Alan Milburn, the health secretary, promised patients more control over the timing of their operations yesterday in a speech which launched a raft of NHS reforms and further details of the long-awaited national cancer plan. By March next year, all NHS hospitals are to start offering an appointment booking system to give at least some of their patients more control over the timing of operations. By March 2002, 43 hospitals should be able to offer every day surgery patient a booked appointment allowing them to pick a time to suit their family, caring work or holiday needs.
While Mr Milburn was on his feet in Brighton, Mike Richards, the cancer tsar now reborn as national cancer director, was putting flesh on the bones of his national plan, some of which was revealed by the prime minister on Tuesday.
An extra £50m is to be invested in palliative care and hospices and GPs are to be helped and supported to diagnose cancer and help those who leave hospital after treatment by designated cancer GPs. One of these will be funded in every primary care trust, jointly by Macmillan Cancer Relief and the government.
Prof Richards revealed a new smoking target - to cut smoking rates in manual classes, among whom cancer and heart disease is highest, from 32%in 1988 to 26% by 2010. A new healthy eating campaign will be launched to encourage fruit and vegetable consumption, and patients will be given more information about the risks as well as benefits of cancer screening.
Mr Milburn got a standing ovation after his first conference speech as health secretary. Delegates cheered his promise to abolish compulsory competitive tendering for catering, cleaning and other hospital services.
Since 1983 hospitals have been obliged to offer private sector firms an opportunity to compete for these contracts. Mr Milburn said this resulted in a race to provide the cheapest service, lowering standards of cleanliness.
"Compulsory competitive tendering has... damaged the NHS for too long. It will now go," he said.
Instead hospitals will be required to demonstrate value for money, with greater emphasis on satisfaction and quality as well as cost. Other announcements included £50m more for carers looking after relatives at home. Up to 75,000 more of them will get grants to provide cover when they take a break from minding older, infirm, disabled and sick people.
Mr Milburn promises to increase the number of chest pain clinics to diagnose patients with suspected heart disease from 50 to 84 by next April. Appointments will be arranged within a fortnight.
He recalled how his close friend Ian Weir, a photographer on the Northern Echo, died last year at 35 while waiting for a heart operation. "The NHS let down Ian Weir... there were far too many waiting just like him. In governments you listen and you learn. We will end long waiting in cardiac and cancer services, across the health service."
Delegates responded enthusiastically when Mr Melburn promised more power and more pay for nurses and doctors.
Aides later explained that he was not calling for a general above inflation settlement but wanted to reward those taking extra responsibility and pay a "market forces supplement" to staff in regions experiencing particularly high cost of living increases.
• £50m for hospices and palliative care, including more support to help the terminally ill stay at home.
• Maximum wait of one month from diagnosis to treatment for all cancers by 2005 and for breast cancer by 2001.
• Smoking among manual groups to be cut from 32% in 1998 to 26% by 2010.
• Campaign to increase fruit and vegetable consumption.
• Better information for patients about the risks as well as benefits of cancer screening programmes.
• Improvements to cervical screening, breast screening extended to age 70 (and over 70 on request)
• Testing for prostate cancer available in the spring, trials for colorectal and ovarian screening underway
• New National Cancer Research Institute to focus efforts where progress most likely
