The new Conservative-Liberal Democrat coalition has set out a vision for the NHS that combines some of the most radical ideas from the two parties’ manifestos.
As the foreword to the detailed coalition document states, the government is set to “take the Conservative thinking on markets, choice and competition” and “combine it with the Liberal Democrat belief in advancing democracy at a local level.”
So the NHS section of the document proposes to slim down the Department of Health, create an independent health board, recast Monitor as an economic regulator and the Care Quality Commission as a quality inspectorate, cut NHS administration “by a third” and hand commissioning to GPs.
Primary care trusts will be given the job of planning and commissioning those services that need to be commissioned “at a wider level”, but will be recast so managers answer to part-elected part-local authority appointed boards.
In line with Tory and Lib Dem campaign pledges, the document says the government will publish significantly more performance information online and let patients rate “hospitals and doctors according to the quality of care that they receive.”
However, a Tory pledge to give patients their own, online health records appears to have been watered down. The coalition document simply says that the new government will “put patients in charge of making decisions about their care, including control of their health records.”
It does retain a Lib Dem pledge to "use technology to let people communicate with their GPs" and says the last government’s plans for a single urgent care number will be taken forward.
Perhaps unsurprisingly, there is no mention of the future of the National Programme for IT in the NHS in the document, which also kicks some other difficult issues into the long grass.
Most obviously, it takes the parties back to square one on the future of social care, which will be subject to another commission, headed by care services minister Paul Burstow.
The review will be one of almost 30 set up by the 34 page document, which is intended to cover how the Liberal Democrats and Conservatives will work together in power.
Health secretary Andrew Lansley said: “That our united vision is for a healthcare system which achieves outcomes that are amongst the best in the world, and free from day-to-day political interference.
“We will cut bureaucracy and hand back power to clinicians and patients to ensure they are at the forefront of decision making about NHS services. The proposals will drive up standards of care, eliminate waste and lead to better outcomes that improve the health of the nation.”