Delivering the Manifesto Promises

Better health for all : - step by step

Delivering the Manifesto Promises

At the 1997 General Election, Labour promised to save the NHS.

We warned people that the NHS that a Labour Government created 50 years ago - in the teeth of opposition from the Conservative Party - was once again under threat from the Tories.

We warned that if the Conservatives were elected again there may well not be an NHS in five years time - neither national nor comprehensive.

People recognised that what we warned was true. Even the Tories admit that they lost the trust of people on health. As John Maples admitted in September 1997 -

'We had a very clear policy on the health service up until May 1. It was rejected by the electorate.

[Birmingham Post - 22nd September, 1997]

In place of the Tory threat to the NHS, we said we would save and modernise the NHS.

That is what we are doing.,

And it is what we will continue to do in the future - step by step:

Since taking office, we have found an extra £2 billion for the NHS. That's £2 billion more than the Tories were planning to spend. More than three times as much as the Liberals promised the NHS at the General Election;

An historic £2.5 billion hospital programme is underway. This is the biggest in the history of the NHS, with 29 new hospitals planned - 25 through PFI - and building already started on 5 of them.,

We have announced exciting new plans for Health Action Zones that will trailblaze new ways of working together to deliver health care in some of the most deprived parts of our country - including inner cities, coalfield communities, struggling rural areas, and places where wealth and poverty live cheek by jowl; We have promoted new ways of working between local hospitals and local councils during the winter coping with winter pressures better and treating more patients than ever before - thanks to a £300 million boost for the NHS.

The new NHS - modern and dependable

On 9 December 1997, we published our plans for the health service in our White Paper The new NHS - modern, dependable.

just as we promised in our Election Manifesto, our White Paper reaffirmed the principles on which the 1945 Labour Government founded the NHS.

That if you fall ill or are injured there will be a national health service there to help; and access to it will be based on

need and need alone - not on your ability to pay, or on who your GP happens to be, or on where you live

But this is only the start.

Here we list the main promises on health in our Election Manifesto.

We set out what we have done so far to meet these promises

and what we plan to do in the future, Step by step.

In our White Paper we promise:

at home: easier and faster advice and information for. people about health, illness and the

NHS so that they are better able to care for themselves and their.

families; in the community: swift advice and treatment in local surgeries or health centres, with family doctors and community nurses working alongside other health and social care staff to provide a wide range of services on the spot; in hospital: prompt access to specialist services linked to local surgeries and health centres so that entry, treatment, and care are seamless and quick.

Manifesto Promise 1 - "Labour will end the Conservative's internal market"

We have already taken a number of steps to end the internal market.

We are ending divisive Tory contracting.

We have got rid of the Tory two-tier care system pitting fundholding GP against non-fundholder.

From April 1999 the internal market will be fully scrapped in its entirety. Our plans for the new NHS are an ambitious, radical, I0-year programme. of continuous improvement.

In its place, new Health Improvement Programmes - putting local doctors and nurses in the driving seat - will in future set the local framework within which local health services and local councils deliver care and treatment to local people.

Delivering the manifesto

At the Election we made a number of promises.

In future, hospitals will be co-operating not competing.

But promises we mike are promises we keep.

We have taken great strides forward in the first year of the new Labour Government.

Manifesto Promise 2 - "Labour will cut costs by removing the bureaucratic processes of the Internal market".

£1 billion will be saved from management costs over this Parliament as a result of changes made, such as ending Tory fund-holding.

Manifesto Promise 3 - "The first £100 million saved will treat an extra 100,000 patients."

In our first year, we have saved £ I0 million from NHS bureaucracy.

And an extra 100,000 patients will have been treated in our first year,(based on provisional estimates at March 1998)

Manifesto Promise 4 - "We will end waiting for cancer surgery" As a result of the new Government's action to halt the planned 8'h wave of Tory fundholding, £10 million has been taken out of Tory NHS red tape, and is now being used to speed up breast. cancer treatment.

