Success of heart surgery pilots means patient choice goes nationwide

Health secretary Alan Milburn today set out plans to extend patient
choice across the NHS - including more parts of the country, more
surgical specialties and more individual choices for patients.

In a keynote speech to a conference of NHS chief executives, Mr
Milburn explained how patient choice would be expanded over the next
three years following the success of two pilot schemes covering heart
and cataract surgery which have been running since last year.

Since the choice scheme was first introduced last July for all
patients in England waiting six months for heart surgery, almost half
of patients offered choice took up the option of earlier treatment.
In London more than two thirds chose to have treatment at an
alternative hospital.

As a result of today's announcements more patients in London and
others across the whole of the South of England will benefit,
together with patients in the North West in Greater Manchester and
West Yorkshire, as the nationwide roll-out of patient choice
continues in July.

Mr Milburn said:
"Building on the success of the existing choice pilots, we now want
to extend choice to other parts of the country and other clinical
specialities. In the next year around 100,000 extra patients will be
able to choose in which hospital they are treated. The areas we have
chosen include those where electronic booking of hospital
appointments is being tested.

"And for the first time some patients will be offered a choice of
hospital at the point they are referred for specialist treatment by a
GP, as well as after waiting six months or more for treatment."

>From this summer more than 50,000 patients in London waiting more
than six months for any planned operation will be offered the choice
of treatment at an alternative hospital. This covers orthopaedic;
ear, nose and throat surgery; urology; gynaecology; plastic surgery;
oral surgery and general surgery.

>From July patients in West Yorkshire needing eye operations will be
offered choice when they are referred to a hospital specialist by
their GP. In Greater Manchester those needing orthopaedic, ENT and
general surgery will also be offered choice if they have been waiting
longer than 6 months.

Also from July, choice will be extended to patients, mainly older
people, needing cataract operations in the south of England where
waiting times are currently longest. Patients will be able to choose,
initially from two and then normally from four hospitals, where to
have their cataract operation. The aim is to cut waiting times to 6
months by 2004 and to 3 months by 2005. For cataract patients in the
south, this means that the NHS Plan target will be achieved three
years ahead of schedule.

Further schemes in the South also announced today and due to start
this July include:

In Berkshire choice will be offered to patients waiting six months or
more for plastic surgery; general surgery; ear, nose and throat
surgery; dermatology surgery and MRI scans- benefiting more than
10,000 patients.

In Surrey and Sussex choice will be offered to patients waiting six
months or more for general and urology operations - benefiting around
6,000 patients.

In Dorset and Somerset choice will be offered to patients both at the
point of referral and for others already on the waiting list for any
operation - benefiting over 10,000 patients.

The lessons learned from these areas will inform the extension of
choice across the whole of England's health service. From summer
2004, as the Prime Minister announced recently, all patients waiting
six months for any form of elective surgery will be able to choose at
least one alternative hospital and normally four - public or private
hospitals or Diagnostic & Treatment Centres (DTCs) - for treatment.

>From December 2005, by when extra capacity will have come on stream,
choice will be extended from those patients waiting longest for
hospital treatment to all patients. They will be offered choice at
the point the GP refers them to hospital.  Patients needing elective
surgery will be able to select from at least 4 or 5 different
hospitals, again including both NHS and private sector providers.

As capacity grows further in the NHS so choice will grow. Beyond 2005
patients needing surgery will be able to choose more hospitals in
which they can be treated.

Choice needs to be embedded across other parts of the NHS where it is
appropriate to do so. In primary care, PCTs will need to use the
annual patient prospectus, they issue to all the households in their
areas, to highlight where women patients are able to see a woman GP.
Later this year we will publish local guides to maternity services so
that mums and dads-to-be are better informed about the choices
available to them.

Choice also requires diversity in capacity. A new generation of DTCs
will be providing care to 250,000 patients a year by 2005. Insulated
from emergency work these will be able to concentrate on elective
surgery and shorter waiting times. Some will be run by NHS providers.
Others by private sector providers. In making their commissioning
decisions PCTs will need to consider how best to use both existing
and new private sector provision for the benefit of NHS patients.
They will also need to consider how best to use voluntary sector
providers. Following discussions with key voluntary health care
providers, the government will draw up a concordat to extend the
relationship between the NHS and the voluntary sector later this
year.

Choice is central to the Government's agenda for modernising and
improving public services and creating a patient-centred NHS. It is
about treating people as active citizens, not passive recipients of
services, enabling them to exercise choice over important aspects of
their lives.

Mr Milburn said:
"Greater choice for patients will mean more equity, not less. Giving
patients greater choice in the NHS requires a fundamental culture
change in how the NHS works. It will put patients in the driving seat
- at the heart of the health service - and not before time. Patients
will be able to choose hospitals rather than hospitals choosing
patients. There will be more choice in primary care and in maternity
care too.

"For too long, for too many, the choice has been to pay or wait. Our
choice is for the NHS but a reformed NHS. An NHS where more can have
that choice of time and place of treatment; where more can share in
choices previously only enjoyed by the few who could afford to pay;
where people choose to stay with the NHS not opt-out. An NHS which
genuinely puts need before ability to pay. That is what our reforms
are about. That is what we intend to deliver."

Notes to Editors
1. Media enquires only to Alicia O'Donnell-Smith, Lee Bailey or
Nicola Plumb on 0207 210 5222/5724/5301.

2. Choice is already available to some patients through pilot
schemes. The Heart Choice project was launched nationally in July
2002 and offers all heart patients who have been waiting six months
for treatment at their local hospital the chance to get speedier care
at a hospital elsewhere. The London Patient Choice Project was
launched in October 2002 and currently offers cataract patients who
have been waiting more than six months treatment at an alternative
hospital. So far nearly half of all heart patients have opted to take
up Choice and 70 per cent of cataract patients under the London
Choice Project.

3. The schemes announced today are the start of a nationwide rollout
of choice across the whole of the NHS. The NHS Plan target is that
"By the end of 2005 every hospital appointment will be booked for the
convenience of the patient, making it easier for patients and their
GP to choose the hospital and consultant that best suits their
needs."

4. Patients will remain as NHS patients, receiving treatment to NHS
standards, free at the point of delivery, wherever it is provided.
They will be able to select from a range of providers operating
within a framework of clear national standards regulated
independently to ensure their performance meets clinical quality
standards. No patient will be forced to travel for treatment if they
choose to be treated at their local hospital.

ENDS