New Health Secretary Jeremy Hunt tears up plans to force NHS to meet specific patient satisfaction targets


By the standards of your typical Government document it is mercifully short in length and remarkably free of jargon.

But, then again, it is also worryingly short on specifics and suspiciously free of concrete commitments.

The new Health Secretary Jeremy Hunt has launched the Government’s much vaunted NHS Mandate – a document which sets out for the first time what the public can expect from Britain’s health service over the next few years.

Under plans to give the NHS greater autonomy from politicians as part of the Government’s health reforms the 28 page Mandate sets out what ministers expect from NHS managers when they assume new responsibility for the service next April.

But unlike the draft Mandate – published a few months ago by his predecessor Andrew Lansley – the new document is a lot shorter and a lot less specific than had been expected.

Mr Hunt has torn up plans to force the NHS to meet specific targets on increasing patient satisfaction, reducing premature deaths and improving the quality of life for those with long term health conditions.

Instead the new Mandate includes no reference to specific targets – suggesting instead that the health service should show “measurable progress” in a whole range of areas.

Launching the document today Mr Hunt insisted that his new measurement did not amount to a “watering down” of expectations on the NHS at a time of huge financial pressure.

In fact he claimed his head would be “on the block” if England did not become one of the most successful countries in Europe for preventing premature deaths.

But he added it would also mean that ministers would no longer be “micro-managing” the NHS for political ends.

“This is the first time that we have tried to represent the operational independence of the NHS by disciplining ourselves as ministers to condense what we want the NHS to focus on into a document of only 28 pages,” he said.

“We are removing the ability of ministers to performance-manage the entire NHS from behind their desks in Whitehall.

“We are replacing that with operational independence for professionals on the front line and the way that we are doing that is by limiting ourselves to specifying outcomes, not specifying processes.”

But Labour said the new document amounted to 28 pages of “motherhood and apple pie” with no clear indication of how the Government could achieve – or be judged against - its “lofty targets” while cutting frontline staff.

The Shadow Health Secretary Andy Burnham told Mr Hunt: “You have just reeled off an impressive wish-list but it begs a simple question: how on earth can you be asking the NHS to do more when 61,000 jobs have been lost in the NHS or are at risk?

“The statement you have just made is dangerously at odds with the reality on the ground.”

Unveiling the Mandate Mr Hunt announcing a range of new measures to improve patient care and experience using the NHS

He said he hoped that within a few years patients would be able to put their postcode into a new system to see how well their local hospital compared to other across a range of treatments and services.

In addition doctors’ surgeries will have to set up services to allow anyone to see their health files, book appointments and order repeat prescriptions on the internet.

The new document was broadly welcomed by health groups who had also been keen not to impose specific targets on the services.

Dr Mark Porter, Chair of British Medical Association Council, said: “The mandate reflects the BMA’s opinion that the NHS Commissioning Board (NHSCB) needs flexibility to exercise its judgement on how to deliver this vision. There are measures to encourage the NHSCB to innovate, and a welcome reduction in targets, objectives and micromanaging that marred the draft mandate.” 

Sir David Nicholson who as the new head of the Commissioning Board which takes over next April described the mandate as “a major step on the road to the more liberated and innovative NHS that can be more responsive to its patients.”

“The mandate avoids the danger of excessively prescribing the actions of health professionals,” he said.

“We have a once in a lifetime opportunity to do things differently.  We will succeed only by releasing the energy, ideas and commitment of front-line staff and organisations. The NHS Commissioning Board wholeheartedly embraces this challenge.”

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