Hospitals to get cash for 'happy' care

Health minister Lord Darzi unveiled a radical shake-up of the NHS and said he wanted to make doctors and nurses focus more on quality of care.

Payments for operations will become partly based on patients' own views about the success and quality of their treatment. They will also be able to request a specific surgeon but will not have a right to choose.

Hospitals could earn hundreds of pounds through the tariff system if patients are happy with the level of care during operations such as a hip replacement, which costs between £3,000 and £4,000 to carry out.

Other factors which will be taken into account under the payment system are clinical outcomes, safety, cleanliness, as well as the patients' own views.

Lord Darzi said that while doctors tend to rely on survival rates and further complications as indicators of success, patients also value the overall quality of care they receive in hospital.

An average district general hospital could earn between £7 million and £9 million a year under the system, due to be introduced in April.

Patients will also have a "responsibility" for their children having the MMR vaccination and giving their doctor information about their health and to follow agreed courses of treatment.

Surgeon-turned minister Lord Darzi also admitted that Londoners have died as they waited for hospital treatment.

In remarks thought to be unprecedented, he said that people in the capital died before they reached the top of waiting lists for cancer operations and other care.

The health minister said he used to regularly adjust his waiting list, which could be up to 18 months long, for deaths.

"I had to do revalidation of my waiting list every three months to figure out how many patients had dropped off the waiting list who had died," he said.

"There were patients dying on the waiting lists, that's exactly what used to happen - that's well known to a lot of my clinical colleagues."

He stressed this was the state of the NHS in the mid-Nineties, when he started as a surgeon at St Mary's Hospital in London, and that the health service had improved significantly.

But Lord Darzi also highlighted that there are still "unacceptable and unexplained variations in the clinical quality of care" in London and all other NHS regions.

Gordon Brown joined Lord Darzi today to begin a week of celebrations marking the 60th anniversary of the NHS. Mr Brown said he wanted a "national standard" for prescription drugs available on the health service.

THE DARZI PLAN

A new NHS constitution setting out the rights of patients and aiming to put privacy, dignity and cleanliness at the heart of care.
Measuring quality of care and outcomes of treatment and publishing more of these details.
Attempts to end the postcode lottery for drugs. Patients would get new right to all drugs approved by the National Institute for Health and Clinical Excellence and there will be a faster approvals process and transparent decision-making.
Patients will get a legal right to choose any provider, including choice of GP.
Five thousand patients with complex long-term conditions will pilot new personal budgets.
Personal care plans for all 15 million patients with a long-term condition.
A far greater focus on preventative public health measures.
Free heart checks for 40 to 74-year-olds.
No more new top-down targets.