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Mark Simmonds: Maintaining and strengthening the NHS

I am delighted to be here in Bolton at the North West Conference, which is one of the key battlegrounds in the forthcoming elections, with nearly 30 key marginal seats. 

We have already seen the evidence of your hard work and campaigning; wining the Crewe and Nantwich by-election was a stunning victory; and in Yorkshire and the North West the Conservatives now control more councils than any other party. 

I have visited the North West on a number of occasions, and you are fortunate to have some excellent healthcare facilities.  I was particularly impressed by my visit to Clatterbridge cancer centre - which is one of the finest and most innovative cancer treatment centres in the country. 

Despite the economic downturn, health remains at the top of the electorate's concerns, and it is the Conservative Party's number one priority.  

Let's be clear, the Conservative Party fully supports 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, based on clinical need, and not ability to pay.

I recognise that the NHS is one of the most comprehensive healthcare systems in the world, and we all need to thank the dedicated staff who work tirelessly and strive to provide a first class quality care.

Since the last election the Health team has given a great deal of careful and considered thought to our health policy.

We believe there must be three fundamental tenets for healthcare policy;
1) An NHS that is patient-centred, not centrally controlled;
2) An NHS that is based on delivering outcomes not meeting narrow process-driven targets;
3) An NHS that has a much greater focus on improving public health. 

We have demonstrated our financial commitment to the health service by matching the Government's spending plans, and even in this severe macro economic contraction retaining Health as one of the four key spending priority areas.

But it is about more than just money. Health spending has doubled under Labour - yet the disparity between inputs and outputs is enormous. In addition health inequalities in the UK remain severe and significant. The Health Select Committee has this week reported that over the last ten years health inequalities between the social classes have actually widened.

Our vision is for a world class NHS achieving the highest levels of care relative to other countries.  This is a significant aspiration, and we still have a long way to go.  The UK has the third worst record on deaths from breast cancer in Europe.  There are nearly three times as many deaths in the UK from heart disease as in France.  We are in the bottom third of European countries on deaths from stroke.  On a wide range of outcome measures we lag behind other Western European countries. 


But the one area in which the Government has a particularly poor record is on public health.  In the UK we spend around 2.5% of our health budget on public health compared with an OECD average of 3.5%. 

Obesity, binge drinking and sexually transmitted infection rates continue to rise and there is a growing public health epidemic. 

We believe that people can and should take responsibility for their lifestyle and health.  This does not ignore the social and environmental factors that influence behaviour, but we must remove the excuses and ensure individuals take responsibility for their own behaviour.  We will promote sport in school, and encourage education about a healthy diet and lifestyle from an early age. 

We would ring fence the public health budget, and enhance the Chief Medical Officer's Department to give greater powers and responsibilities over public health. 

We would also establish local Directors of Public Health jointly appointed by PCTs and Local Authorities with a clear remit to manage public health budgets.


It is only by talking to front line staff that it is possible to get a real sense of how effectively the NHS is operating.  I  regularly travel around the country, talking to staff, and there are two recurring negative themes;

  • Constant structural reorganisation diverting focus from patient care;
  • And a focus on targets distorting clinical priorities. 

Under the Labour Government there have been nine major reorganisations within the NHS in a decade ending with a structure much the same as it was in 1997. This is a significant waste of resources, which should have gone into front line patient care.  We know that these re-organisations are costly and detrimental to staff morale.  We have pledged there will be no more unnecessary structural reorganisations - we will allow the NHS the stability to focus on providing high quality care and better patient outcomes. 

We believe the NHS should be freed from political meddling, and will establish a strong statutory framework to guarantee the independence of the NHS. 

At the heart will be the independent NHS Board, responsible for setting the health outcome objectives and commissioning guidelines of NHS care and accountable to Parliament. Our NHS Board would meet in public and be fully transparent and accountable. 

In short, we will remove day to day political interference in the running of the health service which will allow clinicians to focus on patients. 


The second concern that frontline staff often raise is that of NHS targets. 

We know that Labour has imposed endless central process driven targets in the NHS, which have in some cases distorted clinical priorities and have had a detrimental impact on patient care. 

