‘There are at least three substantial dividing lines between the parties. It is time that they were properly debated. The first concerns national targets and standards. Andrew Lansley says the Tories would scrap Labour's three flagship waiting targets: 18 weeks, four-hour A&E and the two-week cancer target. Removal of these standards, as the Tories propose, would inevitably see a loss of public accountability and a return to postcode variation.
The second dividing line is on NHS pay. Andrew Lansley drops heavy hints that the Tories would reintroduce local pay bargaining...The third area concerns national accountability. The Tories have proposed handing over the day-to-day running of the NHS to an independent board.’
The demolition of target culture and a reduction of day-to-day political interference in the NHS, whilst obviously remaining accountable to government, should liberate staff from red-tape and place emphasis on ‘outcomes’, such as long-term cancer survival rates. The Tories’ ideas are reasonable and humane, and, unintentionally, Burnham vindicates their desire to decentralise: ‘(The NHS) will require different answers from the top-down approach that placed order on a failing system.’ But Burnham, blinded by over-confidence, offers Cameron a ‘wide-ranging debate on the future of the NHS’ – a tactical mistake as Cameron is unlikely to suggest one himself after the Hannan debacle. Cameron should take this opportunity.