Conservative Party Conference: A lively debate around patient choice

by Scott Sinclair
Policy and Public Affairs Manager

Tory Party Conference fringe event

Manchester is the last stop in this year's party conference season, with members of the Conservative Party coming to the city to debate policy and mix and mingle for four days. With the Conservatives being the largest party in the coalition government, announcements made at this conference are likely to occupy Parliament and Whitehall officials for the coming months.

Our event, 'Can giving patients choice be cost effective for the NHS?', with partners Help the Hospices and Sue Ryder, kicked off Monday's fringe at 8am. Despite the early start, we had a busy room, with guests joining us to hear from Dr Sarah Wollaston MP; Dr Maureen Baker, the Chair Elect of the RCGP; Marie Curie Chief Executive Dr Jane Collins; and Thomas Cawston of the think tank Reform.

A question of choice?

Thomas Cawston kicked off proceedings with an overview of the coalition's commitment to choice since the election in 2010. He noted that in the white paper to reform the NHS, choice was front and centre but has since drifted out of policy, pointing out that the Health Secretary Jeremy Hunt had not mentioned choice once in any of his major speeches in the last year.

Dr Jane Collins approached the issue from the perspective of individuals. Looking specifically at end of life care, she said it made absolutely no sense that over 50% of people die in hospital, when 40% of these people had no need to be there and only 3% of people would choose to die in hospital. This indicated that something had gone seriously wrong.

Dr Maureen Baker is the Chair Elect of the Royal College of GPs and will soon take over from predecessor Dr Clare Gerada. Like Dr Gerada at our Labour event, Dr Baker was not sure that choice was always best for patients. She felt, particularly in the case of diseases like cancer, that patients don't always want choice. Rather, they want someone to work with them and guide them through their care and treatment. She also wondered if choice is a luxury we can really afford.

A member of the Health Select Committee and a former GP, Dr Sarah Wollaston MP is a strong and independent voice on health issues. She raised the very important point that some people are much better able to take advantage of choice than others, particularly those with high income and high education. Others, she said, might not have a computer at home to research their options, or even the money to travel to their preferred place of care.

Challenges from the audience

A GP in the audience agreed strongly with Dr Wollaston, saying that he’d been able to find his mother the best available treatment for her glaucoma, but only through his contacts within the health services. His regular patients, he felt, wouldn't get that kind of service.

Questions from the audience were challenging, perhaps as a consequence of the early hour. Dr Baker was pushed in particular to justify her claim that more money to GPs would mean better care for patients. Audience members felt that primary care needed more reform and not more resource.
Dr Wollaston shared some of her concerns about how the current tendering arrangements for the health service are harming small provider organisations, an anxiety that we at Marie Curie share.

A lack of real consensus

Like the events at the Liberal Democrat and Labour Party conference, there was no real consensus about whether giving patients choice is indeed cost effective for the NHS. It's not a simple yes or no, partly because, as these events have shown, choice means different things to different people. Also, it can be beneficial to some people and possibly detrimental to others. Choice can be what we most want from our health services at some points, and at others, when we are most seriously ill, we just want doctors to do what they think is best and make us well or, at least, comfortable.

It's clear there is a lot more thinking to be done around choice, not least from the perspective of end of life care. Later this year, Marie Curie, Help the Hospices and Sue Ryder will be publishing a report into our fringe event at each of the three conferences, where we will be unpacking more the issues that arose and hopefully identifying some areas for future work.

Read our blog post from the Liberal Democrat conference
Read our blog post from the Labour conference
Read more about our party conference events