Nowhere is this more apparent than the horrific case of Mid-Staffordshire this week.  Despite the Government's denials, it is becoming apparent that poor management coupled with "target-chasing" resulted in poor standards of care and possibly even unnecessary deaths. 

This obsession with meeting Government targets must stop.  We need an NHS which looks outwards to the patient and not upwards to Whitehall. 

We believe a more sensible way to judge the performance of the NHS is on outcomes.  Not only will an outcomes based NHS prioritise patient safety and clinical needs, it will also enable the public and purchasers of health services to judge providers based on the results they achieve, which in turn, will raise standards across the board. 


But for our focus on outcomes to be truly effective patients need to be given greater choice over their treatment and care. 

Despite Labour's rhetoric, choice is not yet a widespread concept in the NHS; only one in three patients were aware that they have a choice of hospital for their first appointment. 

We will encourage greater choice; patients will be able to choose to have a single room for elective care, and we will also enable those with long-term conditions to have greater choice over their care through individual budgets, assessed through one process, incorporating both health and social care needs. 

Nowhere is our determination to focus on choice more apparent than at the primary care level.  GPs are the gatekeeper to the NHS, and 80% of all patient interactions and treatments are delivered through primary care. 

We would give people greater choice over their GPs, and more ability to move surgeries if they so wish.  There would be no barriers to the opening of new surgeries, and we would reward and encourage GPs who choose to deliver services in deprived areas. 

Because of the vital GP/Patient relationship, we will give GPs greater control over commissioning services for their patients. We would allow GPs to control real budgets on behalf of patients. This will ensure that money follows the patient.


It would be remiss of me not to mention polyclinics. 

Conservatives are not against polyclinics per se.  In fact, where they are supported by GPs, patients and the local community we will be supportive.  There should be local decisions based upon clinical evidence, health inequalities, provision of prevention measures and a comprehensive understanding of their impact upon the existing provision.

We are however, against centrally imposed polyclinics, which destabilise existing practices, and could, as has been the case in Bradford, poach staff and patients. 

The Government plans for centrally imposed Polyclinics against the wishes of local communities is driven by political outcomes not Health outcomes.

<h2>NICE </h2>

I am regularly contacted by patients who ask why they can't have access to a medicine or drug as a result of a ruling by the National Institute of Clinical Excellence.

We must find a mechanism to enable drugs and treatment to reach patients faster, particularly for serious illness such as cancer.

It is iniquitious that treatments routinely available in other European countries are not available here. We have recently announced detailed proposals which will end this inequality. 

(i)  We would remove the process of Ministerial referral for drugs,

which has caused delays of up to twelve months, even before the NICE process begins. 

(ii)     We would speed up the process by allowing NICE assessments to begin alongside the Medicines and Healthcare products Regulatory Agency's (MHRA) drug licensing process.

(iii) We would allow appraisal of the value or benefit of a treatment to include its wider societal value.

(iv) And we would promote earlier engagement between NICE and pharmaceutical companies.

(v) We are also carefully considering a move towards value based pricing and risk-sharing schemes for new drugs to enable innovative and novel drugs to reach patients as early as possible, at a price that is in line with their therapeutic value.


Finally, for any of our choice proposals to be truly effective there needs to be good, accessible information.

Within the NHS, there is currently a lot of data but not much information.

This information needs to be accessible, understandable and communicable.

We want to see the publication of information on health experiences and clinical outcomes to ensure the NHS is accountable to patients.

We face a number of challenges; how to collect the information and ensure it is accurate and comparable; how to present this data so it is relevant and easy for patients to understand and how increase the use of patient-reported outcomes. 

We believe there needs to be a market place in information with a range of organisations able to collect, interpret and evaluate and disseminate this information to clinicians and patients. 

Real time information flows could dramatically improve standards and drive up clinical care.


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. 

We want an NHS that offers not just equity in access, but also excellence for all.

The NHS is one of the country's greatest assets; not only is the NHS safe under a future Conservative Government but we are determined to work with Healthcare professionals to improve the level of service delivered to patients.

Under a Conservative Government the NHS will have a greater patient focus, continue to receive additional resources and continue to be free at the point of need.

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