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Last Updated: Monday, 28 June, 2004, 15:54 GMT 16:54 UK
Which vision for the NHS do you want?
Surgeon operating

Health Secretary John Reid has announced plans to cut waiting times as part of Labour's five year plan to improve the NHS.

Mr Reid wants to cut waiting times to 18 weeks and give patients more choice over where they are treated.

Under new Tory plans announced on Wednesday patients could choose to be treated at any NHS hospital.

The Tories also want to abolish central targets, and give patients unrestricted choice to pick a hospital for treatment or to take 50% of the cost of their operation out of the NHS and go private.

They also plan to give people with long-term diseases control over how their conditions are managed.

Will the Tory's plan for the NHS work? How would you like to see policies for health changed? Which vision do you prefer?

This debate is now closed. Read a selection of your comments below.

The following comments reflect the balance of opinion we have received so far:

There is certainly a need for change. The NHS is massively inefficient, like all nationalised industries. Bring in some good management principles and many of the problems would disappear, along with most of the expensive and pointless bureaucrats. I am all in favour of real patient choice, as this will be a key market-shaping driver for the necessary change.
Graham Shelton, Oxford, England

Some of these comments are incredible - "why should I pay for a service I'll never use?" What, you, your family, your best friends, will never have the need for a hospital? Wow, your genes should be examined for future generations. In a laboratory of your choice, of course. And people wonder where the sense of community has gone!
Lee, Hebburn, England

Surely what really matters is quality and availability not choice and cost. In order to achieve this, the NHS needs funding, but also needs efficiency. It seems we have to choose between one or the other, or indeed neither.
William Costigan, Merthyr Tydfil, South Wales

All people want is a decent service in a clean local hospital, without a waiting list. I'll vote for anyone who can deliver that
John, UK

Choice is OK when buying a new car - but not so good when it comes to health. I don't pretend to understand medical issues. All people want is a decent service in a clean local hospital, without a waiting list. I'll vote for anyone who can deliver that.
John, UK

I'd like one where I could use what I have already paid for, when I need it. Failing that, an NHS dentist would be a nice start.
Tony, UK, Rochdale

Surely if we have the right to choose our hospital for treatment, the better hospitals will always be full and will attract the best staff. Would we not then end up with the not so popular hospitals under-funded, under-staffed and under threat of closure, whilst the popular hospitals end up with waiting lists as long as your arm because everyone wants to use them!
Kerri, UK

It's time to end this quasi-Marxist concept of no choice, centrally planned and controlled healthcare. Patients pay for the NHS and yet the priorities of the NHS are not always set in their best interests of need. Mr Howard's reforms for choice and freedom for hospitals look fantastic and very similar to the French and German systems which work very well. Howard has my vote on this one, everyone else is playing catch up.
Mike, London, UK

Competition is the only way to improve standards
Dave Mathews, Wales, UK

The NHS is a bureaucratic waste of taxpayers' money. Competition is the only way to improve standards, and only left-wingers or those with a fondness for wasting money on paper pushers want to see the NHS remain as it is. I pay for private healthcare simply because the only concern I have if one of my family is ill is to get them better. Cancer patients waiting several months for treatment is disgusting - but what can you expect from this government.
Dave Mathews, Wales, UK

Have you been involved with the NHS recently? Both my mother and I have been in hospital at different times and for different things this year. My mother's comment: "I'd rather die than go back there." My feelings aren't that different after three days in casualty. Labour's NHS plans are no different from the Conservatives' just hidden in spin as usual.

