Targets focused the NHS on bringing down waiting times, but also put process above clinical judgment and patient choice. Changing the way in which we manage waiting times will empower both patients and clinicians. NHS targets have dictated clinical priorities and harmed patient care. Focusing on long waits has meant less progress on reducing average waits than could otherwise have been achieved.
I noticed that in his answer the Minister did not say that any assessments had taken place. How many representations has he received from clinicians, people working in the NHS and the public demanding the removal of the 18-week target, for instance? Targeting is about making people better and getting them seen more quickly, so is not the real reason for dropping targets the fact that the Minister wants to undermine the NHS again?
I am sorry, but the hon. Gentleman, for whom I have considerable respect, is just plain wrong. There have been a number of representations over the last seven weeks or so. In addition, as my right hon. Friend the Secretary of State and his shadow team went round the country over the past five years, they were constantly told by GPs and clinicians from hospital to hospital that politically motivated targets were distorting clinical decisions and patient care.
Does my hon. Friend agree that by far the most important way of improving the service delivered by the NHS is to focus on the three key indicators of clinical outcomes, patient experience and value for money? Can he assure the House that the Government will pursue those, particularly against the background of increasingly scarce resources, in order to deliver the objective we all have: a better-quality NHS?
I am extremely grateful to my right hon. Friend, who is absolutely right, and I can give him the categorical assurances he is seeking, but I would also like to add one more: we need information to empower patients, because if patients are going to be at the heart of the NHS they must have the information to take the decisions that are important to their health care.
We do, Mr Speaker, very much; we want to see him squirm.
First, let me say that we welcome the Minister back to the Department of Health; he was a Minister in the Department 13 years ago. As I have said before, we trust that he finds the NHS in much better condition than when he left office. Last week we had an independent verdict on those 13 years. The independent and respected Commonwealth Fund said that the NHS was one of the best health care systems in the world, and, indeed, that it was top on efficiency: a ringing endorsement of Labour’s stewardship of the national health service. That verdict reflects the huge progress on waiting times that has been made over those 13 years. So does not the abolition of the 18-week target, which the Minister announced last week, put all that progress at risk? Will he today give us a straight answer to this question: can he guarantee that waiting times will not rise, and that patients will still be treated within 18 weeks?
I thank the right hon. Gentleman for the kind comments at the beginning of his remarks; things went downhill thereafter, but that is politics.
The right hon. Gentleman needs to understand that patients have to come first in a national health service, and the trouble with the approach he took was that he wanted politicians and bureaucrats to micro-manage it from the top down, rather than having a bottom-up system that listened to local people. One of the key aims is to ensure that people get the finest and best treatment possible, and I am afraid that his approach—a straitjacket of targets in certain areas—did not work then, and will not work now.
I shall take that as a no, because the Minister did not answer the question; he could not give that guarantee. He says that we must put people and patients first, yet at a stroke he has taken power away from patients and handed it back to the system, turning the clock back to the bad old days of the Tory NHS. Let me quote some comments by Jill Watts, chair of the NHS Partners Network, which represents private providers. In the Financial Times on 18 May, she is reported as saying the following about the loss of targets:
“Waiting times will go up and if people want a procedure they have a choice: they can wait or they can look to pay”.
Is that not always the Tory choice on the NHS: wait or pay?
The right hon. Gentleman is not right. We have not taken that attitude; we never have taken that attitude. We want to have a system whereby the health service is not in a straitjacket of targets that disrupt and distort clinical decisions. We want to empower clinicians and GPs to take decisions about who should be treated when according to their clinical judgment.