Howard promises the 'right to choose' will end waiting lists within five years

Michael Howard committed the Conservative Party yesterday to fighting the next election on an ambitious target of ending NHS waiting lists within five years.

Michael Howard committed the Conservative Party yesterday to fighting the next election on an ambitious target of ending NHS waiting lists within five years.

"Waiting lists are a British disease and the right to choose is the cure," said the Conservative Party leader.

"Our policy will eradicate the inequalities that exist in our two-tier health service, where the rich get what they pay for and the poor have to shut up and take what they are given," he added.

The Tory leader said Britain could match France and Germany by ending NHS waiting lists for treatment with a series of radical reforms and an increase in spending on the health service of £34bn by 2009-10 - a rise of 7 per cent in real terms over five years.

Under the Conservative plans, NHS patients will be given the right to be referred by their GPs for treatment where they choose, either in NHS hospitals or private hospitals. The treatment would be free of charge, providing the cost is within a tariff set by the NHS.

Patients who opt for more expensive private treatment will receive half the NHS tariff for the operation to use against their bill, leaving them to pay the remainder their own pockets or through private health insurance. The Conservatives claimed that would amount to £1.2bn to cover everyone who currently opts for private healthcare treatment.

Labour attacked the idea of paying patients to go for private treatment as a waste of taxpayers' money. John Reid, the Health Secretary, and Tony Blair branded the Tory plans as a "plan to charge for choice".

Andrew Lansley, the shadow Health Secretary, defended the proposal, saying: "It means that the capacity available is used to the greatest effect in bringing down waiting lists. This will apply to all elective surgery."

Patients who suffer from chronic conditions such as diabetes would also be given more choice under the Conservative proposals, outlined in a booklet, entitled "The Right to Choose".

Where possible tariffs would be set for a care package so that patients with long-term illnesses can also directly purchase care from the provider of their choice. And the Tories said all centrally imposed targets on hospitals would be scrapped in response to protests by clinicians that demands made by ministers are distorting the priorities for treating patients.

All hospitals would become foundation hospitals, with the power to borrow money for expansion without reference to the Department of Health. All hospitals would also be able to set their own rates of pay for their employees.

A hospital that is not financially viable would be forced to accept new management by the independent regulator and it could be offered to another hospital to run it. All hospitals would be run as companies with a board of directors.

The Conservatives said they they would scrap the star-rating system for hospitals. There would be no return to fundholding for GPs, and there is no intention to allow family doctors to compete with each other to obtain treatment from hospitals on contracts for their patients.

Instead, the Tories now propose to allow NHS money to follow patients to the hospital of their choice.

The Health Secretary later released a comparison of charges for various operations in the private sector and NHS, which he said proved patients would be forced to pay thousands of pounds to take up the choice offered by the Tories.

Mr Reid said that if the state provided 50 per cent of the cost of NHS treatment, patients would be left facing a bill of about £9,450 for a heart bypass, £6,400 for a knee replacement, £5,300 for a hip replacement, £3,250 for a hysterectomy, £2,000 for cataract removal and £1,220 for varicose vein treatment.

HISTORY OF A BUZZWORD

Choice in public service is the new buzzword for Tony Blair and Michael Howard and looks to be the main battleground for Labour and the Tories at the general election, expected next May.

The best-known example of "choice" was the decision by the Thatcher government to offer millions of council tenants the chance to buy their homes. Mr Howard's policies for health and education, under the slogan, "The right to choose", are a deliberate echo of Thatcher years.

Her administration also extended "choice", for example, giving people the right not to join a trade union by abolishing the closed shop, and by spreading share ownership with privatisation of state industries such as gas, electricity, telecoms and water.

Baroness Thatcher was influenced by the Adam Smith Institute think-tank, which echoes the credo of the 18th-century Scottish philosopher and economist best known for The Wealth of Nations, a pioneering book on free trade. The institute backs "choice, competition and enterprise".

And "choice" is also at the centre of the heated debate on abortion.