NHS NEEDS ELECTED HEALTH BOARDS AND A LOCAL HEALTH CONTRIBUTION - LAMB

12.01.00am BST (GMT +0100) Fri 14th Sep 2007

Liberal Democrat Shadow Health Secretary, Norman Lamb MP, has today published his Vision Paper, setting out plans for a genuinely local health service freed from Whitehall, giving patients real control over their healthcare.

The paper, which is Norman Lamb's contribution to the party's health policy working group, set to report fully early next year, includes proposals for:

· An elected Local Health Board: putting people in charge of decisions about their local health services.

· A local health contribution: offset by cuts in national income tax, this would allow communities to raise extra money for their local health services.

· A Patient Adviser: a universal information service accessible via the GP surgery, guiding the patient through the full range of health, social care and other support services.

· A 'Patient's Contract': a declaration of entitlements that every citizen has of right, wherever they live.

· Empowering patients: exploring introducing more direct payments and personal budgets.

Commenting on his paper, Norman Lamb said:

"The Liberal Democrats are committed to an NHS which delivers high quality health services to all, irrespective of income."

"As Derek Wanless recently said, this can only be achieved by getting better value for money, but it is crucial to recognise that not every area has the same priorities. In today's highly centralised NHS there is a real 'democratic deficit', with too many decisions made in Whitehall.

"Protests against hospital closures and cuts to services, up and down the country, show that local people do not feel their voices are being heard. Liberal Democrats think the status quo is unacceptable. The key is creating real accountability to local communities, where they have the power to make decisions on how money is spent on their NHS. Patients would be genuinely empowered to take control of their own healthcare through better information and a 'patient contract'."

"My paper will help inform the debate on how the Liberal Democrats can genuinely give people a say in their local health service."

NOTES

1. Norman Lamb's Vision Paper forms part of the Liberal Democrat policy-making process on reforming the NHS in England. All Liberal Democrat policy must be passed by a party conference.

2. A summary of the paper is below:

The Diagnosis

The NHS suffered years of neglect under the Tories, which led to people waiting a long time for vital treatment. As the recent Wanless report points out, Labour put in much needed investment but this has not led to the kind of improvements in healthcare which would be expected.

The issue now is how the money is spent and how you tackle waste, rather than the need for extra investment. Health inequalities have increased under Labour.

Financial mismanagement, largely caused by a straightjacket of central control of local NHS services together with contradictory reform, had led to deep deficits which have only now been cleared due to a programme of ruthless cost cutting.

Hospitals up and down the country have shed jobs and slashed services so that the Secretary of State could say that the NHS was back in the black (effectively 'boom and bust' in the NHS).

Local people have no effective say over their health services - no power to determine their own destiny. No control, no responsibility, no accountability. If we do not like what is happening in our local health services, all we can do is complain to the Government. And it does not listen.

The Prescription

• Local control, empowering communities, empowering patients, ensuring fair access.

• Reconfigurations of hospital services are hard to justify without clear local democratic voice.

• Patients would be genuinely empowered to take control over their own healthcare via better information and a guaranteed right to core treatments.

We propose:

1. An elected Local Health Board: putting people in charge of decisions about their local health services. Local people could choose to focus their allotted money on:

• More access to specific drugs or treatments

• Saving hospital services currently under threat

• Decide on funding of new capital projects - and whether they would be funded by private money or not

• Local people could also elect to give high performing local authorities responsibility for commissioning

2. A Local health contribution: offset by cuts in national income tax, this would be a way of allowing communities to raise extra money for their local health services.

3. A patient adviser: a universal information service accessible via the GP surgery, guiding the patient through the full range of health, social care and other support services.

4. A Patient's Contract: a declaration of entitlements that every citizen, wherever they live in the UK, has, as of right. These would include:

• Rights to accurate and relevant information.

• Rights to advocacy and the right to make their own decisions about their healthcare with advice and support of health professionals.

• Rights with regard to redress.

• Maximum waiting times - if you do not get your operation within a guaranteed time you would have the right to treatment in a private hospital (this has been a driver for improved efficiency in state hospitals in Denmark)

• Access to treatments recommended by NICE and access to core services such as sexual health services, drug and alcohol treatment, mental health services and services for those with chronic conditions as defined from time to time by Parliament.

• Access to GPs.

• Out of Hours Care guarantee.

5. Empowering patients with more direct payments and personal budgets: Exploring extended use of direct payments and personal budgets particularly in care of chronic conditions and other areas. These strategies have been highly successful in empowering patients in the social care sector.

6. A commitment to integrate health and social care, breaking the organisational divide.

7. A Constitution for the NHS enshrining its core principles and setting out what citizens are entitled to expect - and what their responsibilities are. This would include for instance exploring ways of getting bars and nightclubs to take responsibility for drunken arrivals at A and E.

8. A modernised NHS Executive - stop political meddling by Ministers

A new NHS Executive would be independent of Government and charged with overseeing the work of the local Health Boards, providing guidance on best practice in commissioning and allocating funding to them. It would be less susceptible to political interference. It would not, however, be involved in local decisions about the provision of services.

The Department of Health should be slimmed down substantially, focusing primarily on public health, workforce planning and training. Governance of the NHS must be opened up at a national level.

9. Targeted investment in psychological therapies and physiotherapy services to help people get off incapacity benefit and back to work.