Crunch time

Linda Davidson

What are the leading parties offering in terms of healthcare IT? E-Health Insider sent the Labour Party, the Conservatives, the Liberal Democrats and several other parties a set of questions about healthcare IT policy, so readers can see what might be in store on 6 May. 

The Liberal Democrats responded to all and the Conservatives to most of our questions. The Labour Party phoned to say it could not respond to such detailed questions, so we have scanned the manifesto and looked back on the party’s record in government for clues about policy. From the other parties, the only response came from the Scottish National Party. This is what they said.

Q1. Can you outline in broad terms how your party would, if elected, modernise information technology in the National Health Service?

Q2. Specifically, would you continue with the National Programme for IT(NPfIT)/NHS Connecting for Health in England as it is currently organised, and the national health IT strategies in Wales and Scotland?

Q3. Would you continue with the Health and Social Care Information Centre as it is currently organised?

Q4. Would you use a national ID card to prove entitlement to NHS services?

Q5. Would you continue to support NHS Direct, NHS Direct Wales and Scotland’s NHS24 services as they are currently organised?

Q6. Does your manifesto include any other measures involving IT in healthcare or technology-led change?

Can you outline in broad terms how your party would, if elected, modernise information technology in the National Health Service?

Liberal Democrats

"Information technology has an absolutely essential role to play in developing quality patient care in the National Health Service. A reliable, comprehensive system of electronic records will improve patient safety, continuity of care, and the efficiency of how the service is run.

The challenge is to engage healthcare staff and patients to deliver the right solutions, and protect patient confidentiality and safety. "

Scottish National Party

"We would seek to develop a secure system of patient records being accessible online within both the primary and acute sectors which would radically improve communication, efficiency and speed in patient care. We would look to develop an electronic patent record to improve patient care. We would also develop more managed clinical networks. "

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Specifically, would you continue with the National Programme for IT(NPfIT)/NHS Connecting for Health in England as it is currently organised? And the Informing Healthcare Strategy for Wales as it is currently organised? And the Scottish Care Information initiative as it is currently organised?

The outgoing Labour government created and funded the NPfIT, now Connecting for Health. Though the manifesto does not mention the programme specifically, it highlights policies such as the creation of patient choice, patient-centred care, faster results for smear tests and the abolition of ‘hidden waits’ which will need to be underpinned by IT.

Conservatives

"We have no plans to abolish NPfIT. However we would commission an independent review of NPfIT in the light of the problems that have emerged this will take stock of progress to date and inform any changes that might be required to deliver a system that is useful to users and patients.

"Our main concerns with regard to NPfIT are the threat to patient confidentiality, the costs to the programme and the failure to date to consult adequately with users of the system. The NHS in Scotland and Wales is a matter for devolved bodies.

Liberal Democrats

"We support the principle of the National Programme, the Informing Healthcare Strategy and the Care Information initiative, and would continue with the implementation. However, there are huge risks that this IT programme will turn out to be not fit for purpose and will waste taxpayers’ money. There has been a lack of engagement of patients and staff in the delivery of the programme so far.

"We would ensure that patients and staff were consulted to ensure the technology that is delivered meets the needs of the people using it. Confidentiality is a key concern for both frontline staff and patients. Patients must have much more control over their health, including the information held about them. We would involve the National Audit Office during the continued implementation of the project to produce independent reports on how it is being delivered."

Scottish National Party

"We would seek to improve this [Scottish] system. "

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Would you continue with the Health and Social Care Information Centre as it is currently organised?

Labour

The outgoing Labour government introduced the Health and Social Care Information Centre as part of its review of ‘arm’s length bodies’. It started work on 1 April 2005 with a mission to ‘reduce the burden’ of information requirements on frontline staff and organisations.

Liberal Democrats

"We applaud the aims of the Health and Social Care Information Centre to provide high quality information so that patients have more opportunities to have control over their care. We also applaud aims to reduce the burden of red tape and inspection on the NHS frontline. We will continue to watch how the organisation works in practice and listen to all views on how it is developing and its future role. "

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Would you use a national ID card to prove entitlement to NHS services?

Labour

The Labour manifesto includes a pledge to introduce ID cards including biometric data, like fingerprints, backed up by a national register and rolling out initially on a voluntary basis as people renew their passports. Outside the manifesto the ID card bill, discarded at the dissolution of Parliament but due to be reintroduced if Labour wins office, makes clear that the provision of ‘public services’ may become dependent on the production of a valid identity card.

