Niall Dickson: Well-informed patients will make better decisions

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

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

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

SEN (SLD/PMLD) Teacher

£120 - £130 per day: Randstad Education Chelmsford: Are you a quailed Teacher ...

General Cover Teacher

£120 - £125 per day: Randstad Education Luton: Currently looking for teachers ...

SEN Teaching Assistant Runcorn

£50 per day: Randstad Education Cheshire: SEN Teaching Assistant EBD , Septemb...

QA/BA - Agile

£400 Per Day: Clearwater People Solutions Ltd: Our client are currently seekin...

Day In a Page

Read Next
David Cameron gives his keynote speech to the Conservative party conference in Birmingham  

Conservative Party Conference: Here's what David Cameron said in his speech…and what he meant

John Rentoul

Ebola virus in the US: How did the disease ever spread this far?

Sophie Harman
Ebola outbreak: The children orphaned by the virus – then rejected by surviving relatives over fear of infection

The children orphaned by Ebola...

... then rejected by surviving relatives over fear of infection
Pride: Are censors pandering to homophobia?

Are censors pandering to homophobia?

US film censors have ruled 'Pride' unfit for under-16s, though it contains no sex or violence
The magic of roundabouts

Lords of the rings

Just who are the Roundabout Appreciation Society?
Why do we like making lists?

Notes to self: Why do we like making lists?

Well it was good enough for Ancient Egyptians and Picasso...
Hong Kong protests: A good time to open a new restaurant?

A good time to open a new restaurant in Hong Kong?

As pro-democracy demonstrators hold firm, chef Rowley Leigh, who's in the city to open a new restaurant, says you couldn't hope to meet a nicer bunch
Paris Fashion Week: Karl Lagerfeld leads a feminist riot on 'Boulevard Chanel'

Paris Fashion Week

Lagerfeld leads a feminist riot on 'Boulevard Chanel'
Bruce Chatwin's Wales: One of the finest one-day walks in Britain

Simon Calder discovers Bruce Chatwin's Wales

One of the finest one-day walks you could hope for - in Britain
10 best children's nightwear

10 best children's nightwear

Make sure the kids stay cosy on cooler autumn nights in this selection of pjs, onesies and nighties
Manchester City vs Roma: Five things we learnt from City’s draw at the Etihad

Manchester City vs Roma

Five things we learnt from City’s Champions League draw at the Etihad
Martin Hardy: Mike Ashley must act now and end the Alan Pardew reign

Trouble on the Tyne

Ashley must act now and end Pardew's reign at Newcastle, says Martin Hardy
Isis is an hour from Baghdad, the Iraq army has little chance against it, and air strikes won't help

Isis an hour away from Baghdad -

and with no sign of Iraq army being able to make a successful counter-attack
Turner Prize 2014 is frustratingly timid

Turner Prize 2014 is frustratingly timid

The exhibition nods to rich and potentially brilliant ideas, but steps back
Last chance to see: Half the world’s animals have disappeared over the last 40 years

Last chance to see...

The Earth’s animal wildlife population has halved in 40 years
So here's why teenagers are always grumpy - and it's not what you think

Truth behind teens' grumpiness

Early school hours mess with their biological clocks
Why can no one stop hackers putting celebrities' private photos online?

Hacked photos: the third wave

Why can no one stop hackers putting celebrities' private photos online?