Tories plan to halt NHS reforms

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The Independent Online
The Tories are set to enter the general election campaign with promises to spend more on health and to restrain themselves from further changes to the NHS.

A White Paper, to be published in the autumn, will rule out any more free-market reforms to the service. The document, designed to neutralise health as a general election issue, will stress that a universal health service is the most equitable and efficient way of delivering care. It will not envisage any expansion of private health care or insurance. That makes the prospect of widespread tax relief for those taking out private health insurance very unlikely.

Conservative policy makers see the paper as an important ideological statement from Stephen Dorrell, the Secretary of State for Health, since it will make the case for a continuing high level of spending in the NHS.

Although Kenneth Clarke, the Chancellor, has not yet agreed to make a spending pledge, senior Conservative sources do not expect him to resist in the run-up to the election. The 1992 Conservative manifesto promised to protect health spending with real terms increases.

Most ministers regard such a growth in spending as inevitable and are therefore keen to make a virtue out of a necessity - and give a manifesto pledge.

Mr Dorrell, regarded by Conservative moderates as a possible successor to John Major, concedes that health is a "home" issue for Labour and regards his new adversary, Chris Smith, as more formidable than his predecessor, Harriet Harman.

Against this background Mr Dorrell will set out a series of parameters for the NHS which will be presented as a universal, rather than a safety net, service.

His paper will highlight four principles: healthcare on the basis on clinical need without regard to ability to pay; a universal service; high quality care and a patient-centred service.

But the mental health service will be acknowledged as a weakness which needs to be addressed. One senior source said: "You cannot make a case to the tax-payer for extra money unless you have a clear and precise view about what you mean to use that money for."

Ministers now argue that it is impossible to point to a better model in a developed economy for delivering health care than the NHS. That marks the end of radical-right hopes for reform along Canadian or continental lines, with a central role for private health insurance.

Mr Dorrell's paper will also be directed towards the professionals who work within the NHS. Although the Tories acknowledge that there are some areas of low morale, they believe they are winning over the professionals who will not want further disruption to the service which could arise from a Labour government.

The Tories will retain their commitment to the Private Finance Initiative in hospital-building and will plan to develop a network of cottage hospitals.

But the White Paper will, said a senior source, "draw a line under five years of argument over management change". Instead, ministers will promise better use of skills within the health service and a commitment to involve clinicians in management.

The health professionals played a central role in the opposition to earlier Conservative reforms and, because of their contact with voters, are seen as important opinion formers.