Published: 11/12/2003, Volume II3, No. 5885 Page 17
Health secretary John Reid's first major policy paper, published on Tuesday, mirrors both the language and direction of the Labour Party's Big Conversation - the precursor to an election manifesto next year.
This is not surprising - the paper from Mr Reid on Building on the Best: choice, responsiveness and equity in the NHS, may be a government command paper, but many of its numerous and wide-ranging proposals are unlikely to see the light of day ahead of a general election.
Many of the ideas it contains will be welcomed, and seem in tune with consumer expectations: access to GPs at home and work and the ability to collect repeat prescriptions from pharmacists are relatively small changes which could make a big difference to patients. More fundamental, perhaps, is the intention of the document's authors towards provision of primary care. Mr Reid was explicit about the need for a patient-centred NHS to take on the 'vested interests' within the professions that run it.
And discussions at the Downing Street seminar which launched the document suggest that primary care is about to see the kinds of rude awakening that the acute sector is experiencing over the introduction of independent sector treatment centres.
Building on the Best highlights the potential for the private sector to take on not only out-of-hours care, but to expand to deliver day care. It also promises private sector involvement in primary care diagnostics. The paper aims to spread some of best and most radical practice already taking place in the NHS. On Tuesday, Mr Reid described the 26 people sitting around the table with the prime minister discussing the implications of choice as 'pioneers'. But with confusion and suspicion about the choice agenda still rife in many parts the NHS, these pioneers need to make sure they leave trails others can and will follow.
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