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Monday, 7 October, 2002, 14:44 GMT 15:44 UK
Tories aim to overhaul Labour on health
Liam Fox
Dr Liam Fox: Unveiling Conservative health policy
For the past 18 months, Conservative supporters have had precious little weaponry to range against the massed ranks of Labour's NHS Plan.

The ongoing policy review meant that while Shadow Health Secretary Liam Fox launched frequent attacks on ministers, he could not table any firm alternative.

Instead, all that could be reported were his frequent fact-finding tours of health systems across Europe.

At last, however, we are getting a clearer sight of what the Conservatives have in mind for the NHS.

The government is reportedly still holding an internal debate over the merits of a top-tier of "foundation" hospitals.

These top-performing trusts would have greater autonomy and freedom from Whitehall - freedom from certain government targets and restrictions on raising extra capital for improvements.

However, at most, the government plans would only engage only the "best" hospitals - those performing well enough, and deemed worthy of the extra responsibility.

Further on

The Conservatives plan goes the extra mile - throwing the shackles of bureaucracy off all hospital trusts, and turning them all into foundation hospitals.

It is however, likely to to prove relatively more popular within the NHS itself.

Even Unison, hardly the firmest of friends with Conservatism, is opposed to Labour's foundation plans on the grounds that they will create "second-class hospitals".


The British Medical Association and NHS Confederation - which represents managers - both have concerns about Labour's plans for the same reason.

Dr Ian Bogle, the president of the BMA, said in May, when the plans were revealed: "We will want to work with the government to ensure that we don't create a two tier system of foundation hospitals and second division hospitals, some of which are locked into a downward spiral, and where patients are left without the quality of care they deserve."


The Conservatives have also reaffirmed their opposition to increased patient charges in the NHS, but has said it may crack down on those who fail to turn up without good reason for their appointments in hospitals and with their GP.

This could involve fining those who waste doctors' time in this way, although it has not revealed how it plans to collect those fines.

They say this could free up the millions of hours lost every year through missed appointments.

The last thing I would want to do is to discourage anybody from going to their doctor

Professor David Haslam, Royal College of GPs
This, again, is something that Labour are reported to be actively considering - although no official announcement has been made.

While there have been many campaigns to try to cut the number of missed appointments, governments in the past have always fallen shy of actually imposing penalties for "no-shows".

Any many doctors would be concerned about the effect on some of their most vulnerable patients.

Debt collectors

Professor David Haslam, the chairman of the Royal College of GPs, said that while the problem of missed appointments was "massive", he would still be concerned about both the practicalities and the effect of fines on vulnerable patients.

He said: "The last thing I would want to do is to discourage anybody from going to their doctor.

"One of the great things about working in the NHS is that we are not placed in a position where we have to have a credit card sign on the surgery door."

Dr Simon Fradd, the chairman of the Doctor Patient Partnership - which is trying to raise awareness of the problem - also says that the time for fines has not yet arrived.

He said: "Ethically, it is very difficult.

"If you have someone who doesn't turn up for an appointment, and then the next time they come they have chest pains and you think they've had a heart attack, what do you do - say: 'I'm not treating you until you've paid your 5 fine'?"

See also:

07 Oct 02 | Politics
07 Oct 02 | Politics
07 Oct 02 | Education
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