Choice is not the answer: it didn't work for schools and won't work for the NHS. The over-riding impression of hospitals now is of staff dedicated to looking after people, but weighed down with administration, bureaucracy and lack of support. The only solution has to be to cut these out, and let staff concentrate on what they're trained to do - without asking them to do more and more tasks in order to cover the lack of staff.
John Green, Macclesfield, Cheshire

It is not just the rich who pay for private care. Many are people who decide to spend some of their money on health as opposed to entertainment. By doing so they are adding money to the overall health service in the UK. Unlike so many people here who moan but contribute little or nothing.
David, Harlow, Essex

The very fact that people who can afford to do so would be able to choose to go private would in itself shorten waiting lists
Simon Guerrero, Chippenham, UK

Those who claim 'right to choose' will result in a situation where the wealthy are cured while the poor wait, are forever misinterpreting the Tory proposals. The very fact that people who can afford to do so would be able to choose to go private would in itself shorten waiting lists and speed up operations for others. I say let's do it.
Simon Guerrero, Chippenham, UK

Is this the same Tony Blair that "only had 24 hours to save the NHS" ? What has he been doing for the last seven years if he needs another five?
Brian H, Leics, UK

As I am having to wait six months for a minor scan and a close friend is having to wait six months for a knee operation, Blair's NHS reform is obviously not working. At least there may not be so many deadly bugs at the local hospital in winter.
T Newman, B'mth UK

Those who want to opt out of paying for the NHS are relics of Thatcher's "no such thing as society" mob. What else do they want to opt out of paying for ? Libraries, schools, roads, the Army? I am a higher rate taxpayer and believe in contributing towards society because it is just - not just for what it can offer me.
Steve, Leeds, UK

Healthcare is a right that should be provided by every government. Don't undermine the NHS with tax cuts for private plans. Improve it so that it competes better with them. You don't know how lucky you are!
Mike, San Francisco, California, USA

The NHS always gets a bad ride due to sensationalised bad publicity
MB, Derby

I work in a hospital and all I can say is that our work suffers due to silly targets that are put in place. For example 100% of people should be seen within A&E in 4hrs....that sounds reasonable until you take into consideration the people that waist time by turning up for stupid things or turn up, decide its too busy and go home again but come back in the morning - I would have to argue that these cases aren't emergencies and only put pressure on an already over stretched service.

The NHS always gets a bad ride due to sensationalised bad publicity. I can only hope that fly on the wall programs such as the one BBC recently showed serve to open the public's eyes to the type of nonsense that we have to endure day after day with no thanks at all.
MB, Derby

One of the problems the length of time it takes to train GOOD medical staff. So with a bottomless pit of money (which we haven't got) any bright idea involving more front line recourses will take years before the results bear fruit. Disregarding political dogma we are never going to have enough staff to satisfy everyone's needs.
Alex Garry, Crawley

Let's not pretend that the health service is free. Everything needs to be paid for, but running the system in such a centralised way doesn't make sense. Let private companies run the hospitals, paid for from a state-regulated insurance system where all are covered. If individuals choose to pay for additional cover that's up to them.
Rex, Marlborough

Do those people who think they shouldn't have to pay NI because they pay for private medical insurance not realise that you don't get private A&E departments?
Katherine, London, UK

Do those people who think they shouldn't have to pay NI because they pay for private medical insurance not realise that you don't get private A&E departments? Knowing that should an accident ever befall me that I will receive medical care, free at the point of need, is a great comfort, and worth every penny of NI I pay.
Katherine, London, UK

I receive private health cover from my employer. I have never used it to give me "choice". I go to whichever specialist my GP recommends and use whichever hospital the specialist wishes. When tests are required I always seem to be asked to go to NHS hospitals. Perhaps I could demand a "choice" but I'd rapidly go over the maximum cover of my policy and end up back on the NHS.

Perhaps I could demand a different specialist - but am I going to over-rule my GP's opinion? Lets be honest about it - the private cover is not there to give me choice but to let me jump the queue. It would be so much better for everybody if there were no queue and this was not necessary!
John, Fleet, UK

Sounds like the old communist governments of 30 years ago. Their 'five year' plans never worked after seven years either. Lets change the model, it cannot be any worse than the current one.
John Norris, London. UK

Thank heavens for "Have Your Say". It's shown that, like me, no-one really cares about choice in healthcare; they just want a quality public healthcare system. It demonstrates again how out of touch with what the public want the political parties really are.
Adele Mcanuff, Newry, N. Ireland

After four operations, care and support from consultants and stoma care nurses. I support NHS enormously. I do not earn the average salary and if the NHS becomes privatised or part-privatised, there is no way I will be able to afford this!
Theresa Tuckwell, Reading

There needs to be a new system and new ideas
Matthew Chambers, Warwick

I have worked in the NHS for 12 years. People are living longer and new treatments are increasing costs. The NHS is a bottomless pit that could never be sustained in its entirety even if we all paid £1,000,000 per month in tax. What people must realise is that a lot of health problems are caused by us all not looking after ourselves for countless years, then when it all goes wrong we expect a doctor to fix it in a week.

