Niall Dickson: Well-informed patients will make better decisions

'The biggest test, as ever, will be translating the vision into reality'

Share
Related Topics

If good intentions were enough to cure the 60-year-old NHS of its problems, then the job would be well and truly done.

Sadly, when it comes to the health service, it is the gap between policy ambition and the reality of implementation where so many come unstuck. It probably does not help when the Prime Minister and the Health Secretary bill your report as a once-in-a-generation opportunity.

Of course, it was always going to be difficult – no amount of government hyperbole can detract from what is essentially a continuation of Blairite reforms. But that does not make it a bad thing – this review could help to transform healthcare services in ways that traditional reorganisations have repeatedly failed to do. The big test, as ever, will be translating the vision into reality.

Indeed, one of its greatest attributes is what it does not do – there is no big organisational shake-up and no dramatic changes in direction. The report presents a sensible set of measures designed to improve the quality of care, while sending out a clear signal that responsibility for shaping and leading services lies with staff at a local level.

For the first time in a systematic way, services throughout the NHS will be judged and paid for on the basis of the outcomes they achieve. Quality measures will become more important – the old traditional process targets, such as the 18-week wait for treatment, survive but are relegated to being minimum standards.

This should help us all make more informed choices and encourage those providing the care to do better.

On the downside, there are two omissions – first there are no estimates of how much all this will cost; second, there is no indication of just how different the Government expects the health service to be in five or 10 years' time.

Some of the answers lie in the regional plans that have been developed by the strategic health authorities, but an overall view of how far and how fast the Government expects the NHS to change would be helpful. The regional plans also highlight a real tension – the Government is in favour of encouraging local decisions, yet the Health Secretary is keen that patients in one area should not be disadvantaged when compared to another. He wants a universal service, but not a uniform one.

A similar tension is apparent in the NHS constitution and the promise to end the postcode lottery with a right for every patient who needs them to have access to drugs approved by the National Institute for Clinical Excellence (Nice). But some decisions about drugs will still be made locally for drugs that have not yet been Nice approved, and for those patients living in areas where they decide not to fund, the lottery will seem alive and well.

But these should not detract from the main message – which is that as patients we not only want a larger, quicker health service, we also want a better one. A service where our patients are not at risk from MRSA and where GPs refer to specialists at the right time. We want a service where staff are kind and don't lose our notes, and don't keep asking the same questions. Where we get fed when we are hungry and given the pain relief when we need it.

That is what is meant by quality of care and today's report puts that centre stage.

Niall Dickson is chief executive of the King's Fund

React Now

  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Recruitment Genius: Senior Digital Marketing Consultant

£28000 - £45000 per annum: Recruitment Genius: A Senior Digital Marketing Cons...

Recruitment Genius: Assistant Stores Keeper

£16640 - £18500 per annum: Recruitment Genius: An Assistant Stores Keeper is r...

Recruitment Genius: Claims Administrator

£16000 - £18500 per annum: Recruitment Genius: This is an excellent opportunit...

Recruitment Genius: Software Developer - C# / ASP.NET / SQL

£17000 - £30000 per annum: Recruitment Genius: Developer required to join a bu...

Day In a Page

Read Next
 

General Election 2015: The SNP and an SMC (Salmond-Murdoch Conspiracy)

Matthew Norman
A voter placing a ballot paper in the box at a polling station  

General Election 2015: Despite all the seeming cynicism, our political system works

Ian Birrell
Fishing for votes with Nigel Farage: The Ukip leader shows how he can work an audience as he casts his line to the disaffected of Grimsby

Fishing is on Nigel Farage's mind

Ukip leader casts a line to the disaffected
Who is bombing whom in the Middle East? It's amazing they don't all hit each other

Who is bombing whom in the Middle East?

Robert Fisk untangles the countries and factions
China's influence on fashion: At the top of the game both creatively and commercially

China's influence on fashion

At the top of the game both creatively and commercially
Lord O’Donnell: Former cabinet secretary on the election and life away from the levers of power

The man known as GOD has a reputation for getting the job done

Lord O'Donnell's three principles of rule
Rainbow shades: It's all bright on the night

Rainbow shades

It's all bright on the night
'It was first time I had ever tasted chocolate. I kept a piece, and when Amsterdam was liberated, I gave it to the first Allied soldier I saw'

Bread from heaven

Dutch survivors thank RAF for World War II drop that saved millions
Britain will be 'run for the wealthy and powerful' if Tories retain power - Labour

How 'the Axe' helped Labour

UK will be 'run for the wealthy and powerful' if Tories retain power
Rare and exclusive video shows the horrific price paid by activists for challenging the rule of jihadist extremists in Syria

The price to be paid for challenging the rule of extremists

A revolution now 'consuming its own children'
Welcome to the world of Megagames

Welcome to the world of Megagames

300 players take part in Watch the Skies! board game in London
'Nymphomaniac' actress reveals what it was really like to star in one of the most explicit films ever

Charlotte Gainsbourg on 'Nymphomaniac'

Starring in one of the most explicit films ever
Robert Fisk in Abu Dhabi: The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers

Robert Fisk in Abu Dhabi

The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers
Vince Cable interview: Charging fees for employment tribunals was 'a very bad move'

Vince Cable exclusive interview

Charging fees for employment tribunals was 'a very bad move'
Iwan Rheon interview: Game of Thrones star returns to his Welsh roots to record debut album

Iwan Rheon is returning to his Welsh roots

Rheon is best known for his role as the Bastard of Bolton. It's gruelling playing a sadistic torturer, he tells Craig McLean, but it hasn't stopped him recording an album of Welsh psychedelia
Russell Brand's interview with Ed Miliband has got everyone talking about The Trews

Everyone is talking about The Trews

Russell Brand's 'true news' videos attract millions of viewers. But today's 'Milibrand' interview introduced his resolutely amateurish style to a whole new crowd
Morne Hardenberg interview: Cameraman for BBC's upcoming show Shark on filming the ocean's most dangerous predator

It's time for my close-up

Meet the man who films great whites for a living