Patients should ask ‘not what the NHS can do for you, but what you can do for the NHS,’ prime minister Brown warned yesterday.
In his first major speech on the NHS, Brown placed great emphasis on patients’ ‘responsibilities’ and ‘preventative medicine’ and the increased use of the private sector.
He said that ‘during the course of 2008’ there will be ‘new access to check-ups’, ‘new access to screening and preventive vaccines’ and ‘millions, especially older people, making choices to become part of active patient programmes’.
He threatened ‘new and decisive action against failing services, whether in hospitals or primary care.’
He said there will be ‘an NHS constitution’ containing a statement on ‘rights and responsibilities in healthcare’.
He added that the ‘third stage in our reform of the NHS since 1997’ will see ‘increased diversity of supply’ and ‘is about taking new and decisive action against failing services’.
This action will include a ‘new Care Quality Commission with tougher powers to impose fines and close down wards in the case of poor standards; removing underperforming hospital management;
foundation hospitals able to take over failing hospitals to turn around their performance’.
Brown intends to have ‘greater diversity of supply’ so that ‘weak GP or community healthcare services can be improved or replaced’.
He attacked those opposed to Labour’s hospital closure programme, claiming ‘if, for example, reconfigurations of services into specialist units proposed by the consultants were postponed or abandoned, this would lead to lives lost’.
He added that ‘we must take the tough decisions which will save lives’.
He talked of ‘competing local providers’ and allowing ‘money to follow the patient’.
Turning his fire on the elderly, Brown complained that: ‘because much of ill-health is age-related, healthcare costs rise with age, with the average annual cost to the NHS of a person aged over 85 approximately six times the cost for those aged between 16 and 44.
‘At the same time, advances in medical science are enabling people with debilitating conditions to live longer and more active lives.’
He continued: ‘Alongside these demographic trends, increasing numbers of people suffer from what are often called “lifestyle diseases” – with smoking and drinking, but most of all obesity, increasingly the main threats to the health of ourselves and our children.’
Brown predicted ‘that, overall by 2050, the direct healthcare costs of obesity will have risen seven-fold, with the wider costs to society and business reaching almost £50 billion a year.’
He said ‘we can do more to help patients feel engaged and empowered by: managing their own conditions; taking advantage of support offered by GPs and nurses in the home or on the high street’.
He stressed that ‘a preventive service, personal to your needs, is beneficial not just to individuals but to all of us as we reduce the costs of disease.’
Brown added that ‘the nature of NHS provision will and must change, to be based not just on what it can do for you but what, empowered with new advice, support and information, you can do for yourself and your family.’
He moved on to say: ‘Over time everyone in England will have access to the right preventative health check-up.’
He added that ‘to create a more personal and preventative health service is to give people the choice of taking a more active role in managing their own care.’
Patients will ‘become genuine partners in care – not just making choices but knowing more about their condition and taking more responsibility for their health and their lives.
‘This is not about shifting costs but about enhancing care. And in doing so making it more cost-effective too.’
He praised the example of Southampton hospital patient ‘Robbie, who was managing his treatment for a heart condition from home, monitoring his own blood pressure and weight, and feeding his results back to his doctor.’
Brown was pleased that ‘he spent far less time in hospital, reducing the cost of his care to the NHS.’
He said that ‘over the next few years we will give 100,000 people with long-term conditions the opportunity to manage their care in this way as “expert patients”.
‘And during 2008 we will bring forward a patients’ prospectus that sets out how we will extend to all 15 million patients with a chronic or long-term condition access to a choice of “active patient” or “care at home” options’.
He continued: ‘And where it is appropriate, just as with personal care budgets for the 1.5 million social care users, it could include the offer of a personal health budget, giving patients spending power and thus a real choice of services.’
