More patient choice but system yet to be tested

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Thousands of heart patients who have waited more than six months for surgery will be offered treatment at another NHS hospital, at a private clinic or overseas, Alan Milburn, the Health Secretary, said.

From next July people on cardiac waiting lists will benefit from radical plans that will, "for the first time give patients an explicit choice about where they are treated in the NHS".

By 2005, the scheme will be extended to all patients needing hospital treatment to allow them to "choose the hospital and the waiting time that is convenient for them".

Mr Milburn said too often the only choice for patients was between long waiting times in the NHS or paying to go private. "Many patients may choose not to exercise a choice," he said. "Many will prefer to wait at their local hospital. Some will prefer to travel to get faster treatment. But the point is this – it will for the first time be the patient's choice."


Mr Milburn pledged to build a, "fairer, faster and patient-centred NHS" where no one would wait longer than 12 months for an operation by the end of next year.

To build capacity and speed treatment, health authorities will share more than £53bn next year. On average their budgets will rise by £39m or 9.9 per cent, which Mr Milburn said was the biggest increase for a decade. In addition, more than £400m would be available to help trusts shop around for treatment.

"It will be for local health services to decide how best to spend these resources but it may be spent in NHS hospitals, in the private and voluntary sectors, in community and social services."

More choice

From next summer, all patients who have waited more than six months for heart surgery will be asked by their hospital what they want to do.

The options will include another NHS hospital or private clinic with a shorter wait, a European hospital or to stay with their existing hospital on the basis they will wait no longer than 12 months in total.

All chronically ill patients will continue to be seen in a matter of days or weeks and it is likely the healthier patients, with less serious conditions, will travel for treatment.

Foreign hospitals will have to show their standards of care are at least equivalent to those in Britain. The cost of transport, surgery and recovery in hospital will be paid by the NHS, as will expenses for a relative or friend. Patients will also be given support and advice from a network of care advisors.

To provide choice, the local NHS trust will sub-contract treatment through a central clearing system, which will ensure places are found.

Other surgery

To extend the same choice to other patients, pilot schemes will be set up next year in London and the rest of England. By 2005, "all patients and their GPs will be able to book hospital appointments at both a time and a place that is convenient".

In the new year, health authorities on the south coast will give patients waiting for routine surgery the choice to be treated elsewhere.

Many patients have already requested to go overseas and French and German hospitals are said to be queuing up to win contracts to treat British patients.


The plans were welcomed by the British Medical Association as an interim measure, but not as a permanent solution to problems within the NHS.

Dr Ian Bogle, BMA chairman, said: "The Government must invest in the NHS so that patients have no need to go abroad or to private hospitals and have the choice of first-class health care close to home."

Professor Sir Charles George of the British Heart Foundation said it was "great news" for thousands of people who were on waiting lists.

Bruce Keogh, a heart surgeon and secretary of the Society of Thoracic Surgeons, said the plans were a "pragmatic" response.

But the Royal College of Nursing said care had to be taken not to create "a category of hospital where no one wants to go" and to ensure that taxpayers got good value for money in the private sector.