A further £ 1 0 million-is being made available for treating people with bowel cancer. This extra £10 million will be spent in various ways to improve access to services, the quality of treatment and to bring down waiting times for treatment for this cancer.

We have announced plans to ensure that everyone with suspected cancer will be able to see a specialist within two weeks of their GP deciding they need to be seen urgently and requesting an appointment.

We will guarantee this arrangements for suspected breast cancer by April 1999 and for all other suspected cancers by 2000

Promise being delivered - more to

come - step by step

Manifesto Promise 5 - "GPs and nurses will take the lead in combining together locally to plan local health services more efficiently for all the patients in their area."

New 'Primary Care Groups' of GPs and community nurses - putting local doctors and nurses in the driving seat in shaping local health care - will cover the whole of England from April 1999.

As a result of being replaced by these new arrangements, GP fundholding is being scrapped from the same date.

Promise delivered - more to come -

Manifesto Promise 6 - "We will introduce 3 to 5 year agreements between local primary care teams and hospitals"

Selective long term agreements have been required from April 1998 and will be spread from April 1999. HIPs will provide the overarching strategy for long-term agreements.

Manifesto Promise 7 - "Boards will become more representative of the local communities they serve." We have reviewed the criteria governing appointments to NHS Trust boards

In future all Chairs and non-executive Directors of NHS Trusts should:

· live in the area served by the trust;

· have a strong personal commitment to the NHS;

· be able to demonstrate a commitment to the needs of the local community;

be committed to the public service values of accountability, probity, openness and equality of opportunity;

· be able to demonstrate an interest in healthcare issues;

· be able to demonstrate an ability to contribute to the work of the board;

· have experience as a carer or user of the NHS.

All Trust board meetings are now held in public.

The first round of NHS Trust Board appointments made since the new Government took office on 1 May have resulted in a massive change.

More than half the newly appointed non-executives are women.

The proportion of black and Asian

non-executives has almost doubled.

Manifesto Promise 8 - "A new Patients Charter will concentrate on the quality and success of treatment"

A new NHS Charter is being developed to mark the 50th Anniversary of the NHS in July - focusing on the things that really matter to people.

There will be clearly measurable standards of care and the kind of accessible information which people need to make informed choices about their health.

The rights of patients to high quality, effective treatment will be enhanced. However, these rights will be balanced with their responsibilities to the Health Service - for example to keep appointments and to treat NHS staff with respect.

Manifesto Promise 9 - "The Tories so-called efficiency Index counts the number of patient enquiries, not the quality or success of treatment. With Labour the measure will be quality of outcome". The Efficiency Index has been phased out for 1998/99.

From April 1999 it will be replaced with more rounded 'National Performance Framework 'measuring public health, equity, outcomes/ quality, patient satisfaction, and efficiency.

This will end the perverse incentives of the Efficiency Index, where money spent in preventing hospital admissions was defined as a worsening of efficiency, even though it meant money was being spent on keeping people healthy.

Promise delivered - more to come -

Manifesto Promise 10 - "We will work towards the elimination of mixed sex wards." 70 per cent of HA's will have eliminated mixed sex accommodation by end of 1999.

By 2002 95 per cent will have achieved targets for ensuring proper segregation.

Manifesto Promise 11 - "Labour will overcome the problems that have plagued the Private Finance Initiative, end the delays, sort out the mess, and develop new forms of public/private partnership'.

The Tory logjam in the PFI has been broken,

An historic £2.5 billion hospital

programme is underway - the biggest in the history of the NHS including 25 new hospitals planned through the PFI and building already started on 5 of them

The Government's review of PFI will improve the product and the process making it quicker, more efficient, better value for money, more open and give more of a say to staff and unions.

We will also get PFI moving in the community, primary and mental health care sectors.

Manifesto Promise 12 - "Labour is opposed to the privatisation of clinical services's

No clinical services have been or will be included in PFI deals.

Promise delivered

Manifesto Promise 13 - "Labour will promote new developments in telemedicine".