There needs to be a new system and new ideas. The NHS is overstretched because so many people are ill. The cost of treatments leaves little money for anything else, however much of this illness could be prevented. Be careful people, don't blame everyone else. And Blair and Reid can never be trusted, they live in an old dream world set in approximately 1948.
Matthew Chambers, Warwick, UK

Before privatising the NHS, let's remember what happened to the railways...
Andy, Bath

Labour have had seven years in charge of the NHS and nothing has improved, now after seven years we get a five year plan! Couldn't this have happened back in 1997? Sorry but I believe this about as much as I believed "education, education education" back then
Dave, Brighton, England

What has the NHS, The Red Army and the Indian state Railway got in common? Clue; It isn't quality or performance! I've worked in the NHS for over thirty years and the whole thing needs dismantling asap it is a top heavy monster totally out of control.
John, Buckley, Flintshire

Until the NHS sees itself as the customer then nothing will change. The NHS needs to stop being the provider of health services and the procurer of them on our behalf. That way it can use its massive purchasing power to be efficient and leave out the top heavy management system. The front line jobs such as nurses and doctors would not go away but would be part of the private sector and then they might be treated as the asset that they should. Yes it is privatisation but we still have a free at the point of use health service procured on our behalf to agreed standards by the government.
Al, England

This is just a Tory back door policy to privatisation. Healthcare should not be seen as part of the goods and services economy because that means that the rich will get better while the poor suffer. The NHS is one of the great institutions in Britain that does really benefit our society. Do we really want to see an American-style healthcare system where people die on trolleys in corridors because they can't afford health insurance?
Chris, Nottingham, UK

Perhaps those who prefer private health care should be allowed to opt out of paying contributions. But with absolutely no way of coming back to the service if they develop illnesses their insurance companies won't pay out for e.g. cancer, and there are many non-smoking related cancers.
Norm, UK

The "choice" issue is a precursor for more centralized public services and less local facilities. A "choice" of treatment in Nottingham, Newcastle and wherever, is Hobson's choice for someone living in Bristol, for example.
Keith Parker, Hull

We don't need choice we need quality
Lynn England, Brockenhurst
We do not want choice! What we really need is to know that there is high quality medical care within 20 miles of where we live. We don't need choice we need quality.
Lynn England, Brockenhurst

Despite massive increases in NHS spending over the last 20 years under both Labour and the Tories the NHS is one of the world's worst performing healthcare systems. Sooner or later the British people are going to have to wake up to the fact that, by any measure, the state controlled, socialist NHS system of providing healthcare just doesn't work. Until then we'll just keep on wasting our money.
Lance Grundy, Liverpool, Great Britain

Forget ideological arguments about choice. What baffles me is the waiting list problem. Logically, people have to wait because there's not enough capacity. So if there's a lack of capacity then waiting lists should be increasing constantly (maybe they stay constant because people die off before treatment?) I'm sure my logic is over simplified but surely the only solution is to increase capacity in the necessary areas?
Simon, Cheltenham, UK

It's pressure by the users, not the choosers, that has driven up standards in all three units
Helen, Bradford, England
Where I live, I have a "choice" of 3 A&E units to take my kids to when they have nosedived off their bike. I've always had that choice. It's not people choosing which one to attend that has improved A&E units over the years - the number at each unit always evens out to the capacity of that unit. People go where the queue is shortest today (the triage desks seem to keep in touch with each other over who's least overrun at any time). It's pressure by the users, not the choosers, that has driven up standards in all three units.
Helen, Bradford, England

