No hiding place for Cameron

David Cameron has been reading the Patient from Hell. Or bits of it at any rate. In launching his draft manifesto for the NHS, released on 4 January, he proclaimed that he will publish all information about doctors and hospitals, so that there will be no "hiding place for failure". He offers "an information revolution, so that everyone will know who is providing a good service and who is falling behind". Great, that's what I like to hear. The patients will be given the tools to fight back under a Tory government. But hang on a bit. Is the Tory search for better ways for the patients from hell like me to answer back much different from current Department of Health attempts to give the patients a louder voice? It seems to me that the Cameron "reforms" are no different from what Labour is currently trying to do with the NHS. For instance, David Cameron wants to "decentralise power, so that patients have a real choice", and will encourage hospitals to compete for patients. Surely, Labour's choice agenda, enshrined in the dreadful Choose and Book software, has been trying to do just that for about five years? Not with much success, I should add. Shouldn't an incoming government try to avoid the mistakes made by its predecessor? Cameron, chasing his ideal of decentralisation, wants to create "fully autonomous foundation trusts". Again, this is exactly what Labour has been trying to do for years. As a patient, I sometimes worry about this policy. In these columns I have described the bad communications and administrative failures which I believe shortened the lives of two of my oldest friends, Charles and Tom (A matter of life and death, 26 August 2009) . Both of them were treated by foundation hospitals. Furthermore, the hospital trusts which recently fell foul of the Care Quality Commission, Colchester and Basildon, both had foundation status. I begin to fear that the greater autonomy enjoyed by these hospitals could actually contribute to their poor patient care. I go on to think that, maybe, the constituent parts of the NHS can only provide an acceptable level of service, if they are heavily regulated from the centre. Now that's a really heretical statement with which to start the New Year! On health records, David Cameron announces: "We will put patients in charge of their own health records, with the ability to choose which providers they share them with." This sounds good on the surface, but does not specify the important things about health records, which are where they should be held – on the Spine or by GPs or PCTs – or what they should contain – just basic information such as allergies or complete records of treatments at whatever hospitals or clinics the patient may have attended over the years. At least, the draft manifesto document seems to have abandoned the idea of handing the patient record over lock stock and barrel to Google or Microsoft. That's a blessing. David Cameron says loudly that the most important people in the NHS are patients. After that I feel a bit mean to niggle, but there is still a lot of work to be done before the Tory party has a coherent healthcare policy which shows clear blue water between it and Labour. Half-baked is a word that springs to mind.