UK parties set out their health stalls in lead-up to next election
http://www.100md.com
《英国医生杂志》
Labour and the Conservatives last week proclaimed "patient choice" as the focus of their plans for the future of the health service, prior to the next general election, due to take place by June 2006 at the latest.
The Labour government announced that from the end of 2005 patients will have the right to choose from at least four or five different healthcare providers. By 2008 patients will be allowed to choose from any provider, as long as it meets NHS standards and pricing levels.
Meanwhile the Conservative opposition offered unrestricted and immediate choice at any NHS or private hospital—but at NHS prices. Their plans include the controversial measure of allowing patients to put 50% of the cost of NHS treatment towards buying private care.
The health secretary, John Reid, outlined the government's five year NHS improvement plan in the House of Commons. It will update the NHS plan, a 10 year strategy produced in 2000.
He claimed that significant improvements had been made since 1997, with increased capacity, including 19000 more doctors, and faster service access, with maximum waiting times down to nine months.
Mr Reid said the government would now build on these improvements, offering "an even greater degree of power, information, control, and choice to patients than ever before."
The Conservative Party promoted its health plan in the national press last week
A key pledge in the plan is to cut the waiting time from GP's referral to hospital treatment, including surgery, to a maximum of 18 weeks, which Mr Reid said "should ensure an average wait of around 9-10 weeks."
The document claims that by 2008 patients will no longer be focused on waiting times, stating that "with much shorter waiting times for treatment, `how soon?' will cease to be a major issue. `How?' `where?' and `how good? will become increasingly important to patients."
With the focus away from waiting times, the plan predicts that the NHS will be able to concentrate on chronic illness. Community matrons will be provided to improve and personalise care to patients with long term medical conditions.
Mr Reid said he intended to place an increasing emphasis on prevention rather than cure. A public health white paper, due out in the autumn, will set out plans to address the major causes of ill health, such as obesity and smoking.
Launching the opposition's plans for the health service, the Conservative leader, Michael Howard, said a new approach was needed. He said, "Labour's approach has been tried and it has failed. Labour has spent without reform."
Labour and Conservative health plans
Labour Party
Patients able to choose from four or five hospitals by 2006
Unlimited choice of NHS provider by 2008 and choice of private providers who meet the NHS tariff
15% of operations and tests to be carried out in the private sector by 2008
Waiting times to be cut to a maximum of 18 weeks by 2008
Maximum wait of eight weeks for referral to treatment for cancer patients by 2005
More support for patients with chronic conditions
Every primary care trust to offer community matrons by 2008
Electronic booking and prescribing by 2005
Fewer national targets
Primary care trusts to control 80% of NHS budget
Conservative Party
Patients can choose treatment at any hospital, including private providers that match NHS tariff
State subsidy of 50% of NHS cost to be used for private care
Abolish all central targets, allowing trusts to set their own
All hospitals to be given foundation status, with increased borrowing and employment freedoms
NICE clinical guidelines for chronic diseases
Care plans to be agreed with patients with long term conditions
"Right to supply" rights for private providers
The Conservative plan, Right to Choose, would, he said, transform the NHS. It offers patients unrestricted choice for treatment, including at independent hospitals at the standard NHS tariff. In a "patient passport" arrangement any patient who chooses to use a more expensive provider will be able to put half the NHS tariff towards the cost, with the aim of freeing capacity for other patients. Independent providers will be given the "right to supply," entitling them to treat NHS patients if they meet health service tariffs and standards.
All hospitals would be awarded foundation status and given greater flexibility and control over employment policies as well as over borrowing and investment, he said.
Central target setting, including waiting times, will be abolished, permitting doctors and managers to set their own local priorities. The star rating system for hospitals will be scrapped.
The Conservatives will extend choice to patients with chronic conditions, who will be given control over how their conditions are managed. Clinical guidelines for these conditions would be developed by the National Institute for Clinical Excellence. Care plans will be agreed with individual patients, and tariffs will be attached to certain elements, allowing patients to purchase care directly from the provider of their choice.
Mr James Johnson, chairman of the BMA, expressed concern about the emphasis on patients' choice in the plans of both political parties. He said: `The BMA is in favour of patients having choices but recognises that exercising choice has consequences. One person's choice impacts on another patient's ability to choose and on the various providers of services.
"Choice implies spare capacity, and we are still woefully short of the doctors, nurses, and health professionals we need to run a high quality, 21st century health service."
The independent health think tank the King's Fund welcomed the government's five year plan and its emphasis on tackling chronic diseases. The fund saw the 18 week target for operations as a "massive but welcome" challenge.
