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Thursday, 10 May, 2001, 14:27 GMT
Tory health plans: Analysis
The Conservative Party has committed itself to maximising choice for patients and to reducing what it believes is unnecessary political interference in the running of the NHS.
These broad aims have been welcomed by health professionals.
However, concern has been raised that the Tory manifesto says nothing about workforce numbers, or public health.
There is also unease about some of the specific proposals for delivering health care.
The British Medical Association (BMA) welcomed the commitment to allow health professionals to take decisions about patient care without interference by politicians.
A spokeswoman said doctors would also be pleased at plans to focus on the length of time patients wait, rather than on the numbers on the waiting list.
She said the government's waiting list initiative targets had resulted in a distortion of clinical priorities.
"How long a patient waits for treatment is much more important than the number of other people they are waiting with. Patients must be treated according to the urgency of their condition."
However, the BMA is concerned that the manifesto contains no commitments to increase the number of nurses and doctors working in the health service. It wants 10,000 extra GPs and significant increase in consultant numbers.
It warned that plans to increase the specialist expertise of GPs and to expand the role of practice nurses though welcome, would be impossible to implement without an increase in staff levels.
The association is sceptical about plans to link hospital funding to the operations they carry out.
The spokeswoman said: "You have to remember that some specialist hospitals carry out less operations, but that they tend to be more complex."
There are also concerns about plans to develop more stand-alone surgical units specialising in a particular type of operation such as cataract surgery or hip replacements.
Many doctors believe patients are best treated in large district general hospitals as they often tend to suffer from multiple health problems.
The spokeswoman said: "All surgeons want to protect planned surgery. It is deeply frustrating when operations are cancelled because all the beds are full with patients with emergency medical conditions but stand alone, disease specific units may not be the best way forward.
"Building capacity in our district general hospitals by increasing the numbers of surgeons, anaesthetists, pathologists, radiologists, nurses, theatre facilities and in patient beds, and managing this capacity effectively, is probably a better way forward."
The Royal College of Nursing is pleased at the commitment to increase NHS funding, and to keep care free at the point of delivery.
It also supports plans to re-introduce matrons with increased authority over the running of hospital wards - but sees the plans as similar to those already announced by Labour.
A spokeswoman said the plan to increase the role of practice nurses was also welcome.
But she said: "We would like to see an expanded role for all nurses wherever they are working."
The King's Fund, a healthcare watchdog, welcomed both the commitment to a comprehensive, tax-funded NHS free at the point of use, and the pledge to give local health services more control over their business.
However, it said the key to improving the NHS lay in the successful recruitment and retention of more health workers.
A spokesman said: "It is disappointing that there is no mention of what the Conservatives would do to reduce health inequalities and tackle the causes of avoidable ill health.
"Nor is there a commitment to pay for both nursing and personal care for people with long-term illnesses."
He said the Patient's Guarantee may well help patients awaiting surgery - but will do little for people with mental health problems or chronic illnesses.
The biggest difference from Labour was a promise to provide tax incentives for private medical insurance. However, this could prove to be counter-productive.
"It is likely to reduce tax income for public services more than will be saved by people using private health care. This could damage the NHS."
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