If I need to treatment, I want to go to a clean hospital as close as possible to where I live and be seen within a reasonable timescale. Can't really see the need to over complicate matters.
Noel, London, UK

We have not invested enough in the NHS for over 30 years. There are not enough beds, nurses, GPs, consultants or up-to-date equipment. This government is flogging a dead horse - literally! There will be no NHS in five years time. Then the public will really find out what health costs.
Dr SC Martin, Bury St Edmunds, Suffolk

I want a health service where my choices of care and timings are in my hands, not a monopolistic out of date state provider
Steve Willis, Milton Keynes

I want a health service where my choices of care and timings are in my hands, not a monopolistic out of date state provider. This approach, I would have thought, has been discredited for the effective provision of most goods and services. Why should health be any different? Labour doesn't propose state owned supermarkets to provide food for the poor. Health should be no different. The less of our economy under government control the better
Steve Willis, Milton Keynes, UK

I do not want a choice of poor schools, hospitals or doctors. What I want is for my local school to provide a first class education, for my local hospital to make me better (not worse) when I am ill, for my doctor to be able to spot when he is unable to deal with my ailments, not be first class if I have cancer, but fail to spot a heart attack.
Roger Steer, Bristol, UK

Sorry, but anyone who has ever been seriously ill will always stand up for the NHS. I have multiple sclerosis and there is no way I want the NHS privatised - I simply couldn't get health insurance. NHS privatisation, or even part-privatisation, as ever, is only espoused by very short-termist and stupid rich people.
Ian Bartlett, Chesham, UK

You cannot run health under market systems - health is a merit good - it is underprovided and competition would leave many services in a poor state.
Vipul Ganguly, London

What choice do we have? Two parties with the same policy... It is a similar illusion of the choice that will be offered in Labours policy, you can have your operation by a surgeon of whom you know nothing in either Leicester or Rotherham. Under Labour operations are sold to the lowest bidder like cattle at auction, with a minimum of supervision of quality. I can't see the NHS existing in five years time under either party. As a Surgeon this will make me richer, but one more reason to emigrate will exist. If I wanted to work in a private system I would have gone before.
James, Leicester

The debate about choice misses the point. Surgeons comprise less than 10% of NHS consultants, and have access to probably less than 5% of the beds. Elective surgical admissions are outnumbered by emergency admissions, especially when admissions under other specialities are considered. In an emergency, you don't have choice; you go where the ambulance takes you. So the focus should be on uniformly high quality everywhere, rather than providing "choice" to non urgent patients.
James Bellringer, London, UK

The Conservative policy is right in offering choice and this gives all NHS trusts and hospitals an incentive to improve and boost efficiency. I am not entirely convinced by the subsidies on offer, it would be better to privatise the NHS and for the government to then contract out healthcare provision to private companies, therefore boosting efficiency and keeping costs to a minimum as this can still be funded by National Insurance.
Bradley Thomas, Evesham, UK

What happened to the principle of all paying into the NHS just in case we ever needed it?
Bob, UK

What happened to the principle of all paying into the NHS just in case we ever needed it? What happens if you have a stroke or a heart attack when you are poor because of low pay? The NHS was and is a good idea, and Blair and Howard, as rich Tories, will ruin it. I would trust Charles Kennedy more on this one.
Bob, UK

Two comments: Labour policy has been a failure so far. Why should that change now? There is no limit on demand for a free good. The country simply cannot afford unlimited healthcare for everyone, without any restriction - that's a utopian ideal but who would want to pay for that? Why don't the major parties admit this?
Maria, London

The Tory policy seems very sensible. Encourage people to take private healthcare to free up NHS beds for those who can afford it. And any policy that gets rid of all those silly star systems and targets is fine with me!
Chris Halladay, Shrewsbury, UK

We've had seven years of Labour talking about making things better. Nothing's happened. Let's try the Tories!
Laurence Tailby, Cambridge, UK

Higher taxes and decent hospitals. Whilst resident in the Netherlands I paid 40% income tax. The hospitals were clean and hygienic, the trains ran on time and there were ample cycle lanes for everyone. That's one country that's really got it sorted out....
Simon Soaper, England

