family and our employer. The ban on smoking in public places will be maintained. Wherever necessary, we will act to protect children’s health from tobacco, alcohol and sunbeds.
GPs will be encouraged to keep their patients healthy through exercise and healthy eating advice. The ambitious Change 4 Life programme will support a more active, health-conscious country.
We will pioneer better mental health care and tackle the scourge of mental illness. Over the next Parliament more than 8,000 new therapists will ensure access to psychological therapy for all who need it as we seek to change our society’s attitudes to mental illness.
Empowering NHS staff and enabling Mutuals Central to our agenda for improvement is the hardworking NHS workforce. We will continue the process of empowering staff – freeing them from bureaucracy and ensuring they get proper support.
We will expand the role of NHS nurses, particularly in primary care, in line with the best clinical evidence. And across the NHS we will extend the right for staff, particularly nurses, to request to run their own services in the not-for-profit sector. To strengthen local accountability, we will increase the membership of Foundation Trusts to over three million by the end of the next Parliament.
The NHS will benefit from a period of organisational stability: we will make no top- down changes to the structure of Primary Care Trusts or Strategic Health Authorities during the next Parliament, and we will ensure stability in the hospital payment system.
Real guarantees and real choices for patients
People rightly want public services that are not just universal but also personal to their needs. We will expand patient choice, empowering patients with information, and giving individuals the right to determine the time and place of treatment. At the heart of this will be new legally binding guarantees enshrined in the NHS constitution:
• The waiting-time guarantee will ensure that treatment begins within 18 weeks of seeing your GP, or the NHS will find you to go private.
• The cancer guarantee will ensure that all patients see a cancer specialist within two weeks of GP referral and that all cancer tests will be completed and the results received within just one week – helping save tens of thousands of lives over the next ten years.
• The health-check guaranteewill ensure that everyone between 40 and 74 will be guaranteed routine health checks on the NHS, preventing up to 10,000 heart attacks and strokes each year.
• The GP access guarantee will ensure everyone has the right to choose a GP in their area offering evening and weekend opening.
A personal NHS
We will ensure the NHS suits the lives of busy families expanding further the availability of GP-led health centres open seven days a week ‘8 til 8′ in towns and cities. NHS organisations will offer telephone and online booking via the NHS Choices website. Online patient comments about the quality of any NHS service will inform people’s choices. A new national 111 telephone number will make non- emergency services far easier for people to access and book.
We will bring the NHS closer to people through a major expansion in care available at home, including chemotherapy and dialysis. More services will be available from GPs and through local pharmacists. Patients will have the right to register with a GP anywhere they choose, including near their place of work. Choice of when and where you are treated will be extended whenever patients are booking routine appointments.
We will offer more personal healthcare. All cancer patients will be offered one-to-one dedicated nursing for the duration of their care and we will work with Marie Curie Cancer Care and other providers to guarantee everyone who wants it the opportunity to receive palliative care in their own home at the end of their lives.
Everyone with a long-term condition, such as those with diabetes, will have the right to a care plan and an individual budget.
All women will have the right, wherever it is safe, to a home-birth, and every expectant mother will have a named midwife providing continuity of care. More mums and dads will be offered single rooms if they need to stay in hospital overnight, and post-natal care will be further expanded so that every area of the country has a Family Nurse Partnership, supporting families in greatest need.
With new rights to treatment come new responsibilities for patients: patients who fail to turn up for pre-booked appointments will not be guaranteed fast-track treatment.
The NHS Constitution will guarantee the legal rights of patients, wherever they live, to all treatments and drugs approved by NICE for use in the NHS. We will continue to improve the process of approving new drugs and treatments so that these can be made available to NHS patients more quickly. We will ensure all leading drugs available internationally are assessed by NICE and those which are deemed effective will be available within six months of referral.
We will establish a new National Care Service working in partnership with the NHS to transform the way care is provided to the elderly and disabled people.
Safety and cleanliness
We will ensure all hospitals are clean and safe for both patients and staff. More than 3,000 matrons across the NHS will have the power to manage wards, order deep cleaning, and report problems directly to hospital boards. Every patient who comes into an NHS hospital will be screened for MRSA.
We will establish national standards of infection control that get tougher every year and which every hospital and ward must meet. The safety regulator will have the power to close wards, impose fines or order cleaning wherever necessary.