Targets’ rebirth as NHS constitution rights will not ensure a cultural shift

Its policy document Building Britain’s Future sets out plans to turn NHS targets into enforceable patient entitlements.

The idea is appealing: top-down targets metamorphosing into rights. And if the NHS fails to deliver, the patients’ “champion” will come to their aid, clutching a copy of the NHS constitution. Perhaps there will be a red phone in every hospital reception with a direct line.

The proposal would give teeth to the NHS constitution, currently progressing through Parliament. The Department of Health is determined to prove the sceptics wrong and make the constitution a powerful dynamic in the drive to make the NHS more patient centred.

But the ideas lack essential detail. Only two targets – 18 weeks from referral to treatment and two weeks referral time to a cancer specialist, both of which are largely met already – are flagged for replacement.

This is nowhere near enough to instil a culture of patient rights in the NHS, but extending the list is fraught with risks at a time when trusts are searching for cashable savings.

For example, a right to die at home is also mooted. While this is desirable for comfort and dignity – as well as to free up beds – it could require significant resources to implement as an entitlement. Would it be right to prioritise the dying over the living when money is tight? Rights could distort resource allocation just as much as targets.

Having a patient champion is an attractive notion for a voter but, again, the real impact the creation of such posts might have is unclear. Being optimistic, primary care trusts could use them and the constitution to harness patient power in the pursuit of better services, helping rebalance the health service away from the producer and towards the consumer.

But this will only work if the constitution reaches beyond the middle classes to those who are least empowered in the health system.

Whatever its shortcomings, Labour’s document is another step in the slow death of targets.

Perhaps as each one is abolished it will be driven to Tony Blair’s house; it should, after all, be allowed to die at home.