The NHS wish list for 2001

The BMA says more doctors are needed

The future of the NHS is likely to come under close scrutiny in what seems almost certain to a general election year. Leading figures in the health service tell BBC News Online what they see as the priorities for the service in the next 12 months.

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Mike Stone, director, Patients' Association:

"We need better communication between doctors and patients so that patients understand what doctors are saying to them and doctors understand what patients want.

Mike Stone says doctors should work in partnership with patients

"There has to be a total culture change. Everybody is still in awe of doctors a little bit, but we need a more equal partnership.

"Doctors must be encouraged to speak to patients and treat them as equals.

"Attitudes are changing gradually by there is still a long way to go.

"Another top priority is to see a better patient environment in hospitals. I have seen toilets in hospitals that look like something out of the film Trainspotting.

"There have been some encouraging signs, but while there are still patients coming out of hospital with malnutrition, there is still a long way to go.

"It is not just about food quality, it is about proper delivery of that food. It is not acceptable that food is prepared in the hospital kitchens, taken up to the ward and then left standing for one-and-a-half hours.

"Neither is it acceptable just to put food down at the end of a patient's bed, because they might not be able to reach down to get it."

Professor Gordon McVie, director general, Cancer Research Campaign:

Prof McVie wants more drugs to combat cancer.

Professor Gordon McVie wants tobacco companies to pay for NHS treatment

"Top of my wish list is that the National Institute for Clinical Excellence agrees to a range of anti-cancer drugs that NHS patients are currently not allowed to have.

"These include gemcitabine, for lung cancer, and topotecan for ovarian cancer.

"Drugs like these would help to bring the cancer death rate down. I also wish a cancer gene will be found so we can develop new treatments."

Prof McVie is also keen for the UK to follow the lead of the US, where legislation has been introduced forcing tobacco companies to pay 10% of the estimated cost of providing healthcare to patients with tobacco-related illness.

He says: "In Florida and California, this money has been used to fund anti-smoking campaigns aimed at teenagers. That would be an immensely constructive thing for the government here to do."

Dr Ian Bogle, chairman, British Medical Association:

Dr Bogle said doctors felt daunted by plans for fundamental reform laid down in the NHS Plan for England.

BMA's New Year wish list

More doctors

More nurses

More beds

More time for patients with their doctors

Fewer spin doctors

No flu outbreak

Staff beginning to see the new NHS money getting through to front line services

A recognition that admissions pressures are a year-round problem

The beginnings of a strategy to tackle them

Matching investment in social services

He said: "That creates a political problem for government because demoralised staff find it difficult to believe that life is ever going to get any better.

"The temptation is to send the spin doctors in because the real doctors have yet to be recruited and trained.

"My wish for the NHS in 2001 is that we can get a creative combination of both long-term investment and short term fixes so that patients, doctors and nurses all start to see and feel a difference.

"Everyone knows it takes nine or ten years to train a GP, 15 years to produce a fully trained consultant.

Dr Ian Bogle wants better planning

"But there's nothing wrong with a few quick fixes, provided we are all honest about what they are."

Dr Bogle said these could include pensions incentives, flexible training opportunities and part time contract options.

He also called for a guaranteed consultant post for every registrar who completes their hospital training.

Stephen Thornton, chief executive, NHS Confederation:

Mr Thornton, who represents NHS authorities and trusts, said it was important the government's proposals for NHS modernisation were made law before an election.

Stephen Thornton recongises the need for radical change

"This bill contains some key planks of the modernisation agenda, particularly when it comes to patients involvement and primary care.

"Without it we will not be able to develop care trusts or patient's forums."

Like Dr Bogle, he believes the so-called winter crisis is actually a year-round phenomenon.

"The NHS needs to see the extra investment promised by the government for beds and staff and needs to continue to find innovative ways to reduce pressure on beds, such as making more use of GP clinics and day surgery."

"There is also no doubt that we need more nurses and doctors - but there are also real recruitment problems in other professions allied to medicine - such as physiotherapists.

"More people doing the same sort of things will only help solve our people-problem to a certain extent - we also need to look at how we an do things more efficiently using the people we already have.

"The line between what a doctor and what a nurse or other professional can do is blurring all the time. The NHS needs to embrace and promote this multidisciplinary working."

Another priority for Mr Thornton is to establish uniform high quality in the primary care service.