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ss nucleus - Easter 2010,  proposed health reforms of the UK's 3 main political parties

proposed health reforms of the UK's 3 main political parties

With the UK's next general election fast approaching, the future of the NHS is being fiercely debated at every level. But what are Labour, the Conservatives and the Liberal Democrats actually proposing?

the main themes

The unifying ideal throughout the proposals seems to be a patient-led NHS with all three parties putting a great deal of emphasis on patient preference and the 'right to choose'. In addition, the recent buzz around the issue of health inequalities has resulted in every party paying a great deal of attention to the topic. Other common themes include the Liberal Democrats' (LibDems) and Conservatives' (Tories) proposals to revive NHS dentistry and reform the NHS dentists' contract in order to do so. They also plan to scrap central Government targets. Abolishing all mixed-sex wards is on the agenda for both the Tories and Labour. In no particular order, here is some more detail:

the Conservative Party

The Tories plan to give patients more control through patient-held records, in the hope that patients would be able to make more informed choices about their care. Payment-by-results would be implemented in GP surgeries as well as hospitals. An 'information revolution' would aid transparency of the system: the online publishing of detailed information on the performance of all areas of the NHS and its staff would ensure that the NHS is accountable to its patients.

An independent NHS board would be charged with allocating resources fairly across the country. The focus on tackling health inequalities continues with a Health Premium, ensuring extra resources for the poorest areas with the worst outcomes. The renaming of the Department of Health into the Department of Public Health hopes to bring a new focus onto disease prevention. Palliative care services would be boosted by per-patient funding, as opposed to a general budget, and a £10 million per year budget for children's hospices after 2011. The introduction of a one-off £8,000 payment, as an Insurance Premium, for people entering retirement will allow them to fund potential future residential care without being forced to sell their homes.

the Liberal Democrats

The LibDems propose to abolish the Strategic Health Authorities and create Local Health Boards run by elected local people, thus enabling local people to have some control over their local services (eg save hospitals which are threatened with closure). The introduction of a Patient Contract, which would explain in detail the services and treatments that a person is entitled to, as well as explaining their rights with regards to access to medical records, would be expected to guarantee high standards. Patients with chronic conditions would be given a Personal Care Plan explaining how, where and when they will be treated and any extra support they will receive (eg social care), the idea being that informed patients can then make more decisions about the management of their condition.

A Universal Care Payment would be made to those over 65 who need help with caring for themselves. This would be allocated based on needs rather than ability to pay, with the aim of ensuring a minimum standard of care country-wide. To control the 'superbug' infection threat, a zero-tolerance stance would be enforced in all areas and patients given compensation if they suffer as a result of negligence in relation to 'superbugs'.

To improve access to GPs, patients would be allowed to register at more than one GP practice. A Warm Homes Package would be rolled out to help increase energy efficiency of homes and a Winter Fuel Payment of £250 would be given to disabled people, similar to that which pensioners currently receive.

the Labour Party

Like the other parties, Labour are planning to offer patients guarantees on aspects of treatment, such as waiting lists, but Labour intend to make these guarantees legally enforceable. There are plans to create a National Care Service to look after the most at-need in society and the offer of free, home personal care for those with greatest need.

The creation of at least 100 GP-led centres in the poorest areas is aimed at addressing widening health inequalities. The recently published NHS constitution informs both staff and patients what they can expect from the NHS. There is £100million directed to increase privacy and dignity in the NHS, with the abolition of mixed sex wards being a high priority and financial penalties enforced for hospitals that fail to work towards this.

New vascular checks and extended ages for screening breast and bowel cancer are planned to address public health needs. More psychological therapists will be employed to help treat mental illness.

(BMJ 2010;340:c684 (10 February),,,

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