In reality when you become ill it's the nearest hospital that you want to go to in an emergency
Sam Morris, Oxford

The Tories talk about "choice" for everyone, but in reality when you become ill it's the nearest hospital that you want to go to in an emergency. The worse a hospital becomes, the more patients will move elsewhere, and the less money it will receive, resulting in the creation of a failing hospital with substandard facilities and care. Lower income areas could easily become health deserts where the only way to get decent treatment is to travel outside the county - simply not an option for emergencies, even for those that could afford it.
Sam Morris, Oxford, UK

The Tories have my vote on this issue. Patient choice will increase competition and force hospitals to raise standards to compete.
Sarah Mirren, Wales

As a worker in the NHS, I'm ashamed to say that we are failing our patients. It is time to abolish the idealistic world of a National Health Service and opt for private healthcare. This could be met by switching all National Insurance contributions to private health plans and the government subsidising those who cannot afford to pay. Only a private, business-like approach to working can tighten the NHS to spending effectively and efficiently in the best interest of its patients.
Ben, Norwich, England

I am a nurse who emigrated to the USA in order to quadruple his salary. I can only reflect that until any British government will pay healthcare professionals what they can make in other countries, the only "choice" good nurses and physicians can be expected to make is the choice to leave the NHS.
Sean Murray, Arizona, USA

The lack of choice is the main strength of the NHS
Steve, Bristol

The lack of choice is the main strength of the NHS. It ensures that resources are allocated efficiently. In Germany and the USA, where health is funded through insurance, patients have the freedom to choose any treatment they like. I know people in Germany who will head straight to a senior dermatologist to treat a wart, and they are not the exception.

Skyrocketing insurance contributions are the result. While the UK spends 7% of its GPD on health, Germany spends 11% and the USA 14% (source: WHO). Here is the choice you have in those countries: either you pay a fortune for health and subsidise the hypochondriacs, or you choose an insurance plan that doesn't provide full cover (I don't know anyone sane who would consider this option).

So please let's not head down the "choice" path. It will wreck our economy and health.
Steve, Bristol, UK

Please don't make the NHS a political football. The last thing we need is a divisive haves and have nots situation.
Ray Dawn, Nottingham, England

Their reforms have ruined morale, failed to deliver the promises made and wasted money in levels of needless bureaucracy
Phil, UK
As a NHS worker of 25 years experience, I believe that labour are continuing to sell their view of the NHS. Their reforms have ruined morale, failed to deliver the promises made and wasted money in levels of needless bureaucracy. The Conservative ideas may reduce the massive waste of funds in administration and reduce NHS waiting times by increasing the use of the private sector. What their ideas would also do is to raise the morale within the NHS and offer more flexibility for the patients. We should give them a chance.
Phil, UK

I'm all in favour of choice and welcome this initiative from the Tory party. Personally, I only wish they would go that one step further and work towards offering tax relief to those people who pay for private cover. The more people who can afford to go private do so, the less the burden on the NHS. Seems logical, full of common sense and worthwhile to me. It would certainly be a step forward in freeing up beds within the NHS, benefit non-private patients accessing NHS services and incentives people to take out private plans.
Linda bookman, London, UK

I'm sure it will be great for middle England
Simon Rerrie, Birmingham, UK
Classic Tory policy, the choice they offer is for those that have, the have knot's will be stuck with the same old service. I'm sure it will be great for middle England though.
Simon Rerrie, Birmingham, UK

As someone who works in the NHS I would like to see the system completely reviewed. With the overall aim of reducing administration and paperwork. The severe cutting of administration from non frontline roles. And radically overhauling the pay levels of front line staff. If the military can pay £19,000 a year for a newly qualified nurse then why can't the NHS?
Darren, York

The Party that gets my vote will have to have a clear commitment to proper funding and nationwide provision of the preventative areas of the NHS like dentistry, GP monitoring and opticians. I am amazed that people let politicians get away with confining the promotion of spending on 'the NHS' to hospital treatment that, thankfully, is sparsely used by the majority.
Chris, Woking, England

