Liberal Democrat shadow health secretary Norman Lamb has called for NHS Connecting for Health to be scrapped, the Care Records Service to be abandoned, and Choose and Book to be revamped as a simple online booking system.
The MP has set out his proposals in a document, The NHS: a liberal blueprint, which the party says is not formal party policy but Lamb’s vision of a decentralised NHS.
The 44 page document also argues that patients should be in charge of their own health records and that they should be given the right to communicate with their GP by email and telephone.
Lamb’s other proposals include linking the GP Quality and Outcomes Framework payment scheme to improving patients’ health, changing financial incentives in the NHS to promote the prevention of ill health, and fining people who turn up drunk in A&E and are aggressive to staff.
The Lib Dem shadow health secretary said the NHS was facing an unprecedented financial challenge and claimed Labour and the Conservatives were in denial about the problems.
He added: ““These proposals set out a liberal approach to the NHS which can drastically reduce costs, improve the quality of care and give people a say in how their local services are run.
"The NHS is far too important to the people of this country to ignore this challenge anymore – we must act now to secure its future.”
Overall, the document favours the approach of the US health management organisation Kaiser Permanente to integrated healthcare.
It argues that giving power and budgets to hospital and primary care clinicians – and encouraging them to work together to keep patients healthy – would prove more cost-effective than the present split between commissioners and providers.
It also argues that three steps are needed to tackle the “NHS IT Crisis” – abolishing CfH, reworking Choose and Book and abandoning the NCRS.
Lamb says Choose and Book “should revert back to what it was originally designed for – a simple online appointment bookings system” which he argues would be widely welcomed by clinicians.
The document argues that the Choose and Book programme has caused “enormous frustration for doctors and patients” and failed to deliver choice because of problems such as slot availability.
Lamb argues the NCRS should be scrapped because there is no need for a central database and that while contractual obligations with existing providers would have to be respected, variations could be negotiated “to achieve the desired objectives.”
The document says the national IT strategy should instead be focused on local connectivity between primary, secondary and social care.
It adds: “This approach would also unleash the innovative energy of the small and medium sized IT companies which have been excluded from the development of the national programme.”
On email and telephone consultations, the document quotes a study from Kaiser Permanente, which claimed that use of such consultations cut GP visits by as much as 26% per patient.
Lamb adds: “In so many other walks of life we exchange emails to avoid waiting for a formal meeting. There is no reason why the same logic should not apply in the NHS.”