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EDITIONS
Blair years Monday, 6 May, 2002, 08:37 GMT 09:37 UK
Labour's 1997 pledges: Health
The following page details Labour's activity in government on health, based on what it committed itself to in the manifesto. Some pledges have been omitted for the sake of brevity. No judgement has been made to the inherent value of the pledge, but important criticisms are included where applicable.

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WHAT THE MANIFESTO SAID:
"Labour will cut costs by removing the internal market. The savings achieved will go on direct care ... the first 100 million saved will treat an extra 100,000 patients"
CONCLUSION: PLEDGE MET
In March 2000 the government announced that this target had been met. On first coming to office, the figure stood at 1,158,000. In March 2000 the list had come down to 1,037,066, meeting the key election pledge. The figures for the end of February 2002 was 1,050,400.
CRITICISMS AND QUALIFICATIONS
While the government can claim to have met the letter of the pledge, there are many criticisms of how it did so. Ministers struggled for three years to meet the commitment, leading to accusations that clinical priorities were being skewed to meet the target. The most significant criticism was that the list was being massaged downwards through delays in giving people their first appointment with a consultant - in effect a waiting list to get on the official waiting list. The government has now adopted waiting times rather than numbers of patients as the key target.

WHAT THE MANIFESTO SAID:
"GPs and nurses will take the lead in combining together locally to plan local health services more efficiently for all the patients in their area..."
CONCLUSION: PLEDGE MET
Commissioning pilots were started in 1998 and the network of Primary Care Groups established in April 1999.
WHAT THE MANIFESTO SAID:
"The current system of year-on-year contracts is costly and unstable. We will introduce three to five year agreements between the local primary care teams and hospitals..."
CONCLUSION: PLEDGE MET
The Government introduced this change in its White Paper 'The New NHS', published on 8 December 1997, saying that the policy change would allow health officials more scope to strategically plan the needs of an area.
WHAT THE MANIFESTO SAID:
"Hospitals will retain their autonomy over day-to-day administrative functions, but, as part of the NHS, they will be required to meet high-quality standards in the provision of care. Management will be held to account for performance levels."
CONCLUSION: PLEDGE MET
Hospitals remain responsible for their own administration. 'NHS performance indicators' (league tables) are published. If the government considers an NHS trust to be failing, it can send in a "hit squad" to overhaul the hospital.
WHAT THE MANIFESTO SAID:
"Boards will become more representative of the local communities they serve."
CONCLUSION: PLEDGE MET
Labour complained prior to the 1997 election that hospital boards were being stuffed with Tory place men and women. Appointments to hospital boards are no longer made by the Secretary of State. Since April 2001 they have been handled by an NHS Appointments Commission.
CRITICISMS AND QUALIFICATIONS
Critics say that given that up to 1,500 posts come up for renewal every year, Labour used the four years between coming to power and the establishment of the new commission to do exactly what the previous administration had done and stuff boards with its own supporters.
WHAT THE MANIFESTO SAID:
"A greater proportion of every pound spent will go on patient care not bureaucracy."
CONCLUSION: DEBATABLE
There is no single accepted definition of NHS administration costs or bureaucratic load. The Department of Health says that it "has no current plans to develop such a definition" and it is arguable whether one could ever be agreed upon by all concerned. While the parties can argue over whether there is actually more red tape or not, figures in February 2000 revealed that the number of administrators relative to NHS beds had actually increased to an all-time high.
WHAT THE MANIFESTO SAID:
"We will raise spending on the NHS in real terms every year... "
CONCLUSION: PLEDGE MET
NHS spending in 2002-03 will increase by 5.7bn to 68.9bn. This is an annual real increase of 5.7% up to the end of the current spending round in 2003/04.
WHAT THE MANIFESTO SAID:
"We will end waiting for cancer surgery, thereby helping thousands of women waiting for breast cancer treatment."
CONCLUSION: PLEDGE NOT MET
In March 2002, a report by the Royal College of Radiologists found that the number of patients starting radiotherapy within the government target of four weeks of a consultant's recommendation had fallen in just two years from 68% to 32%. The government accepted the report but said that the number of radiographers had actually increased by 10% since Labour came to power.
WHAT THE MANIFESTO SAID:
"A new patients' charter will concentrate on the quality and success of treatment."
CONCLUSION: PLEDGE MET
Two reports published in 1998 highlighted the need to make the patients charter more patient focused. In April 2001, the government replaced the charter with Your Guide to the NHS. There are still patients' charters in Scotland, Wales and Northern Ireland.
WHAT THE MANIFESTO SAID:
"As part of our concern to ensure quality, we will work towards the elimination of mixed-sex wards."
CONCLUSION: PLEDGE NOT MET
A BBC survey in November 2001 found that health authorities do not expect to meet target of eliminating 95% of mixed sex wards by end of 2002.
WHAT THE MANIFESTO SAID:
"Health authorities will become the guardians of high standards. They will monitor services, spread best practice and ensure rising standards of care."
CONCLUSION: PLEDGE NOT MET
While the government has established structures to monitor standards, they are not based on Health Authorities, as pledged.
CRITICISMS AND QUALIFICATIONS
However, the government says that its national Commission for Health Improvement (CHI), established in 1999, and the National Institute for Clinical Excellence (NICE), share responsibility for spreading best practice.
WHAT THE MANIFESTO SAID:
"Labour will overcome the problems that have plagued the Private Finance Initiative ... and develop new forms of public/private partnership that work better and protect the interests of the NHS."
CONCLUSION: DEBATABLE
The Government argues that private money leads to better management and incentives to keep within a deadline and budget. However, the influential Institute for Public Policy Research, says that there is no evidence to support Most hospitals built under PFI are scheduled to open in 2004 so it is difficult to draw any firm conclusions yet. One of the most controversial aspects of Labour's pursuit of PFI is its move towards paying private companies to run hospitals - including responsibility for staff.
WHAT THE MANIFESTO SAID:
"A new minister for public health will attack the root causes of ill health, and so improve lives and save the NHS money."
CONCLUSION: PLEDGE MET
Yvette Cooper is the current minister for public health. Her responsibilities health promotion and prevention and tackling inequalities.
WHAT THE MANIFESTO SAID:
"Labour will set new goals for improving the overall health of the nation which recognise the impact that poverty, poor housing, unemployment and a polluted environment have on health."
CONCLUSION: PLEDGE MET
In 1999, the Government published a strategy for public health which included in targets for cutting deaths from cancer, heart disease and stroke, accidents and mental illness. The document stressed that the government recognized that many of these deaths were linked to social, economic and environmental factors.
WHAT THE MANIFESTO SAID:
"Labour will establish an independent food standards agency."
CONCLUSION: PLEDGE MET
Established by an Act of Parliament in 2000, the Food Standards Agency aims to protect the public's health and consumer interests in relation to food and its production.
WHAT THE MANIFESTO SAID:
"Smoking is the greatest single cause of preventable illness and premature death in the UK. We will therefore ban tobacco advertising."
CONCLUSION: ON COURSE
The Government introduced a bill to ban tobacco advertising in the 2000-01 session. It failed to reach the statute book because of the calling of the General Election. The legislation was reintroduced in the Lords by the Liberal Democrats and the Government says that it will be given time and support in the Commons.
CRITICISMS AND QUALIFICATIONS
One of the Labour government's few early wobbles came as a consequence of the plan to ban tobacco advertising when the government agreed a highly controversial exception for Formula One motor racing. It then emerged that the head of the Sport, Bernie Ecclestone, had donated 1m to Labour. The party subsequently returned the cash after taking advice from public standards watchdog Sir Patrick Neill.

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