The Conservative Party's Health policies Breakfast Seminar

The second Care Conversation event of 2010 heard from Shadow Secretary of State for Health, Andrew Lansley MP

Health was top of everyone’s agenda, Andrew Lansley told delegates – it was the public’s number one priority. ‘We need to give people reassurance about the quality of healthcare provided for them,’ he said.

The Conservatives had recently published their public health green paper, A healthier nation, which spelled out the party’s commitment to prevention. ‘If we don’t deliver an improved public health infrastructure focused on results there will be ever-increasing demands on our health and social services,’ he said. There were major opportunities for prevention but public health budgets had consistently been raided for the acute sector – a Conservative government would not do that, he pledged, and would hold primary care trusts and local authorities to account on public health delivery.

The Conservatives were committed to the values of the NHS as the ‘bedrock of a fair society’, he stressed – universal access to healthcare based on need rather than ability to pay. The NHS had received, in real terms, a 4.2 per cent budget increase year-on-year over its lifetime, but a radical culture change was needed to achieve improvements in quality. ‘The question is not whether the NHS requires reform, but how that reform is delivered,’ he said, in the light of issues such as the exponential rise in the number of managers with a failure to deliver results.

Tony Blair had promised reform in 2006, he said, but ministers had ‘lost their nerve’, failing to deliver on any of the key points. Practice-based commissioning had now been likened to ‘a corpse not suitable for resuscitation’, the principle of Foundation Trusts had been blocked and Health Secretary Andy Burnham had effectively ‘turned his back on the independent sector’ in terms of driving quality through competition. Regarding patient choice, meanwhile, the option to choose hospitals for outpatient care was in reality available to fewer than half the population. ‘Reform is not being realised,’ he said.

Reform needed to consistent and coherent, he stressed. ‘Part of the problem has been the incoherence of the process.’ Labour’s system was top-down and target-driven, he said. ‘People in Germany don’t have targets in order to have no waiting lists. They have capacity, and they have choice.’ The reform process needed to be about decentralisation, transparency and accountability, and to be patient-driven, with a shift from Trusts focusing on targets to focusing on patients.

Patients needed someone who could combine decisions about clinical management with decisions about patient care, he said. GPs were best placed to do this, and under a Conservative government, GPs would have access to commissioning budgets as a consortium. ‘It’s a vision of commissioning that’s about maximum quality care, not just supply and demand. The performance we’re looking for includes qualitative results in terms of patient outcomes and experience.’

It was also essential to have a level playing field among providers, with a purchaser/provider split, he said, and patients needed to be supported with more information. ‘At every level of the NHS and social care our goal will be to organise care around the needs of patients,’ he said – this meant local delivery as well as prevention, personalisation, partnership and protection.

‘The NHS is a very big organisation where power has gravitated towards the centre,’ he told the conference. ‘It behaves like a nationalised industry – there’s no incentive for innovation. So it’s about shifting power outwards and disempowering the centre. In three or four years’ time I hope people will have stopped focusing on what the Secretary of State thinks about the NHS and instead the focus is on what patients think. The NHS must be about treatment and results and it needs to listen to patients to make that happen.’