Tony Blair's long awaited National Plan for radically overhauling the health service - billed as the biggest shake-up the NHS has seen since it was founded in 1948 - was published by the government today. The prime minister today announced in the Commons massive changes in the way the NHS is structured, managed and staffed. The blueprint, designed to modernise the NHS over the next 10 years, has been drawn up by six committees made up of government ministers, doctors' leaders, patients' groups and other experts. Mr Blair, who believes Labour's record on the health service will be a key battleground in the next election, has also been closely involved in the formulation of the plan.
The National Plan was announced after the budget this year when spending on the health service received a £19bn boost for the next four years. The government wants to bring spending on health up to EU levels by 2005 - but has warned that huge cash injections must be matched by fundamental reform of the way the NHS is run.
A report commissioned by the health secretary, Alan Milburn, from consultants at Virgin Group highlighted problems of poor management, disillusioned staff, dirty hospitals and massive bureaucracy.
Details of the plan have been widely leaked in recent weeks. Key changes were expected to include:
• Waiting lists: Any NHS patient whose operation is cancelled for non-medical reasons will be guaranteed surgery within 28 days, even if it means sending them to a private hospital. By 2005, 90% of patients will wait less than three months for non-urgent hospital care, and no one should be waiting longer than six months.
Special centres dedicated to particular operations such as cataract surgery or hip replacements could work 24 hours a day to reduce hospital queues.
• Doctors: There is to be a huge increase in the number of medical school placements and changes in the way junior doctors are selected and trained.
Because these new doctors will take years to be trained and filtered through the system, a massive recruitment drive will be launched to attract qualified doctors from the US, Australia and Europe to boost UK numbers. Doctors from developing countries will not be poached to avoid accusations of depriving poorer countries of their much-needed workforce.
• Nurses: Big increases in the numbers of nurses are also expected under the National Plan.
Nurses will also be given extra powers to prescribe drugs, treat patients in casualty departments and carry out minor routine surgery in a bid to improve their status and end the traditional "rigid demarcations" between doctors and nurses.
• Hospitals: New standards to clean up filthy wards and hospitals will be laid down and bosses will have to work to ensure there are enough beds to cope with winter pressures and other problems. Hospitals will be set a range of performance targets and those that fail to meet them will be deprived of extra cash.
• Patients: The crux of the National Plan is to make the health service more "consumer-friendly" for patients. Every hospital will have a "patients' champion" - a patient, advocacy and liaison service which will handle complaints from patients and their relatives on anything from dirty wards and hospital food to disputes with doctors, and have the power to demand action.
• The elderly: The National Plan will also include the government's long awaited response to the proposal by the Royal Commission on Long Term Care of the Elderly, which recommended that all personal and nursing care for old people should be free. The government is expected to incur the wrath of the elderly by saying that nursing care will be paid for by the NHS but that personal care (including changing dressings and catheters, among other things) will have to be paid for by individuals.
