The Liberal Democrat Manifesto 1997

Our aim: To make year-on-year improvements in the health of Britain's people and the quality of the National Health Service.

The problem: The NHS has been squeezed between rising demand and government underfunding, and disrupted by repeated changes in government policy. Morale amongst NHS professionals is falling, and bureaucracy has grown at the expense of front-line patient care, while numbers of nurses and hospital beds have fallen.

Our commitment: Liberal Democrats will increase funding for the NHS and secure funding for the future. We will maintain the NHS as a comprehensive service, free at the point of need and funded primarily from general taxation. We will immediately tackle the crisis in the hospital sector, make the NHS more accountable and begin a long term shift towards preventive medicine.

Our priorities are to:

Halt all finance driven closures for 6 months, pending an independent audit of needs and facilities.
Invest Ł200 million each year to recruit more staff for front-line patient care. This would be enough, for example, for 10,000 extra nurses or 5,000 extra doctors.
Cut hospital waiting lists to a maximum of 6 months over 3 years.
End the two-tier system in the NHS.
Restore free eye and dental checks.

Raising standards in the NHS
Whilst many of the recent reforms to the NHS have been beneficial, they have resulted in the creation of a two-tier health service. The standard of health care a person receives is increasingly becoming a lottery. The length of time people have to wait, the chance of treatment being postponed and the quality of health care vary enormously from one part of the UK to another.

We will:

Match NHS facilities to needs. We will place an immediate 6-month halt on the finance driven closure of beds and wards, and set up an independent audit of needs and facilities.

End the built-in two-tier service in the NHS. We will end the present system where treatment depends on the type of GP people go to. We will treat all GPs equally, with a common basis for funding. We want all GPs to have the benefits of flexibility and access to services currently enjoyed by fundholders. Those who choose to manage their own affairs will be able to do so on their own or as part of a consortium. Those who do not will be able to leave management to the local health authority.

Raise standards of care in all areas. We will set up a National Inspectorate for Health and Social Care to improve standards and promote patients' interests. This body will work with the Audit Commission to ensure that all spending is monitored and results in real improvements in patient care. Funding the Health Service
The NHS is underfunded. Too much goes into bureaucracy and not enough into patient care. There is a crisis in the NHS, especially in hospitals. Morale is dropping, standards of care are at risk from underfunding and highly qualified doctors and nurses are leaving the profession.

We will:

Invest more in the NHS. We will invest at least an extra Ł540 million every year in the NHS to pay for our policy priorities. This will be paid for by closing the loophole that allows employers to avoid paying National Insurance contributions on certain benefits in kind and by putting 5p on the price of a packet of 20 cigarettes. We will use these extra funds to tackle the crisis in staffing, especially in the hospital sector, and begin a shift to preventive care. We will ensure that the NHS budget keeps pace with increasing cost pressures.
Shift money from unnecessary bureaucracy into patient care. We will move from annual to at least three yearly contracts between Health Authorities and Trusts, and shift the money saved into front-line patient care. We will replace time consuming local pay bargaining with a new national pay structure and a single NHS-wide Pay Review Body that covers all pay, from the cleaner to the chief executive.

Building on the best of the NHS
The NHS needs to be strengthened and improved.

We will:

Cut waiting lists. We will cut waiting times between diagnosis and treatment to a maximum of 6 months over 3 years.
Improve the quality of care and raise morale. We will recruit and train more professional staff. Our carefully costed plans would, for instance, pay for the equivalent of 10,000 more nurses or 5,000 more doctors. We will ban the use of 'gagging clauses' in employment contracts which prevent professional staff from speaking out against unsafe standards.
Tackle the crisis in NHS dental care. We will require local authorities to ensure that the public has access to NHS dentistry in all areas.

Promoting good health
Britain has a health service that concentrates too much on curing illness rather than preventing it. A healthier nation and a more cost-effective NHS depend on shifting the emphasis towards prevention, tackling the root causes of ill health (e.g. poverty and homelessness) and making people more responsible for their own health.

We will:

Make prevention a priority. We will immediately abolish charges for eye and dental check-ups and freeze prescription charges as the first steps in a radical shift of policy that emphasises the prevention of illness rather than treatment.
Encourage people to take more responsibility for their own health. We will improve health education and promote healthy living. We will ban tobacco advertising and promotion and increase the duty on tobacco products. We will make the Health Education Authority truly independent and free to criticise government policy.
Ensure that food is healthy and safe. We will create an independent and powerful Food Commission, separate from MAFF, and responsible to Parliament for food quality and safety.
Put health promotion at the heart of government policy. We will require all government departments to assess the impact of their policies on health. Each year there will be an independent report, to be published and debated in Parliament, on the state of the nation's health.

Bringing health services closer to people
The local institutions of the NHS must become more accountable to those they serve and more responsive to patients' needs.

We will:

Enable citizens to play a part in setting health policies in their area. We will build on current pilot schemes to bring together Health Authorities and Social Services Departments, within the framework of elected local authorities.
Give local people a stronger voice on NHS Trusts. We will end the right of the Secretary of State for Health to appoint members of NHS Trusts, Authorities and Boards. We will require at least half the membership of Trusts to be drawn from the population they serve. We will open up meetings of NHS Trust boards to the public and press, and give local people, staff and professionals speaking rights. We will guarantee direct representation from the staff of each Trust. We will give Community Health Councils improved rights to consultation and greater access to information and meetings.
Give the public more say in setting priorities within the NHS. Difficult choices about priorities must be faced. They cannot be left to bureaucrats and health professionals alone. We will develop new ways of involving the public in setting health service priorities.

Giving patients more choice
Patients should have more choice over their type of treatment, who delivers it and when.

We will:

Enhance the rights of patients. We will strengthen the Patients' Charter and include rights to treatment within a specified time, a choice of GP, information about the options for treatment, guaranteed access to health records and better redress.
Ensure that action is taken to improve poor quality services. We will enable patients and staff to apply directly to our new National Inspectorate of Health and Social Care to carry out inspections and take action where deficiencies come to light.

Community care
Our aim is to create a society in which people, whatever their needs, can live their lives with dignity.

We will:

Give people choice in the services they use and the way they are provided. We will require Councils to extend to those over 65 the right to arrange their own care privately, if they wish. This will promote independence and enable them to find better value for money.

Care for carers. We will introduce a new Carer's Benefit, in place of the Independent Living Allowance, in order to meet more of the financial cost of caring. We will extend the Carer's Benefit, as resources allow, to those over retirement age and work to improve advice, information, training and counselling for carers. We will seek to increase access to respite care and ensure that carers and users are involved in decisions about care. We will draw up a Charter that sets out carers' rights and responsibilities.

Establish high national standards for all community care services. Our new independent Inspectorate of Health and Social Care will publish codes of practice for residential and nursing homes, and have the power to close any home that consistently falls short of national standards. We will introduce national charging and eligibility guidelines to ensure a 'level playing field' of provision and charges.

Protect people from the excessive cost of care. We will, as resources allow, raise the threshold at which older people are required to make a contribution to their long-term care. We are committed to working on a cross-party basis, to establish a national agreement on a system for funding care services that does not penalise thrift. [an error occurred while processing this directive]