Published: 14/04/2005, Volume II5, No. 5951 Page 9
Health minister John Hutton refused to guarantee the future of strategic health authorities at a high-profile election debate between the three main parties.
Directly challenged at the King's Fund breakfast grill last Thursday, Mr Hutton said: 'You will have to wait for the manifesto.' It was due to be published yesterday.
Mr Hutton confirmed that Labour's policies are likely to mean a reduction in the number of primary care trusts. 'Further organisational change is possible, ' he said.
'The permanent secretary indicated as much in his report.' (News, page 5, 17 March. ) But Mr Hutton lambasted Liberal Democrat plans to abolish SHAs and hand PCTs' commissioning powers to upper-tier local authorities. 'There is no support whatsoever for the sort of change that the Liberal Democrats are proposing, ' he said. 'It would be a diversion. We need to make improvements but this would not be the right way.
'I do not think the NHS needs another lot of structural change.' Liberal Democrat health spokesman Paul Burstow insisted that the proposal was 'the only way to address the democratic deficit in the NHS' and would mean more integrated service delivery. But he accepted the changes would be 'a huge challenge.' Shadow health secretary Andrew Lansley said he detected little enthusiasm in local government to 'take over the health service'. But he reiterated Conservative policy to scrap SHAs, and reduce the number of PCTs, with commissioning falling to GPs and clinical networks.
Audience member Rob Larkham, chief executive of Camden primary care trust, said: 'I do not think we should fall into the trap of thinking that organisational change can solve rooted structural problems.
They can be disruptive and resourceintensive. However some anomalies with the roles of SHAs and PCTs do need to be addressed.'
Next week's HSJ Interview: Lib Dem health spokesman Paul Burstow.
Labour: 'Treating more people, more quickly'
Health minister John Hutton described the coming general election as 'the most important in a generation' in terms of health - and went on to insist there is a 'clear divide' between Labour and Conservative policy.
Offering a 'bit of context' to the debate, he compared underinvestment in the NHS before 1997 with the service now, which was 'treating more people, more quickly'.
He said the future would be about using choice to drive up quality, as well as reward efficiency and innovation. The next stage of investment and reform would focus on primary care, he said, and on long-term care.
Conservatives: 'An end to micromanagement'
Public health - not 'micro-managing the NHS' - would be the NHS's priority if the Conservatives took the reins of government.
'If we do not deal with this, over the coming years the NHS will not be able to cope with pressing needs, ' said shadow health secretary Andrew Lansley. 'We will not have what [Sir Derek] Wanless called the 'fully engaged scenario' in which people actively look after their own health.' He said the party would establish a public health commission to provide independent advice on public health - and he would take personal charge of the issue, rather than leaving it to junior ministers.
He also said cutting red tape was an essential task. 'Good management and leadership will thrive if bureaucracy is cut, ' he claimed.
Lib Dems: 'Committed to founding principles'
'At the 2001 election we argued for increased investment in the NHS, ' said Lib Dem spokesman Paul Burstow. 'That argument has been won.' His party was 'committed to reiterating the principles on which the NHS was founded in the middle of the last century', while ensuring that it could meet the needs of today.
So a Liberal Democrat government would match Labour's spending plans while offering additional resources to pay for faster diagnosis to eliminate the scourge of 'hidden' waiting lists, more action to tackle MRSA, free personal care and - possibly - direct payments for people with long-term conditions.
He said the DoH's role would be to 'work across government' to promote better public health and introduce a complete ban on public smoking.