News 2005 UK election special

Reducing the time from soup to nuts

BMJ 2005; 330 doi: (Published 28 April 2005) Cite this as: BMJ 2005;330:988
  1. Nicholas Timmins, public policy editor

    Financial Times

    Everything in the Labour party's plan for the NHS is subordinate to the need to increase capacity and to bring down the waiting time between seeing a GP and having an operation. Nick Timminsreports

    At election time some people (probably, in truth, a small and rather sad minority) pore over the parties' manifestos. They are often a pretty poor guide to the future. No one could possibly have gleaned from the Conservative manifesto for health in 1987, for example, that by 1992 the NHS would be operating an internal market. The big financial crisis late in 1987 that triggered the Conservatives' NHS review was just about visible; its outcome, to all but clairvoyants and those now granted the gift of hindsight, was not.

    Equally, a newly landed Martian reading Labour's 1997 manifesto and looking at the NHS today would be entitled to wonder how on earth we got from there to here. That manifesto contained, for example, no mention of the National Institute for Clinical Excellence or the creation of an NHS inspectorate and a social care inspectorate, a clinical assessment authority, or a patient safety agency. A party that was later to introduce more central targets and a tougher performance management regime than any of its predecessors promised not to return to the “top down management of …

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