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Last Updated: Tuesday, 1 January 2008, 14:09 GMT
PM signals first NHS constitution
Gordon Brown and Alan Johnson at the Royal Marsden in London
Gordon Brown said patients admired NHS doctors and nurses
Prime Minister Gordon Brown has signalled his intention to press ahead with a constitution for the NHS.

It would set out for the first time the rights and responsibilities linked to entitlement to NHS care.

Mr Brown's comments came in a New Year message to NHS staff ahead of the 60th anniversary of the health service.

He said a constitution - which was first suggested by former PM Tony Blair - would help secure its future for another 60 years.

In a letter to NHS staff, Mr Brown warned of major changes in the health service in the year ahead.

These could be enshrined in a formal NHS constitution, setting out the "rights and responsibilities" linked to entitlement to NHS care, he added.

Patient guarantees

The idea was first floated in a September 2006 pamphlet by then health minister Andy Burnham.

A constitution would effectively be a bill of rights for patients and is seen as a major reform - comparable to Mr Brown giving the Bank of England control of interest rates when he was chancellor.

It is being considered as part of Lord Darzi's review of the NHS.

A Department of Health spokesman stressed it would be subject to extensive consultation, adding: "The government has no blueprint for action."

If a constitution reduces the day-to-day influence of politicians in the NHS, that would be a positive step
Dr Peter Carter

Mr Brown has rejected a totally independent NHS, saying it must be held to account through Parliament and ministers.

Dr Peter Carter, general secretary of the Royal College of Nursing, said: "If a constitution reduces the day-to-day influence of politicians in the NHS, that would be a positive step, but ultimately taxpayers need to be able to hold politicians to account.

"We are starting to debate with our members in the next few months what we would like to see in a constitution."

Dr Michael Dixon, chairman of the NHS Alliance, said there was a need to be explicit about what the NHS did and what people could expect.

"A constitution is not as big an issue as it once was," he added. "We've had the NHS Plan and there are some fairly radical reforms going through, like practice-based commissioning, and getting the implementation of these things right is the absolute priority."

He added: "To the average member of the public and patients and, frankly, doctor or nurse it doesn't mean much. It's just another big idea from on high."

In his letter, Mr Brown said better care and higher standards over the past 10 years had reduced waiting times and saved thousands of lives.

"These are your achievements and I want to thank you for them," he wrote.

'Personalised care'

He said plans for 2008 involved tackling hospital infections and improving access to care.

And warning of a major shake-up in the coming year, he said, "We will describe how we will achieve our shared ambition of an NHS which is more personal and responsive to individual needs.

"Personalised not just because patients can get the treatment that they need when and where they want, but because from an early stage we are all given the information and advice to take greater responsibility for our own health."

He talked of wanting to create an NHS which is "as good at prevention and keeping us healthy as it is at the care and the cures we know are there when we need them".

The NHS - the world's first completely free healthcare system - was created by Nye Bevan, then minister for health, on 4 July 1948.

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