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Last Updated: Monday, 6 October, 2003, 13:35 GMT 14:35 UK
Q&A: Patients' passports
The Conservatives are unveiling more details of their "patients' passports" scheme for healthcare on Monday. BBC News Online explains what the policy is all about.

What are patients' passports?

The Tories announced the scheme last June after their search for distinctive policies for improving public services.

Under the plans, patients would be able to choose either a different NHS hospital for treatment or take some of the money out of the NHS to help them go private.

Haven't the government come up with something similar?

From this summer, patients in London waiting six months for an operation have been offered treatment at an alternative hospital. The scheme will be extended to patients in the rest of England by summer 2004.

But the Tories argue the Labour scheme only gives patients any choice once the system has already failed them. Under their plans, people would be able to choose a hospital as soon as their GP refers them for treatment - so there would be no waiting time trigger.

They also say the government plans restrict choice. Instead, their proposals would allow patients in Bristol to choose a hospital in Swindon.

So what's new now?

Shadow health secretary Liam Fox is using his speech at the Tory annual conference in Blackpool to put a cash figure on how much help patients going private would get through patients' passports.

We have a right as taxpayers to make sure the money we put into health is spent in a fair, justifiable and transparent way
Liam Fox

Standard prices would be put on the cost of operations - perhaps 5,000 for a hip replacement operation - and patients could then spend 60% of that money at a hospital outside the NHS, he will say.

Does this say anything about wider Tory thinking?

Senior party officials argue it shows a different approach to taxes - that once people hand over their taxes to Labour, the government thinks the money is its own, while the Tories believe it still partly belongs to the taxpayer so people should be able to use some of it for private treatment.

They are unable to say, however, whether that could apply to other policies - education, for example.

What operations could come under the scheme?

That is still one of the big question marks, with the details still being worked out. Conservative officials say they have accepted there is no reason why it should be limited to elective surgery - things like hip replacements and cataracts.

It could also be rolled out to other treatments - helping stroke sufferers get rehabilitation from GPs or physiotherapists or paying for hospice care for people with chronic illnesses.

But the scheme would be rolled out gradually - and the Tories have been impressed by criticisms of Labour's policy that focusing on the more straight forward elective surgery risks skewing the system.

The speed of its introduction will depend on coping with demand - and on getting the IT systems in place to allow transfer of money across different health providers - something the government is working on for its own system.

How much would the plans cost?

Labour claimed earlier this summer the plans would take 2bn out of the NHS and only really help private patients.

The Tories cannot say that patients passports would add costs but they say those could be balanced by their "bonfire" of bureaucracy elsewhere in the health service. Dr Fox is talking about "dismantling" the Department of Health - and will reveal some of those details on Monday.


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