New NHS constitution

The government plans to enshrine in law the right to receive private care if NHS waiting times exceed national targets. Hospital patients in England will get the legal right to be seen privately if they face NHS delays.

Hospitals have to start treating patients within 18 weeks of referral, or two weeks in the case of cancer. But ministers will now give patients a legal right to private care, or treatment at another NHS centre if so desired, if this does not happen.

The consultation on patient rights:

  • Ministers will ask the public whether they should get a legal right to choose to die at home
  • Access NHS dentistry
  • Personal health budgets
  • Choose a GP practice offering extended access to evening and weekend appointments
  • Key diagnostic tests for suspected cancer patients within one week of seeing a GP

Health Secretary Andy Burnham adds that everyone aged 40-74 would have a legal right to a five-yearly NHS health check from 2012 to assess their risk of heart disease, stroke, diabetes and kidney disease.

The guarantees, to come into force in April next year, will be set down in the NHS Constitution. The other potential measures will be put out for public consultation.

Several thousand patients a month are already being treated at private hospitals under the NHS through the patient choice initiative. At the start of the referral process, they are able to choose from an approved list of providers that are willing to carry out the treatment at NHS cost. But the new rules will allow patients to opt to switch to private care at a later date if it turns out the NHS cannot see them within the deadline. In theory, this has already been possible during the drive to cut waiting times since Labour came to power. However, it has been incumbent on trusts themselves to arrange such steps, meaning it has not been routinely done. And since most waiting targets were met, there was little need to take such action in the first place. But the government believes that by introducing a legal right it will empower patients to hold the health service to the shorter waiting times that have now been achieved.

The Conservatives have said they would scrap the 18-week target, preferring to concentrate on outcomes, such as deaths, rather than processes. Shadow health secretary Andrew Lansley says, "This is the latest in a series of unaffordable and uncosted pledges that have more to do with electioneering than improving the NHS."

Dr Mark Porter of the British Medical Association comments, “Clearly the NHS has made huge progress in cutting excessive waiting times. However, many doctors remain frustrated by examples of political targets being prioritised over the needs of individual patients. If one group of patients gains a legal right by virtue of how long they have waited, there is a risk that others with more serious conditions will wait longer. We also have concerns that this will mean more NHS work going to private providers, with destabilising effects on hard-pressed NHS services."

A clue to the election date is given, as the start date is 1st April – make of that what you will.


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