Matron does the rounds

Just when you thought fundholding was dead, along comes shadow health secretary Ann Widdecombe to revive it and put it on a life-support machine.

'If primary care groups did not work we will find the means to allow GPs to opt back into fundholding - if that is what they prefer - under the next Conservative government,' she told the Tories' spring forum in Reading.

Ms Widdecombe's resurrection of this old policy was virtually the only nod in the direction of new health policy during her short address to party activists, which was received, as befits her 'darling of the party' status, with ritual

fervour.

But expect a new health policy by the end of the year. Party chair Peter Lilley announced that each shadow department is to set up a policy agenda group charged with 'defining the issues and priorities that we need to follow'.

For now the Tories are attempting to remove the unsightly ideological stains they left when in government. Party leaders effectively apologised for the excesses of their NHS reforms, and gamely tried to relaunch themselves as the 'champions' of public service.

'Our obsession with costs meant the public and professionals thought we had lost sight of the values and principles of the NHS,' said Party leader William Hague. The party would 'let go of the old arguments' and change its policies and language.

It would devolve power to GPs, hospitals, and local government, unlike Labour, which thought 'Whitehall knows best', he said.

The Tory party had 'listened to Britain and was going to change', he promised. 'The next Conservative government will champion public service.'

Mr Lilley continued the theme. The Tories had listened to public servants, he said. It knew now it must respect them, allow them to use NHS resources for 'caring', and assure them that they had the 'freedom and responsibility to improve the services to which they have dedicated their lives'.

Ms Widdecombe was confrontational rather than contrite. Under Labour, waiting lists had not come down, she said. Instead 'the bulge had shifted from those waiting between seeing a consultant and having an operation to those waiting to see a consultant in the first place'.

The government's own figures, which showed a rise of 250,000 people waiting to see a consultant, proved they had failed to address the problem.

She invoked the case of a Mr Nelson who had waited for 80 weeks to see a consultant, and a Leeds consultant who had warned patients they might not get to see him for years.

'Now are those people waiting to see a consultant or are they not? Frank Dobson may tell them they are not waiting, but they know whether they are waiting or not.'

The Tories would change the way lists were measured. 'We will first of all not measure by numbers but by waiting times, by the time people have to wait from the moment they are referred to a consultant to the moment they get an operation.'

Waiting lists, Ms Widdecombe added, would 'reflect individual conditions' so that urgent cases would have shorter times.

The government's failure to address the huge demand on the NHS meant that there was now a 'three-tier' NHS, said Ms Widdecombe.

The 'top tier' patients who were confronted with long NHS waiting lists could afford to go straight to the private or independent sector for treatment.

Second-tier patients, who couldn't get swift NHS treatment but could 'just about' afford private treatment, often made great personal sacrifices to get the services they needed, such as multiple sclerosis sufferers who sold their houses in order to pay for beta interferon drugs unavailable on the NHS. The third tier constituted the 'dispossessed' - those people who 'cannot get NHS treatment and who even if they did not eat could not afford the private sector'.

She said: 'Frank Dobson's refusal to accept that the NHS cannot do it all is betraying those very people. We will not betray them. We will make sure the private sector takes a fair share of the burden.'

Under the Tories there would be a 'proper partnership' between the private, independent, and public sectors. People would be encouraged to use the private sector 'to take the strain from the NHS'.

The private sector would be regulated in the same way as the NHS.

Ms Widdecombe made familiar criticisms of PCGs - 'a triumph of ideology over common sense' - and finished with a rhetorical 'Where's matron?' provoking the standard Pavlovian applause.

Mr Hague might talk of ditching all the old arguments, but some, it seems, are just too good to let go.