NHS patients needing specialist treatment will for the first time be able to choose the consultant to whom they are referred, a move that could create huge queues for the best practitioners.
Hospitals will be required to accept all "clinically appropriate referrals to named hospital consultant led teams," Andrew Lansley, the Health Secretary, said. The announcement, timed to bolster public support for the Health and Social Care Bill during its second reading debate in the Lords, extends to NHS patients the same privileges enjoyed by private patients who already have the right to choose a named consultant. But the move could lead to long waiting lists for the most popular consultants, as patients use the internet to research the top doctors.
In that event, patients will have to weigh up whether they want to wait to see the best specialist or be seen more quickly by a less popular colleague, a spokesperson said. Patients will be able to travel to any part of the country to see the consultant of their choice and hospitals would be required to publish individual "success rates" for their specialists to help patients choose.
The move marks a divergence from past policy which prohibited named consultant referrals, in order to help the NHS use its resources efficiently to drive down waiting lists. Rating individual doctor's performance has also been rejected in the past on the grounds that modern medicine is a team activity and individual performance measures would be misleading. Mr Lansley said: "From April next year patients will be able to choose not only where, but who provides their care. But this will only work if patients can access relevant information about NHS consultants and the service s they provide. That's why all NHS providers will be required to publish this vital information and support real patients choice."
Currently only heart surgeons publish their individual success rates, in terms of the deaths of their patients.
The Royal College of Surgeons recently criticised other specialties for failing to follow this example. A study published in August showed thousands of patients had to go under the knife for a second time because as many as half the operations carried out by some NHS bowel surgeons ended in failure.
There is much concern in the NHS over variations in quality and how to improve the poorest performers.