This page summarises recent Conservative Party green papers and outlines the NHS Confederation response.
Measuring outcomes
David Cameron has launched a green paper which sets out how a Conservative Government would create a health service that is "truly the envy of the world."
In the document, Delivering some of the best health in Europe, the Conservative Party outlines its ambitions to improve healthcare outcomes such as cancer survival rates, after-care service and patient satisfaction. This will be done by scrapping Labour's 'bureaucratic process targets' and replacing them with outcome measures.
At the launch of the green paper, David Cameron said the shift would lead to an "information revolution", with patients able to compare and contrast different care providers on the things that really matter to them.
In our response to the consultation, we very much agreed with the idea of a shift towards greater measurement of outcomes and less of processes. We also agree that there have been too many top-down targets in recent years. There are nevertheless important processes to measure. This can be because the time lags between the outcomes of some processes occur many years later. An example is diabetes, where an outcome to be avoided is amputations but the cause could be poor quality care years before.
The document quoted Dr Gill Morgan, former chief executive of the NHS Confederation saying: 'We need to radically overhaul the way that we measure success in the NHS'. Our response reflected this saying that we are in favour of retaining some limited process measures because there are some outcomes that are too distant or hard to measure and need well designed process measures.
Voluntary action
On 3 June 2008, the Conservatives announced major changes to how voluntary organisations would be commissioned by the public sector at the launch of a discussion paper on voluntary action. Launching the 80-page document, David Cameron said: 'Just as we needed [in 1979] to realise that the state couldn't run British businesses properly and shouldn't try, today we need to realise that the state can't run British society properly, and shouldn't try.'
Current problems
Mr Cameron said that the problems currently facing the sector in delivering public services include unreasonably short funding periods, centralised commissioning systems and onerous monitoring requirements. He said these hold back the sector from providing more efficient, more personal services to the public.
Long-term approach
In what he called a long-term approach, he said that his first priority was to do no harm by valuing and protecting the voluntary sector that already exists - that sets its own priorities, raises its own resources and works for social change beyond the limits of the state. Mr Cameron also proposes a systematic reform of commissioning structures to make full cost delivery a reality. At present, the Charity Commission has found that only 12 per cent of charities say they always the cover the full cost of the public services they provide.
The Conservatives also want to introduce a fair deal on contracts to remove artificial barriers to smaller charities and social enterprises, bring in multiyear contracts and other examples of best practice. To cut bureaucracy in commissioning Mr Cameron is pledging to replace intensive monitoring and micromanagement of process-base contracts with outcome-based contacts. A light-touch 'trustmarking' system would streamline tendering processes and cut out repetitive due diligence procedures.