Patients will benefit from quicker test results, up-to-date specialist advice in the doctor's surgery and on-line booking of out-patient appointments, when we connect every GP surgery and hospital to NHSnet, the NHS's own information superhighway.

By the end of 1998 demonstration sites will be established in every Region to pilot how the NHS net can be used to bring direct benefits to patients.

As a second step, by the end of 1999 all computerised GP surgeries will be able to receive some hospital test results over NHSnet.

By 2002, these services will be available across the country.

Manifesto Promise 14 - "A new minister for public health" The new Labour Government has given Britain its first ever Minister for Public Health - Tessa Jowell.

Manifesto Promise 15 - "Labour will set new goals for improving the overall health of the nation which recognise the impact that poverty, poor housing, unemployment and a polluted environment have on health."

Our public health Green Paper Our Healthier Nation was published in February 1998.

We have 2 key aims:

to improve the health of the population, by increasing lengths of people's lives and the number of years spent free from illness, and to improve the health of the worst off and narrow the health gap.

No Government has previously set itself this challenging task of improving the health of the worst off at a faster rate than that of the overall population.

To make real progress, we 'Will focus on four priority areas, setting clear targets for improvement in each: By the year 2010:

Heart disease and stroke - to reduce the death from heart disease and stroke and related illnesses amongst people aged under 65 years by at least a further third

Accidents (An accident is defined here as one which involves a hospital visit or consultation with a family doctor) - to reduce accidents by at least a fifth

Cancer - to reduce the death rate from cancer amongst people under 65 years by at least a further fifth

Mental health - to reduce the death rate from suicide and undetermined injury by at least a further sixth

The whole of Government is working to focus on the underlying causes of ill health - including poverty, poor housing, crime and disorder, unemployment and a polluted environment.

Manifesto Promise 16 - "We will ban tobacco advertising".

In December 1997, agreement was secured at the EU Health Council on an historic draft Tobacco Advertising Directive, banning tobacco advertising and sponsorship within the countries making up the European Union.

In April 1998, this agreement was backed by the European Parliament Environment Committee and forwarded to the full Parliament.

A White Paper on reducing tobacco consumption will soon be published.

Manifesto Promise 21 - "We will establish a Royal Commission to work out a fair system for funding long term care for the elderly" The Royal Commission was set up in December 1997. It will report by December 1998.

They are talking to users and carers to work out a fair and affordable system for long-term care based on consensus.

Manifesto Promise 22 - "We will Introduce a long term care charter" Work is progressing on the Charter for all adults with long-term community care needs.

The Charter will promote awareness of what local health, housing and social services can offer and will give users and carers the information they need about the services they provide.

Promise being delivered - more to

come - step by step

Manifesto Promise 23 - "We are committed to an Independent Inspection and registration-service for residential homes, and domiciliary care."

A Social Services White Paper will be published later in 1998, delivering a new regulation system that. is tough, transparent and accountable.. That puts users needs at the heart of the system and ensures safe and secure care for often very vulnerable people.

Manifesto Promise 24 - "100,000 off waiting lists"

On 18th March'1998, Frank Dobson told the House of Commons- "By April next year, I expect hospital waiting lists in England to be shorter than the 1. 1 6 million record level we inherited from the previous Government."

Our top priority for the coming year is to reduce waiting lists - using the extra £500 million which the Chancellor announced in his Budget. £417 million of the extra money will be invested in the Health Service in England. £320 million of that will go directly into cutting Waiting lists.

That money will be invested in more operations, more surgical and medical sessions, more doctors, more nurses, more flexible 7-day working. It should result in the biggest ever increase in operations in the history of the NHS and the biggest ever cut in waiting lists.

Through targeted investment, good management and innovative change, we will do better than the Tories ever did. The 18 years of Tory Government saw waiting lists rise by over 400,000. In the next 12 months of a Labour Government, they will fall. And they will continue to fall.

Delivering this target will be a significant stepping stone towards delivering our pledge of reducing waiting lists by 100,000 from the level we inherited in the lifetime of this Parliament.