Tories will offer doctors and nurses more power, but pay cuts if they fail

The Conservatives today laid out firm plans to give the health service independence from the Government.

The party pledged to remove political interference by handing an independent board power over finances and giving hospitals more autonomy.

And it plans to abolish centralised targets - including the Government's commitment to reduce waiting times to 18 weeks by the end of next year.

In a blueprint for the NHS it also promised to link managers' pay to patient satisfaction rates and to establish a consumer group with a say at board level.

Doctors and nurses would be given "real powerî to make decisions and teams of GPs, not managers, would choose how most of the £90billion budget was spent.

But those doctors - known as "primary care commissioners" - could face pay cuts if they deliver "poor services" to patients. The document, which the Tories will present to Parliament in November, clarifies leader David Cameron's proposals for NHS independence.

It follows intense debate over the issue after Gordon Brown floated the idea last year.

The proposal was scorned by Tony Blair and last week health secretary Patricia Hewitt said it would turn the service into a "1960s nationalised industry".

But under Tory plans ministers would be forced to take a back seat as board members worked directly with local councils, clinicians and patient groups.

The board would oversee commissioning - purchasing services - but would not run hospitals.

Each trust would be encouraged to turn itself into a business-style "Foundation Trust" in an extension of current government policy, but the health secretary would still hold ultimate responsibility for the service.

Andrew Lansley, the shadow health secretary, said: "We are offering a coherence to NHS reforms which is sadly lacking. These are proposals for legislation that Gordon Brown will follow if he has any sense."

The Tory paper on NHS Autonomy and Accountability calls for:

• Independent boards to have power to dictate how funds are allocated; to draw up new care standards; and to improve overall results for patients.

• 'Perverse' waiting time targets to be replaced by measurements such as cancer survival rates.

• The vast majority of decisions on local NHS spending to be handed to doctors and nurses.

• Patients to choose any hospital in the country, NHS or private.

•A HealthWatch patient group with a veto on hospital closures and direct say at Board.

• A new regulation system.

Attacking the Blair era of NHS reform, the document states: "In just 10 years, and at a total cost to the taxpayer of £3billion, Labour has reorganised the NHS nine times. Staff have been overwhelmed by the organisational upheaval, centrally imposed targets and political interference since Labour came to power.

"At present, the NHS is neither autonomous from central government interference nor accountable to patients and members of the public.î

The paper suggests that primary care commissioners should take a pay cut if they do not choose services that satisfy people.

Patients would be given a budget to choose where they are treated. But the plans rule out using NHS money to pay for private care if it costs more than the health service equivalent.