The whole concept of having to wait for medical treatment is obscene
Ray Gray, London, England
Waiting lists are a form of rationing. Anything that gets rid of them is good. The whole concept of having to wait for medical treatment is obscene.
Ray Gray, London, England

Less of the silly comments like "health should remain free for British" what planet are you living on? I pay a large percentage of my monthly income into the NHS and get very little back. Privatise the lot.
Andrew, Ascot, Berkshire

If we want a quality health service like other European countries we need to be prepared to put more money into it. Everyone should put their share into it by way of taxes and there should be no concessions for the rich to go private. The very fact that they need to go to the private sector means that we are not putting enough into the health service. Why should it only be the poorer in our society that has to accept a second rate service? It should be good enough to serve all.
Nigel Robson, Diss Norfolk

Its all very good saying you only want to pay when you use it (smokers, pensioners, parents) but who can say when you'll need the NHS? Car accident, work accident, trouble on a Friday night - all of these could send you to A&E and no one would like to be told, "sorry no help for you". I like the Tory idea of banning centrally imposed hospital targets as these are massaged by labour anyway. But I really like the fact that if you wanted private healthcare you could have a 50% subsidy. What a fantastic idea and a lesser waiting time!!
Anjuli Woolhouse, Reading, Berks

The lucky proactive ones get to go to the best hospitals, while the rest have to put up with the bad ones
Alex W, Oxford, U
As others have said, "choice" within the NHS is pointless and wasteful. Without a huge amount of spare capacity (i.e. beds and staff who aren't doing anything most of the time), "choice" simply means the lucky proactive ones get to go to the best hospitals, while the rest have to put up with the bad ones. The focus should be on making all hospitals better, not on putting the burden of choice onto patients.
Alex W, Oxford, UK

The Conservative Party seem to have a vendetta against the NHS. This policy is just another example of that policy. The reality is in America the major cause of personal bankruptcies are caused by health insurance and bills.
Mike Walker, London

The idea of choice is brilliant. It would force the hospitals with a low standard of care to pull their socks up (or lose their jobs). This is much better than the pointless labour ¿target' system, which serves no purpose whatsoever (apart from generating more paperwork and cost). Well done Mr Howard, roll on 2005!
James Murphy, Dorset, UK

The state of the NHS is so poor at the moment that I don't believe it can ever be changed. Too many managers, under funding and the bad use of spending all contribute to this. The way forward is a compulsory private healthcare- subsidised by the government for those on a lower income. This way foreigners cannot abuse the service either.
Rajiv Ruwala, London

The NHS was close to the most cost-efficient (if not effective) in the world
Clive, Milton Keynes, UK
I don't understand those who compare the NHS unfavourably in cost terms with European or American health services. The last statistics I saw, the NHS was close to the most cost-efficient (if not effective) in the world. France and Germany are spending beyond the permitted debt levels in the Euro-zone on precisely services like healthcare.
Clive, Milton Keynes, UK

It seems that once again we have the parties bidding to outspend each other on health. When will they realise that spending money is not a virtue in itself? Improving services is virtuous & if this requires extra spending lets see a proper cost/benefit analysis done so we can decide the best place to spend what has to be a finite amount of money.
Geoff Trenner, Glastonbury, UK

I do not think that many people will be interested in having a choice of hospitals - most, I feel, want really high quality services near where they live. Let's scrap this nonsense about "choice" and concentrate on improving services in all hospitals.
Tony, Dudley, UK

Compare a French and UK hospital to see the problem. The French hospitals have a third of the 'managers', cost a third to run and have almost no waiting lists. Scrap targets and let the Dr's and nurses do what they are trained to, look after patients.
Andrew, Herts

Focussing on bringing all levels up the scratch is better than allowing patients to travel
Ian, UK
The reality is that NHS funding under the Tories will fall back to the levels they were when last in power. As to the right to choose - focussing on bringing all levels up the scratch is better than allowing patients to travel away from their local services. This will lead to the chaos we have today with the so called "Right to choose" where your child gets educated and simply create an elitist NHS.
Ian, UK

