Coalition Health Policy 2010
Summary of the coalition government’s future health policy focus. These points which seem to bear most directly on health are gathered together from various parts of the document. The words have not been changed, but the points are not always in the same context as in the original. For criticism and comment on these proposals go here.
Analysis of Conservative health policy and Liberal Democrat health policy before the election
Health and Social Services
For example, when you take Conservative plans to strengthen families and encourage social responsibility, and add to them the Liberal Democrat passion for protecting our civil liberties and stopping the relentless incursion of the state into the lives of individuals, you create a Big Society matched by big citizens. This offers the potential to completely recast
The Government believes that the NHS is an important expression of our national values. We are committed to an NHS that is free at the point of use and available to everyone based on need, not the ability to pay. We want to free NHS staff from political micromanagement, increase democratic participation in the NHS and make the NHS more accountable to the patients that it serves. That way we will drive up standards, support professional responsibility, deliver better value for money and create a healthier nation.
- We will guarantee that health spending increases in real terms in each year of the Parliament, while recognising the impact this decision will have on other departments.
- We will stop the top-down reorganisations of the NHS that have got in the way of patient care. We are committed to reducing duplication and the resources spent on administration, and diverting these resources back to front-line care.
- We will significantly cut the number of health quangos.
- We will cut the cost of NHS administration by a third and transfer resources to support doctors and nurses on the front line.
- We will stop the centrally dictated closure of A&E and maternity wards, so that people have better access to local services.
- We will strengthen the power of GPs as patients’ expert guides through the health system by enabling them to commission care on their behalf.
- We will ensure that there is a stronger voice for patients locally through directly elected individuals on the boards of their local primary care trust (PCT). The remainder of the PCT’s board will be appointed by the relevant local authority or authorities, and the Chief Executive and principal officers will be appointed by the Secretary of State on the advice of the new independent NHS board. This will ensure the right balance between locally accountable individuals and technical expertise.
- The local PCT will act as a champion for patients and commission those residual services that are best undertaken at a wider level, rather than directly by GPs. It will also take responsibility for improving public health for people in their area, working closely with the local authority and other local organisations.
- If a local authority has concerns about a significant proposed closure of local services, for example an A&E department, it will have the right to challenge health organisations, and refer the case to the Independent Reconfiguration Panel. The Panel would then provide advice to the Secretary of State for Health.
- We will give every patient the right to choose to register with the GP they want, without being restricted by where they live.
- We will develop a 24/7 urgent care service in every area of England, including GP out-of-hours services, and ensure every patient can access a local GP. We will make care more accessible by introducing a single number for every kind of urgent care and by using technology to help people communicate with their doctors.
- We will renegotiate the GP contract and incentivise ways of improving access to primary care in disadvantaged areas.
- We will make the NHS work better by extending best practice on improving discharge from hospital, maximising the number of day care operations, reducing delays prior to operations, and where possible enabling community access to care and treatments.
- We will help elderly people live at home for longer through solutions such as home adaptations and community support programmes.
- We will prioritise dementia research within the health research and development budget.
- We will seek to stop foreign healthcare professionals working in the NHS unless they have passed robust language and competence tests.
- Doctors and nurses need to be able to use their professional judgement about what is right for patients and we will support this by giving front-line staff more control of their working environment.
- We will strengthen the role of the Care Quality Commission so it becomes an effective quality inspectorate. We will develop Monitor into an economic regulator that will oversee aspects of access, competition and price-setting in the NHS.
- We will establish an independent NHS board to allocate resources and provide commissioning guidelines.
- We will enable patients to rate hospitals and doctors according to the quality of care they received, and we will require hospitals to be open about mistakes and always tell patients if something has gone wrong.
- We will measure our success on the health results that really matter – such as improving cancer and stroke survival rates or reducing hospital infections.
- We will publish detailed data about the performance of healthcare providers online, so everyone will know who is providing a good service and who is falling behind.
- We will put patients in charge of making decisions about their care, including control of their health records.
- We will create a Cancer Drugs Fund to enable patients to access the cancer drugs their doctors think will help them, paid for using money saved by the NHS through our pledge to stop the rise in Employer National Insurance contributions from April 2011.
- We will reform NICE and move to a system of value-based pricing, so that all patients can access the drugs and treatments their doctors think they need.
- We will introduce a new dentistry contract that will focus on achieving good dental health and increasing access to NHS dentistry, with an additional focus on the oral health of schoolchildren.
- We will provide £10 million a year beyond 2011 from within the budget of the Department of Health to support children’s hospices in their vital work. And so that proper support for the most sick children and adults can continue in the setting of their choice, we will introduce a new per-patient funding system for all hospices and providers of palliative care.
- We will encourage NHS organisations to work better with their local police forces to clamp down on anyone who is aggressive and abusive to staff.
- We are committed to the continuous improvement of the quality of services to patients, and to achieving this through much greater involvement of independent and voluntary providers.
- We will give every patient the power to choose any healthcare provider that meets NHS standards, within NHS prices. This includes independent, voluntary and community sector providers.
- We will promote small business procurement, in particular by introducing an aspiration that 25% of government contracts should be awarded to small and medium-sized businesses and by publishing government tenders in full online and free of charge.
- We will introduce new powers to help communities save local facilities and services threatened with closure, and give communities the right to bid to take over local state-run services.