The manifesto points to changes which have already ended some ‘health tourism’ – the use of NHS facilities by visitors who come to UK to take advantage of its healthcare.

Conservatives

"We have no plans currently to use any national ID card that might emerge for health related purposes. "

Liberal Democrats

"No. The Liberal Democrats have opposed the ID card scheme. ID cards are an expensive way of achieving very little. They will not help to fight crime or terrorism. The terrorists who attacked New York on 11 September 2001 and Madrid on 11 March 2004 carried valid identity documents. ID cards will not help tackle most illegal working and benefit fraud. Employers in industries with high levels of illegal labour are already required to check identity documents. And most benefit fraud involves claimants misrepresenting their circumstances rather then their identity.

"The issue of ‘health tourism’ is complex and the first thing that needs to be done is to get a clear picture of how serious the problem of free care for foreign nationals who are not entitled to NHS care is, and how best to deal with this. We do not need costly and problematic ‘quick fix’ solutions."

Scottish National Party

"No."

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Would you continue to support NHS Direct, NHS Direct Wales and Scotland’s NHS24 services as they are currently organised?

Labour

The party’s manifesto says: “We will provide more information and advice. Through NHS Direct, Health Direct, interactive TV, print media and the internet we will give more convenient access to much better information about health services, including the performance of doctors and hospitals.”

Conservative

The Conservative press office directed us to an article in The Guardian, published on 30 March 2005, in which the party’s health spokesman, Andrew Lansley said: "The Conservatives have no plans to abolish NHS Direct. The proposals from the James review [on efficiency] make it clear that we intend to reconfigure NHS Direct and our manifesto sets out our intention to create a more integrated emergency care network. This will enable GP out of hours services, accident and emergency, ambulance trusts, walk-in centres and NHS Direct to be commissioned on a basis which works for each local emergency care network.

"This will be consistent with retaining a national NHS Direct number, NHS Online and support software, but will enable the delivery of NHS Direct including call centre services and a triage of callers to be managed locally. In short, we will deliver a better, improved service."

Liberal Democrats

"We are very supportive of the introduction of new services such as NHS Direct, NHS Direct Wales and NHS 24 to ensure that patients can get appropriate care from the most appropriate place. We also support new ways of working, to enable nurses to undertake roles with the right training and support, which were previously the preserve of doctors.

"However, we do have some concerns over the drain of staff away from A&E and other services to NHS Direct, and we must ensure that staff shortages in A&E are tackled. In Scotland, the Executive has announced it is establishing a review group to consider the operational performance of NHS 24 and to come forward with recommendations for action, including actions for NHS 24, NHS boards, other partners and the Health Department for improving the services provided.

"We want services like NHS Direct and walk in centres to be part of a joined up approach to out of hours and emergency care so that patients can get the right care, in the right place, at the right time."

Scottish National Party

"We called for the current review of NHS 24 sometime ago. We would improve the way it is organised by ensuring that there are clear routes for the public depending on the seriousness of their condition. The public must be more clearly informed of who they should contact in which circumstances.

"Communication with the public has been poor. This requires the current out of hours arrangements also to be reviewed. We would ensure adequate staffing levels. Call back times must be dramatically improved and trust restored in the service if it is to work in the way intended. "

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Does your manifesto include any other measures involving IT in healthcare or technology-led change?

Labour

The party manifesto says: “We will deliver our cross-government strategy for closing the digital divide and and using ICT to further transform public services.”

Conservatives

"We will study emerging technology to see if a handheld medical record can be created electronically with proper safeguards to ensure patient confidentiality."

Liberal Democrats

"Yes. We are very supportive of the use of new technology to improve services within the NHS. Specifically we look to get the best use out of expensive NHS scanning equipment by providing £350m over a parliament to help trusts to run scanners for longer, at evenings and weekends, to tackle waiting times for diagnosis. We would look to access new technology to provide diagnostic tests closer to home, in GP surgeries, community hospitals and on the high street.

"We would also invest in new evidence based screening tests to develop a health MOT, which would be targeted through the electronic patient record so that people were given appropriate tests based on their age and risk factors. We will harness the power of new technology to give people more control over their health and their healthcare."

Scottish National Party

"Not specifically. "

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