I worry that the Tories' "right to choose" will actually mean the "right to buy". In other words those who are well off and don't have chronic conditions will have subsidised private treatment while the less well-off or people with long-term (and therefore expensive) medical conditions will go to the wall.
Suzanne B, Herts, UK

The only one speaking sense is Charles Kennedy - Quality local care. The arguments about choice are moot in a system that cannot compete (unless we want long waiting lists again!) while it remains, rightly, state funded.
Chris, UK

There are far too many levels of (mis-)management
Steve, UK
To really make a difference the NHS has to be changed from the ground up, there are far too many levels of (mis-)management and too many people who siphon money off what the government pays to the NHS. It needs a radical overhaul, not just more money thrown at it. I agree that people who choose to go private should have the right to money from the NHS, particularly for dental treatment, after all everyone still has to pay NHS contributions even when they go private. Why shouldn't people have the right to choose, after all we are customers of the NHS, why aren't we treated that way? I also believe in the NHS entitlement card idea, there are far too many people taking advantage of the NHS who have no right to do so, putting extra strain on an already overstretched service.
Steve, UK

I think Charles Kennedy has it right; whilst I may want to be able to travel to a specialist hospital in certain cases, for general hospital treatment I don't want a choice of 5 hospitals or anything like that - I want my local hospital to be clean, competent, and convenient for friends and family to visit. This is exactly the same pointless argument as the one about schools - in reality there's little choice, you just want the school your kids go to be good.
Andy Stansfield, Milton Keynes UK

More choice please
Paul, Yorks, UK
Get the politicians as far away as possible from the NHS. It is an inefficient, state run monolith reminiscent of a past age. Hospitals are shabby, unclean and run-down. They do not make an effort because in a position of monopoly they do not have to. More choice please.
Paul, Yorks, UK

As the Labour government's 'targets' are routinely massaged by NHS managers in order to comply, lets be rid of them and then perhaps the managers can be free to do what they're paid to do, manage.
David, London, UK

The National Health Service means just that a National Health Service paid for and used by everyone. Health is not a commodity that can be bought and sold like bread or a new TV! The "choice" offered by the Tories is a false one all it does is help those who would opt for private health care to in effect get a tax break. Taking your voucher for half the cost of private care will not free up beds as the Tories claim but deprive the NHS of funds! By all means go private if you want but pay for it all. The NHS is for the collective good of society poor and rich we all pay in if we can .
Iain D Monaghan, Brighton UK

Tax relief for people like me who pay for private healthcare. Why should I pay extra in taxes for a service I will never use?
Monique, London

Both sides are guilty of thoughtless political one-upmanship
Ed, London
Both sides are guilty of thoughtless political one-upmanship. The idea of choice is dependent on there being a surplus of a product and I've never seen a doctor or nurse in a dole queue- choice can not work in the NHS. People don't want choice anyway, they just want their local service to be better.
Ed, London

I prefer the vision which enables NHS to expand its capacity with quality services. Health should remain free for British.
Toosy, Guildford, UK

It's time we broke up the NHS, which is the biggest employer in Europe, into individual hospitals and regions, and let them compete against each other in the free market. Beds would soon be provided in areas where there is demand, and the marketplace would automatically generate centres of excellence where the best doctors would be paid what they are worth and the worst would not have their failings hidden. From both main parties it is too little, too late.
Geoff, Portsmouth

The 'one size fits all' NHS is a relic from a ghastly collectivist past
David Moran, Nr. Aberdeen, Scotland
I'd like to see the Tories take the big step forward of allowing those who take out private health-cover to offset 100% of the cost against their current income-tax and national-insurance payments. This would give the NHS some real competition for once - something which it just doesn't have at the moment. As it stands, the 'one size fits all' NHS is a relic from a ghastly collectivist past which nobody wants to live in any more. Be Brave, Mr. Howard - and end the State monopoly of healthcare.
David Moran, Nr. Aberdeen, Scotland.