- We will work to rebuild the Military Covenant by...providing extra support for veteran mental health needs.
- We will ensure that injured personnel are treated in dedicated military wards.
- We will regulate lobbying through introducing a statutory register of lobbyists and ensuring greater transparency.
- We will introduce new protections for whistleblowers in the public sector.
- We will take steps to open up government procurement and reduce costs; and we will publish government ICT contracts online.
- We will create a level playing field for opensource software and will enable large ICT projects to be split into smaller components.
- We will require full, online disclosure of all central government spending and contracts over £25,000.
- We will create a new ‘right to data’ so that government-held datasets can be requested and used by the public, and then published on a regular basis.
- We will explore alternative forms of secure, treatment-based accommodation for mentally ill and drugs offenders.
- We will ensure greater access to talking therapies to reduce long-term costs for the NHS.
- We believe the most vulnerable children deserve the very highest quality of care. We will improve diagnostic assessment for schoolchildren, prevent the unnecessary closure of special schools, and remove the bias towards inclusion.
- We will establish a commission on long-term care, to report within a year. The commission will consider a range of ideas, including both a voluntary insurance scheme to protect the assets of those who go into residential care, and a partnership scheme as proposed by Derek Wanless.
- We will break down barriers between health and social care funding to incentivise preventative action.
- We will extend the greater roll-out of personal budgets to give people and their carers more control and purchasing power.
- We will use direct payments to carers and better community-based provision to improve access to respite care.
- We will reform Access to Work, so disabled people can apply for jobs with funding already secured for any adaptations and equipment they will need.
- We will support the creation and expansion of mutuals, co-operatives, charities and social enterprises, and enable these groups to have much greater involvement in the running of public services.
- We will give public sector workers a new right to form employee-owned co-operatives and bid to take over the services they deliver. This will empower millions of public sector workers to become their own boss and help them to deliver better services.
PUBLIC HEALTH
We both want a Britain where social mobility is unlocked; where everyone, regardless of background, has the chance to rise as high as their talents and ambition allow them.
The Government believes that we need action to promote public health, and encourage behaviour change to help people live healthier lives. We need an ambitious strategy to prevent ill-health which harnesses innovative techniques to help people take responsibility for their own health.
- We will give local communities greater control over public health budgets with payment by the outcomes they achieve in improving the health of local residents.
- We will give GPs greater incentives to tackle public health problems.
- We will investigate ways of improving access to preventative healthcare for those in disadvantaged areas to help tackle health inequalities.
- We will create Britain’s first free national financial advice service, which will be funded in full from a new social responsibility levy on the financial services sector.
- We will review employment and workplace laws, for employers and employees, to ensure they maximise flexibility for both parties while protecting fairness and providing the competitive environment required for enterprise to thrive.
- We will reinstate an Operating and Financial Review to ensure that directors’ social and environmental duties have to be covered in company reporting, and investigate further ways of improving corporate accountability and transparency.
- We will promote the radical devolution of power and greater financial autonomy to local government and community groups. This will include a review of local government finance.
- We will ban the sale of alcohol below cost price.
- We will review alcohol taxation and pricing to ensure it tackles binge drinking without unfairly penalising responsible drinkers, pubs and important local industries.
- We will introduce a system of temporary bans on new ‘legal highs’ while health issues are considered by independent experts. We will not permanently ban a substance without receiving full advice from the Advisory Council on the Misuse of Drugs.
- We will work towards full compliance with European Air Quality standards.
- We will promote equal pay and take a range of measures to end discrimination in the workplace.
- We will extend the right to request flexible working to all employees, consulting with business on how best to do so.
- We will undertake a fair pay review in the public sector to implement our proposed ‘20 times’ pay multiple.
- We will look to promote gender equality on the boards of listed companies.
- We will promote improved community relations and opportunities for Black, Asian and Minority Ethnic (BAME) communities, including by providing internships for underrepresented minorities in every Whitehall department and funding a targeted national enterprise mentoring scheme for BAME people who want to start a business.
- We will maintain the goal of ending child poverty in the UK by 2020.
- We will bring forward plans to reduce the couple penalty in the tax credit system as we make savings from our welfare reform plans.
- We support the provision of free nursery care for pre-school children, and we want that support to be provided by a diverse range of providers, with a greater gender balance in the early years workforce.
- We will take Sure Start back to its original purpose of early intervention, increase its focus on the neediest families, and better involve organisations with a track record of supporting families. We will investigate ways of ensuring that providers are paid in part by the results they achieve.
- We will refocus funding from Sure Start peripatetic outreach services, and from the Department of Health budget, to pay for 4,200 extra Sure Start health visitors.
- We will investigate a new approach to helping families with multiple problems.
- We will crack down on irresponsible advertising and marketing, especially to children. We will also take steps to tackle the commercialisation and sexualisation of childhood.
- We will encourage shared parenting from the earliest stages of pregnancy – including the promotion of a system of flexible parental leave.
- We will put funding for relationship support on a stable, long-term footing, and make sure that couples are given greater encouragement to use existing relationship support.
- We will train a new generation of community organisers and support the creation of neighbourhood groups across the UK, especially in the most deprived areas
- We will support sustainable travel initiatives, including the promotion of cycling and walking, and will encourage joint working between bus operators and local authorities.
Full Coalition Programme May 2010