Tories rule out forced NHS closures

By Branwen Jeffreys Health correspondent, BBC News

Mr Cameron says he wants to give patients "a real choice"

Conservative leader David Cameron has ruled out the forced closure of A&E and maternity wards in the party's manifesto for England.

It is a move likely to be popular with local campaigners, but which will dismay some health experts.

Reorganisations of hospital services which have already happened would remain unchanged.

Others in the pipeline, including several large-scale plans for London hospitals, would be reviewed.

In August 2007, David Cameron promised the government a "bare knuckled fight" over the future of local hospitals.

But critics say some closures are needed.

The new chief executive of the King's Fund, Professor Chris Ham said: "It's pretty clear to most people you can't freeze existing services in their current pattern. This is not primarily financial, but about patient safety and to ensure they get a good experience, and that the NHS delivers the best possible results."

The promises

The manifesto confirms several plans already announced including scrapping top-down Government targets, such as waiting times for treatment.

The Tories have previously said they would instead move to outcomes - in essence a target that is about results not about how much the NHS done.

These have included increasing five-year survival of cancer to above EU average by 2015 - something that could only be measured with time.

The Conservatives say that by making NHS staff more directly accountable for their performance, NHS administration costs can be cut by a third as "expensive layers of bureaucracy" are removed.

Elsewhere the creation of an independent NHS board is confirmed for the day-to-day running of the NHS, which will have power over how money is spent.

So is the policy of a one off £8,000 payment for residential costs.

The Tories also pledge a Cancer Drug Fund to allow doctors to prescribe new medicines which might fail to pass the cost restrictions of the rationing body the National Institute for Health and Clinical Excellence.

This would benefit patients with rare cancers, for example.

They promise to ensure every patient in England has access to a GP 8am to 8pm seven days a week.

This is something already happening or is due to soon with every area in England having a GP-led health centre is either open just those hours.

And they say it would be up to GPs to organise how they offer care out of hours - something many doctors gave up when they signed a new contract for family doctors in 2004.

This would mean renegotiating the GP contract.

Commenting on the manifesto, Dr Hamish Meldrum, Chairman of BMA Council said: "The idea of being able to see a GP from 8am to 8pm, seven days a week is bound to be popular, and patients deserve good access to GP services, but this shouldn't come at the expense of the quality of a patient's overall care, which is at risk if services become fragmented.

"It's also a luxury that we may not be able to afford in these financially straightened times."

He said all the political parties needed to move away from a market model for the NHS in England, which wasted NHS money.

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