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Mark Simmonds: The future of the NHS

In a speech on the future of the NHS, Shadow Health Minister Mark Simmonds said:

David Cameron has described the establishment of the NHS as one of the greatest achievements of the 20th Century and has pledged that improving the health service is our number one priority. We have demonstrated this commitment by pledging to match the Government's public services spending over the next three years.

David Cameron, myself and the Conservative Party fully support the objectives and ethos of the NHS and are completely committed to the principle that NHS services should be free at the point of delivery. We recognise that what makes the NHS the envy of the world are the highly skilled and dedicated professionals who work within the organisation and I pay tribute to their commitment and professionalism, in often difficult circumstances.

Under David Cameron we have committed to sharing the proceeds of economic growth between funding of our public services and ensuring a competitive tax framework in which our economy can thrive. We recognise that one of the most important calls on the proceeds of growth will be the NHS and we will provide our health service with the resources it requires, exposing criticism from our political opponents that we will cut services as patently untrue.

But our vision for the health service goes further than just resource commitments - we want to see the British NHS exceeding European averages in outcomes such as survival and recovery rates. We also want a patient centred system in which NHS professionals are able to exercise their professional judgement free from central controls and targets.

Whatever the Labour Party may say, all is not well in the NHS.


Under this Government there has been an accepted and acknowledged growth in public spending, much of which has not been used effectively. Health spending has doubled under Labour yet the Government has mismanaged this increased funding with excessive bureaucracy, arbitrary targets, constant reorganisations and limited vision leading to declining productivity, escalating costs and an alienation of professionals. According to Department of Heath figures 1.2 million more patients could have been treated with more efficient resource allocation.

Despite the best efforts of the dedicated NHS staff recent reports have evidenced that health systems in the UK lag far behind other European countries and the expected squeeze in funding in this autumn's spending round could further exacerbate the situation.

Both staff and patients recognise that this Government has failed the NHS at several levels particularly in the effectiveness of service provision. After a decade of budget increases and an array of new drugs and treatments the outcomes for patients should be significantly better. The Labour Party has focussed too heavily on the inputs into the system - money spent, time waited and patient numbers treated when it should be judging the outcomes - treating people as individuals - how effective the NHS is in making people better.

Two recent reports have highlighted the Government's failure to improve outcomes; concluding that cancer survival rates in England are amongst the lowest in Europe and outcomes for stroke patients are far worse than in equivalent European countries. We believe that assessments of healthcare should be based on survival and treatment rates, not just money spent.

Despite this obsession with inputs, the Labour Party is still closing and reducing services across the country. 29 hospitals are at risk from losing their maternity or A&E services, alongside the 81 threatened community hospitals. We have warned against closures not based on clinical evidence.

Significant resources have been wasted on repeated NHS restructuring. There have been ten major reorganisations of the NHS since Labour came to power in 1997, each of which wastes money and prevents NHS staff fulfilling their primary role - providing treatment and care as well as damaging staff morale - which has hit rock bottom. The merger of Primary Care Trusts and the regionalisation of Strategic Health Authorities in 2006 alone are together estimated to have cost £320 million - money which should and could have been invested in improving facilities and providing treatments and care.

[comes full circle to where we were in 1997]

The Labour Government have also diminished the professional responsibility of the dedicated and highly skilled NHS staff by imposing politically motivated targets and interfering in clinical judgements. By trivialising the professionals Labour have demoralised and frustrated the people who best understand the needs of the NHS and its patients. We are committed to giving doctors greater control over their budgets and will allow clinicians to set their own priorities.


The NHS is at the top of Conservative agenda and we have pledged to match the Government's public spending totals. However, we recognise that the problems in the NHS are about more than just providing additional resources; it is about the efficient and productive use of these resources to maximise benefit to the patients. Whilst other countries have invested in specialised diagnostic care and staffing this Government has been constantly reorganising NHS structures. We need to focus more on the acute aspects of care, and invest in specialised and highly skilled staff that are able to make the difference to recovery and treatment rates.

That is why we have produced a detailed document outlining our vision and commitment for the health service. The 'NHS Autonomy and Accountability' White Paper would entrench the core principles of the NHS in statute and outlines mechanisms to improve and strengthen the NHS. This details our proposals for greater NHS autonomy; an end to political interference and enhanced accountability to patients and the public. It also aims to make NHS leaders and managers responsive to patients rather than bureaucratic requirements - resulting in the providers of healthcare being rewarded on the basis of effectiveness of patient treatment rather than their current adherence to centrally imposed and process driven targets.

We have also pledged that there would be 'no more pointless reorganisations' of the NHS, which are both costly and disruptive.

Additionally, we would also give the NHS greater independence and free it from day-to-day interference by Ministers, such as removing the setting of the NHS tariff, or price list, from the control of the Secretary of State. We believe decisions affecting local services should not be taken by distant politicians, but by the patients and frontline staff who use and work in the NHS. To do this, we would like to see greater control for GPs of their budgets, independent regulation of healthcare providers and an independent NHS Board. The NHS Board would be responsible for commissioning or buying NHS services, the allocation of NHS resources and the delivery of objectives to improve the outcomes for patients.

We are also determined to re-engage the demoralised health professionals, relieving them of the burden of unnecessary bureaucracy and putting them back at the centre of healthcare delivery. We would give clinicians greater freedom, and we would go further towards GP budgetary independence. A recent poll gave the Conservatives a 25% lead over Labour amongst GPs who recognise that Conservative policies would be better for their patients.

In essence, we do not differ from the Government over funding for the NHS - only about how those funds are used to benefit the people who use the health service. We want to see a new direction for the NHS, away from centrally imposed decisions, targets and control towards local decision making, greater independence and assessment based on recovery and treatment rates.


We recognise healthcare is changing rapidly, with new drugs and treatments becoming available. We recognise that the NHS can often be a challenging place to work, and we pay tribute to the dedicated and professional staff who provide a first class service across the country.

Conservatives are determined to maintain and strengthen the NHS, and have pledged to put the patients and professionals at the heart of the NHS, as we believe that they are best placed to make decisions about the treatment and care required.

The NHS is one of the country's greatest assets, and under a future Conservative Government the NHS will have a greater patient focus, it will be properly resources and it will be free at the point of delivery.

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