Conservative's Cameron would hand power to GPs
Many centralist targets for the National Health Service would be scrapped under a Conservative government as more purchasing power was handed to family doctors, David Cameron, the Tory leader, said yesterday. The policy would encompass a full-blooded return to GP fundholding - the practice of giving family doctors budgets to buy care on behalf of their patients, which Labour abolished but is now partially reinstating through practice based commissioning.
But as yet few doctors have the real budgets that fundholding and some of its more ambitious subsequent developments provided.
Despite the growth in practice-based commissioning, primary care trusts still do most of the contracting with hospitals and otherproviders.
The Conservatives appear keen to focus less on numerical targets and more on measuring whether patients' health improves. Mr Cameron and Andrew Lansley, the shadow health secretary, acknowledge that they need to discuss with doctors how that might be achieved.
It is a subtler position than the one the party adopted before the last election, when they simply trumpeted their determination to scrap all targets.
The problem they face is that while too many targets, or poorly chosen ones, can distort patient care and lead to "cheating" over figures, targets do deliver results.
That was starkly illustrated a little over a year ago when the NHS in England achieved the aim of no patient waiting more than six months for an operation - although there were still more than 900 patients waiting at English hospitals for treatment because they had been referred from Scotland and Wales. Neither country had such a target and the hospitals thus faced no obligation to treat them within six months.
Mr Lansley said the aim was "to use measures of health outcome which reflect the quality of service provided from start to finish of care".
The British Medical Association said it would welcome the change if the targets were evidence-based, while the NHS Confederation said it was "an important step in the right direction". The service needed to measure not just how many things it did but whether patients actually got better as the result of treatment.
From:
http://www.ft.com/cms/s/2929bf84-aa87-11db-83b0-0000779e2340.html
Health Direct has frequently raised the issue of waste that labour's blizzard of targets has created for the NHS. On Dec 18 06 in Labour's mismanagement has led to NHS deficits according to Commons Health Select Commitee Mismanagement at all levels of the NHS in England has led to the current multimillion pound deficit, a committee of MPs has found. The Commons health select committee said existing deficits were made worse by the cost of new staff pay deals and the expense of meeting NHS targets. Last year's NHS deficit was £547m.
The committee said historic deficits, long hidden, were revealed when the government changed the rules so trusts could not underspend their capital budget to subsidise current spending.
But it said the government fuelled the problem by agreeing to new pay deals for doctors and nurses using estimates of the cost which were "hopelessly unrealistic".
In addition, meeting national targets such as the requirement that no patient should wait more than four hours in A&E had been costly.
Changing targets at short notice also placed unnecessary financial costs on trusts, the report said.
It attacked short-term measures being used by the government to address deficits.
And it said raiding staff training budgets was "unacceptable", and warned such cuts were affecting staff morale and could damage the quality of the workforce.
http://www.healthdirect.co.uk/2006/12/labours-mismanagement-has-led-to-nhs.html
But as yet few doctors have the real budgets that fundholding and some of its more ambitious subsequent developments provided.
Despite the growth in practice-based commissioning, primary care trusts still do most of the contracting with hospitals and otherproviders.
The Conservatives appear keen to focus less on numerical targets and more on measuring whether patients' health improves. Mr Cameron and Andrew Lansley, the shadow health secretary, acknowledge that they need to discuss with doctors how that might be achieved.
It is a subtler position than the one the party adopted before the last election, when they simply trumpeted their determination to scrap all targets.
The problem they face is that while too many targets, or poorly chosen ones, can distort patient care and lead to "cheating" over figures, targets do deliver results.
That was starkly illustrated a little over a year ago when the NHS in England achieved the aim of no patient waiting more than six months for an operation - although there were still more than 900 patients waiting at English hospitals for treatment because they had been referred from Scotland and Wales. Neither country had such a target and the hospitals thus faced no obligation to treat them within six months.
Mr Lansley said the aim was "to use measures of health outcome which reflect the quality of service provided from start to finish of care".
The British Medical Association said it would welcome the change if the targets were evidence-based, while the NHS Confederation said it was "an important step in the right direction". The service needed to measure not just how many things it did but whether patients actually got better as the result of treatment.
From:
http://www.ft.com/cms/s/2929bf84-aa87-11db-83b0-0000779e2340.html
Health Direct has frequently raised the issue of waste that labour's blizzard of targets has created for the NHS. On Dec 18 06 in Labour's mismanagement has led to NHS deficits according to Commons Health Select Commitee Mismanagement at all levels of the NHS in England has led to the current multimillion pound deficit, a committee of MPs has found. The Commons health select committee said existing deficits were made worse by the cost of new staff pay deals and the expense of meeting NHS targets. Last year's NHS deficit was £547m.
The committee said historic deficits, long hidden, were revealed when the government changed the rules so trusts could not underspend their capital budget to subsidise current spending.
But it said the government fuelled the problem by agreeing to new pay deals for doctors and nurses using estimates of the cost which were "hopelessly unrealistic".
In addition, meeting national targets such as the requirement that no patient should wait more than four hours in A&E had been costly.
Changing targets at short notice also placed unnecessary financial costs on trusts, the report said.
It attacked short-term measures being used by the government to address deficits.
And it said raiding staff training budgets was "unacceptable", and warned such cuts were affecting staff morale and could damage the quality of the workforce.
http://www.healthdirect.co.uk/2006/12/labours-mismanagement-has-led-to-nhs.html
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