Reid puts patient choice at centre of health reforms

John Reid, the Health Secretary, put the Government on a collision course with some of its own supporters yesterday by telling the Cabinet that patient choice will be the centrepiece of Labour's plans for the NHS.

Mr Reid was given the backing of Tony Blair and the Cabinet for the next election manifesto which will promise to make greater use of private health care, paid for by the NHS, to convince the public the service is improving.

In an uncompromising message, Mr Reid told the Cabinet that the government would unequivocally stick by its traditional commitments to free health care at the point of use on the NHS. However, he said the next Labour manifesto would deliver a system which was "fair to all and personal to each". People's greater demands for choice elsewhere in their lives should be reflected in the NHS, he said.

Labour was reducing maximum waiting times from 18 months to six months in 2005 but it had to make further improvements.

"People's needs should take precedence over systems of delivery where the two come into conflict."

By putting the patient first, Mr Reid, in effect, acknowledged the Government will have to overcome the resistance of health service unions and Labour MPs including the former health secretary Frank Dobson, who this week spoke out against giving priority to "choice'' for NHS patients.

The five-year programme, to be announced next week, will be used by Mr Blair to try to extricate his premiership from the mire over Iraq and get the Government back on the road for the general election by focusing on improvements to public services.

The plan will shift the emphasis from cutting waiting lists for acute illnesses to improvements in long term care for chronic diseases, such as asthma, heart disease, lung disease, arthritis, diabetes and some cancers.

Mr Reid told colleagues that patients would have more choice through NHS walk-in centres, nurse-led clinics, and more medicines sold over the counter in community pharmacists, such as statins that can prevent heart attacks. More capacity would be bought from private clinics for the NHS where necessary

Mr Reid will rule out the threat of NHS "hotel' charges for patients who want better rooms while staying in NHS hospitals. However, some Labour MPs are wary about concentrating on offering patients the choice of faster access to free treatment on the NHS by travelling to hospitals with shorter queues. Mr Dobson protested that patients wanted their local hospitals to offer the best treatment, and they did not want to have to choose.

The health five-year programme will be followed in mid-July by the five-year plan for education, which will also focus on expanding schools to provide choice for parents.

However, those plans are likely to run into opposition from Labour supporters of comprehensive schools.