So, basically the choice is between the 'right to choose' vision and the 'right to choose' vision? Personally I would prefer the 'treat everyone quickly and for free' vision, but it seems that's not on offer.
Helen, Exeter, UK

I pay my taxes and National Insurance. In return, I want a system that gives me the treatment I need, when I need it. This includes Dental and Optical services. I don't want to pay for a NHS that sends me to the back of the queue whilst foreigners waltz into the country and get treated for free. I also do not want a NHS that harvests doctors and nurses from third world countries, compounding the health problems they are already facing.
Ian, Wolverhampton

Let those who use it most (pensioners, smokers, parents) pay for it
Robert Wood, Bradford
I would prefer an NHS that I didn't have to pay for when I wasn't using it. Let those who use it most (pensioners, smokers, parents) pay for it.
Robert Wood, Bradford

The NHS should concentrate on A&E and outpatient type requirements. Private hospitals should carry out operations under contract to the health trusts. This would greatly reduce the administrative burden on the NHS coffers and offer a suitable service to the public. Private patients could also be treated in the same hospitals so maximising the professional skills available.
Terry, Epsom, Surrey

I want a health service that doesn't tell me that it's going to take quite a time to get on to a waiting list. I'm having to go private. They said that it was probably the sensible thing to do.
Steve, UK

The NHS will never change until it is better staffed and most importantly managed better
Judith, Bury, England
My son was ill in hospital for a week last year. If I could have had a wish list for choice while he was in there, it would have been: 1. A choice to have his room cleaned properly every day and his sheets changed more than once in a week while he was bed-ridden. 2. A choice to be seen by the same doctor every day, so they know what is happening. 3. A choice to have doctors who speak good enough English so they can understand the symptoms that are being described. 3. A choice that the excellent nursing care he received would be better rewarded and their responsibilities increased. The NHS will never change until it is better staffed and most importantly managed better.
Judith, Bury, England

The Tories are not offering choice, they are offering a two-tier service for the haves and have-nots. The poor and working classes won't have choice, they'll be subsidising the rich as they race past the queue at the tax-payers expense! Defend the NHS Vote Labour!
Rob, Northfleet

Only the Tory proposals will preserve the NHS as a free-at-the-point-of-delivery, universal service in the long run. Both the Lib Dems and, ultimately, the Labour proposals will only mean delaying necessary reforms until it is too late. If that happens, there may not be an NHS at all in ten years.
Anatole Pang, London

Surely if we have the right to choose our hospital for treatment, the better hospitals will always be full and will attract the best staff. Would we not then end up with the not so popular hospitals, underfunded, under-staffed and under threat of closure, whilst the popular hospitals end up with waiting lists as long as your arm because everyone wants to use them!
Kerri, UK

The best value for money (and benefit to the individual) is to be gained from measures preventing ill health. Unfortunately this carries no political points as the results are often long-term, difficult to quantify and not directly attributable to the government. By contrast, people readily understand money spent; number of beds; waiting times etc... None of these figures give any indication of public wellbeing. With such a large proportion of NHS resources used to treat the rapidly-increasing cases of preventable illness, why not take a bold step and concentrate the NHS on health rather than illness!
S Ross, Leeds, UK

What is all this about patient choice? Surely we should get the NHS on track first before we start throwing yet more radical ideas in the air!
stuart, Cambridge, UK

Neither of them. I want it broken up, privatised and real competition introduced.
Richard Read, London, UK

The NHS should be abolished
Clare, UK
Any service free at the point of delivery is a bad idea. People do not value what they do not pay for. If the consumer does none of the paying then there is no reason for a service culture in which the consumer matters. The NHS wastes huge amounts of money on unnecessary office equipment. It buys computers and services at exorbitant prices. The NHS should be abolished. If we want to help those with long term conditions then we should give them vouchers for private health. It would be much cheaper and they would receive better service.
Clare, UK

If any politician is serious about protecting the NHS as an asset to this country, they would propose the decimation of management and the abolition of the Department of Health. The NHS should concentrate on what it is good at - acute and specialist medicine, research and development, and commissioning and inspecting care. Less intervention please. Let us do our jobs for once!
Anon (senior consultant in the NHS), Lytham St Annes


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