Patient will get right to choose hospital, pledges Milburn

A pioneering scheme that lets NHS patients choose where to have their operation if they have been waiting more than six months was extended by the Government yesterday.

Alan Milburn, the Health Secretary, announced at the conference that the initiative, which applies to some heart patients, would now be used for those waiting for cataract operations in London.

In July, the Department of Health announced that 2,000 heart patients across the country who were waiting six months or more for an operation at their local hospital could opt for treatment elsewhere in the NHS or in the private sector. So far, 400 patients have been treated under this Heart Choice scheme.

The new pilot will mean cataract patients in the capital who have been waiting at least six months can also choose to go elsewhere. By next spring the idea will be extended to also include people in London waiting for orthopaedic operations, ear, nose and throat treatment, general surgery and other specialities.

"If we want a health service which puts patients first then patients have got to have more power. And that means they've got to have some choice," Mr Milburn said. "So if their local NHS hospital cannot offer them a shorter waiting time but another hospital can, they can decide to choose."

Dr Liam Fox, the shadow Health Secretary, dismissed the extension as a gimmick. "This shows how little importance Labour really attaches to choice. It is a pathetic extension to a system which begins from a very low base. Patients are given a choice only if the system has already failed them. Alan Milburn's centralised system of healthcare is completely insensitive to the needs and wishes of patients,'' he said.

Mr Milburn also announced an extra £10m will be given to areas of England with the highest levels of coronary heart disease. In addition, the Government has published a document introducing a new three-year planning system for the NHS and social services to replace the current annual system. Each local area will now submit a single three-year plan. The document – Investment, Expansion and Reform – also included a commitment to avoid the introduction of new national targets where possible.

Meanwhile, Tony Blair was under pressure last night to resolve the growing cabinet feud between the Chancellor, Gordon Brown, and Mr Milburn over the future of foundation hospitals. With both sides refusing to back off, the Prime Minister was expected to step into the dispute, which centres on the issue of whether high-performing hospitals should be allowed to borrow free of Treasury control.

Alarm has grown among the duo's cabinet colleagues that the stand-off between them is threatening to distract attention from government attempts to focus attention on its health-service reforms. They now expect Mr Blair to risk a row with the Chancellor by intervening. One senior source said: "Don't forget that the Prime Minister is First Lord of the Treasury."

During a session with delegates, Mr Milburn placed heavy emphasis on offering greater choice to patients in the National Health Service. He said: "Rather than the hospitals choosing the patients, we've got to have patients choosing the hospitals." Mr Milburn admitted this amounted to a big change, but added: "In the end, if we are going to have a health service that puts patients first, patients are going to have to have more power and more choice."

Bemoaning the widening of health inequalities over the past 50 years, he said: "Too often the poorest services are in the poorest communities. Patients have little say and precious little choice."

He dismissed charges that the pace of change in the NHS was undermining the quality of the service. "I don't think too much reform is the problem, but whether we are prepared to reform enough," he said.