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Tories pledge 'independent NHS' Tories pledge 'independent NHS'
(about 8 hours later)
The Tories are pledging to hand day-to-day control of the NHS to an independent board, as part of reforms aimed at making it more autonomous. The Tories have pledged to hand day-to-day control of the NHS in England to an independent board, part of efforts to make it more autonomous.
They say the board should allocate billions of pounds to primary care trusts across England, and oversee the commissioning of services. Members would be chosen by the health secretary and would be accountable to ministers, the party says.
Ministers would appoint board members, set objectives and hold it to account. They would commission services while centralised targets, such as those on waiting lists, would be abolished.
Health Secretary Patricia Hewitt has ruled out a similar plan, saying the NHS was too vast to be run by a board.Health Secretary Patricia Hewitt has ruled out a similar plan, saying the NHS was too vast to be run by a board.
The proposals, to be set out on Wednesday, form the party's first detailed and concrete policy pledge on the public services. The proposals set out on Wednesday form the party's first detailed and concrete policy pledge on public services.
Health watchdogsHealth watchdogs
It is expected to be the first of several policy pledges announced over the next few weeks.
The Conservatives believe the NHS should have more autonomy but should also be made more accountable through strengthened health watchdogs and new patients' groups.The Conservatives believe the NHS should have more autonomy but should also be made more accountable through strengthened health watchdogs and new patients' groups.
The proposals would mean substantial powers being handed over to the independent board, which would report directly to Parliament, if the Conservatives took power at the next general election. Board members would be appointed on the advice of an appointments commission, and would include financial, commissioning and clinical directors.
The board would allocate funds to primary care trusts and oversee the commissioning of NHS services, in line with objectives agreed with the health secretary. Top-down targets - all they do is meet a need for political grandstanding and damage patient care Andrew LansleyShadow health secretary class="" href="/1/hi/health/6221398.stm">Tory health plans: reaction
Improvement plans They would allocate funds to primary care trusts and oversee the commissioning of NHS services, in line with objectives agreed with the health secretary.
Other proposals to increase independence for the NHS include giving more powers for NHS Foundation Trusts to invest and expand, and taking away the power of the health secretary to set prices of NHS procedures. And all government targets would be scrapped.
To make it more accountable, the party proposes giving more power to planned patients' watchdogs known as Local Involvement Networks and requiring all primary care trusts to publish annual improvement plans. Shadow health secretary Andrew Lansley said: "Top-down targets - all they do is meet a need for political grandstanding and damage patient care.
And it proposes streamlining the bodies which inspect the NHS, so one focuses on economic performance, another on quality and value for money of care. "The NHS board which we propose will give a high degree of independence which represents patient and public interests."
The problem can't be solved by proposing that a modern health service be run like a 1960s nationalised industry Patricia Hewitt 'Long term stability'
In the foreword to the document, the Tories pledge to end "pointless upheavals" and "increased bureaucracy".
And they say the plans will secure the "long term stability of our NHS" by giving NHS professionals more opportunity to exercise their judgment and expertise.
Under the proposals, GPs' pay would be linked to the quality and success of treatments they provide.
But Mr Lansley said there would be no change to the GP contract introduced in 2004, allowing them to opt-out of out-of-hours care.
"That day has gone," he said.
The Tories' plan to scrap waiting list targets means only one thing: longer waits Hazel BlearsLabour chairwoman
Other proposals include making the NHS more accountable, by creating more powerful patients' watchdogs and requiring all primary care trusts to publish annual improvement plans.
The Tories would also set up a new national organisation, Healthwatch, to represent patients and would enshrine 10 "core principles" of the NHS in legislation.The Tories would also set up a new national organisation, Healthwatch, to represent patients and would enshrine 10 "core principles" of the NHS in legislation.
Prime minister-in-waiting Gordon Brown was last year thought to favour handing day-to-day control of the NHS to an independent board. It is thought prime minister-in-waiting Gordon Brown had considered an independent board to run the NHS, but last week Health Secretary Patricia Hewitt appeared to rule that out.
It was seen as a move which might echo his 1997 decision to hand day-to-day decisions on interest rates to the Bank of England's Monetary Policy Committee. Unelected board
But last week Health Secretary Patricia Hewitt appeared to rule that out. On Wednesday, health minister Andy Burnham said an unelected board should not be made responsible for allocating £90bn of taxpayers' money.
She said the NHS was too vast and the proposal - which has been backed by the British Medical Association - would not work. And Labour chairwoman Hazel Blears, a deputy leadership contender, said: "The Tories' plan to scrap waiting list targets means only one thing: longer waits."
In a speech she said: "The NHS is four times the size of the Cuban economy and more centralised. "This, at the very time when the public aspires to shorter waits, more say, and more personalised services from their NHS."
"That is part of its problem, and the problem can't be solved by proposing that a modern health service be run like a 1960s nationalised industry." The shift from a culture of targets to a focus on outcomes for patients is also a step in the right direction Dr Gill MorganNHS Confederation
But she supported creating an NHS constitution, and giving more powers to patients, GPs and health staff. She added: "Their proposals for an NHS board sounds like a return to the days of nationalised industries.
"You can't run a £90bn-a-year enterprise like the NHS as though it were British Leyland."
The NHS Confederation, which represents 90% of NHS organisations, welcomed the Tories' commitment to a tax-funded NHS.
Chief executive Dr Gill Morgan said she was pleased there was no " violent change of direction or major reorganisation" as the NHS needed stability.
She added: "The shift from a culture of targets to a focus on outcomes for patients is also a step in the right direction."
The British Medical Association welcomed the proposals for an independent NHS board.
But it said GPs' pay was already linked to the success of treatments and it would need to be persuaded of the need to extend it further.