But it queried the scrapping of targets, seeing them as "importatnt benchmarks for the health service." It said the plan to subsidise private treatment with NHS funds was "not a good use of public funds," but was more positive about the plans for foundation hospitals and the freedom to allow them to borrow on the open market.(Kathryn Godfrey)
The Labour government announced that from the end of 2005 patients will have the right to choose from at least four or five different healthcare providers. By 2008 patients will be allowed to choose from any provider, as long as it meets NHS standards and pricing levels.
Meanwhile the Conservative opposition offered unrestricted and immediate choice at any NHS or private hospital—but at NHS prices. Their plans include the controversial measure of allowing patients to put 50% of the cost of NHS treatment towards buying private care.
The health secretary, John Reid, outlined the government's five year NHS improvement plan in the House of Commons. It will update the NHS plan, a 10 year strategy produced in 2000.
He claimed that significant improvements had been made since 1997, with increased capacity, including 19000 more doctors, and faster service access, with maximum waiting times down to nine months.
Mr Reid said the government would now build on these improvements, offering "an even greater degree of power, information, control, and choice to patients than ever before."
The Conservative Party promoted its health plan in the national press last week
A key pledge in the plan is to cut the waiting time from GP's referral to hospital treatment, including surgery, to a maximum of 18 weeks, which Mr Reid said "should ensure an average wait of around 9-10 weeks."
The document claims that by 2008 patients will no longer be focused on waiting times, stating that "with much shorter waiting times for treatment, `how soon?' will cease to be a major issue. `How?' `where?' and `how good? will become increasingly important to patients."
With the focus away from waiting times, the plan predicts that the NHS will be able to concentrate on chronic illness. Community matrons will be provided to improve and personalise care to patients with long term medical conditions.
Mr Reid said he intended to place an increasing emphasis on prevention rather than cure. A public health white paper, due out in the autumn, will set out plans to address the major causes of ill health, such as obesity and smoking.
Launching the opposition's plans for the health service, the Conservative leader, Michael Howard, said a new approach was needed. He said, "Labour's approach has been tried and it has failed. Labour has spent without reform."
Labour and Conservative health plans
Labour Party
Patients able to choose from four or five hospitals by 2006
Unlimited choice of NHS provider by 2008 and choice of private providers who meet the NHS tariff
15% of operations and tests to be carried out in the private sector by 2008
Waiting times to be cut to a maximum of 18 weeks by 2008
Maximum wait of eight weeks for referral to treatment for cancer patients by 2005
More support for patients with chronic conditions
Every primary care trust to offer community matrons by 2008
Electronic booking and prescribing by 2005
Fewer national targets
Primary care trusts to control 80% of NHS budget
Conservative Party
Patients can choose treatment at any hospital, including private providers that match NHS tariff
State subsidy of 50% of NHS cost to be used for private care
Abolish all central targets, allowing trusts to set their own
All hospitals to be given foundation status, with increased borrowing and employment freedoms
NICE clinical guidelines for chronic diseases
Care plans to be agreed with patients with long term conditions
"Right to supply" rights for private providers
The Conservative plan, Right to Choose, would, he said, transform the NHS. It offers patients unrestricted choice for treatment, including at independent hospitals at the standard NHS tariff. In a "patient passport" arrangement any patient who chooses to use a more expensive provider will be able to put half the NHS tariff towards the cost, with the aim of freeing capacity for other patients. Independent providers will be given the "right to supply," entitling them to treat NHS patients if they meet health service tariffs and standards.
All hospitals would be awarded foundation status and given greater flexibility and control over employment policies as well as over borrowing and investment, he said.
Central target setting, including waiting times, will be abolished, permitting doctors and managers to set their own local priorities. The star rating system for hospitals will be scrapped.
The Conservatives will extend choice to patients with chronic conditions, who will be given control over how their conditions are managed. Clinical guidelines for these conditions would be developed by the National Institute for Clinical Excellence. Care plans will be agreed with individual patients, and tariffs will be attached to certain elements, allowing patients to purchase care directly from the provider of their choice.
Mr James Johnson, chairman of the BMA, expressed concern about the emphasis on patients' choice in the plans of both political parties. He said: `The BMA is in favour of patients having choices but recognises that exercising choice has consequences. One person's choice impacts on another patient's ability to choose and on the various providers of services.
"Choice implies spare capacity, and we are still woefully short of the doctors, nurses, and health professionals we need to run a high quality, 21st century health service."
The independent health think tank the King's Fund welcomed the government's five year plan and its emphasis on tackling chronic diseases. The fund saw the 18 week target for operations as a "massive but welcome" challenge.
But it queried the scrapping of targets, seeing them as "importatnt benchmarks for the health service." It said the plan to subsidise private treatment with NHS funds was "not a good use of public funds," but was more positive about the plans for foundation hospitals and the freedom to allow them to borrow on the open market.(Kathryn Godfrey)