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Foreword by the Secretary of State

It gives me great pleasure to present the fifteenth annual report of the Department of Health.

In July 2004, the Chancellor announced the outcome of the spending review which set out spending plans up to 2007-08. For the NHS this confirmed the historic levels of sustained growth in the 5-year settlement announced in 2002. This gives the NHS an average increase of 7.1% over inflation for the period 2005-06 to 2007-08. The settlement also delivered a further average annual real terms increase for Personal Social Services of 2.7% over the same three years. This demonstrates the Government's continued commitment to investment in health and social care services to deliver better quality care for the whole population.

It is vital that we deliver maximum benefit from this funding. Therefore, in the 2004 Budget, the Chancellor announced the outcome of the Gershon report which detailed efficiency savings across Government. In this, the Department is committed to making savings of £6.5 billion a year by 2007-08 which will be recycled into frontline services. Savings will be delivered through:

The generous settlement for health and social care will be used to deliver our new public service agreement. This reflects our continued drive to reduce waiting times, reduce inequalities, improve the health of the nation and ensure care is delivered to those who need it, when they need it and in a setting that is most appropriate to them.

Our plans mean that waiting for treatment will reduce to the point where waiting time for elective care is no longer the major issue for patients. By 2008, the maximum wait for the whole of a patient's journey from GP referral to treatment will be 18 weeks, with most people being treated much quicker.

We have also introduced a target to improve outcomes for people with long-term conditions by providing more proactive care, through case managers, including community matrons, in primary and community settings. Early intervention and management of long-term conditions will both improve patients' overall health and prevent acute episodes of illness requiring emergency admission to hospital.

The public is naturally concerned about healthcare associated infections. It is a top priority for my Department to reduce the risk of infection, and this is why in 2004 we set a target for acute trusts to halve their numbers of MRSA bloodstream infections by 2008. Measures put in place are already having an effect, and in March 2005 we were able to announce a 6% decrease for the period April to October 2004 by comparison with the same period in 2003. This is a difficult challenge for the NHS, but I am confident that continued action in NHS hospitals will result in further reductions in MRSA bloodstream infections.

We are addressing the difficult issue of the long-term health of the whole nation. We have targets to reduce smoking, to halt the rise in childhood obesity, to reduce mortality rates from heart disease and stroke, and to reduce health inequalities. These are supported by the plans set out in the Public Health White Paper Choosing Health published in November 2004. This is a genuine and fundamental shift in the health policy for this country - from simply providing a sickness service to a true health service where prevention is as important as cure.

We are also revolutionising the way patients access services with every patient being offered a choice of providers, both NHS and independent sector, and being able to book their appointment at the point of referral. Patients will be able to choose from a range of providers funded by the NHS and regulated by the Healthcare Commission as well as have access to a wider range of services in primary care.

As we increase investment in social services we need to ensure that services are provided in a way that gives maximum benefits to clients. This is why in March 2005 we published our consultation paper Independence, Wellbeing and Choice. This set out our vision for the future of social care for adults in England and asked for views on our proposals, so we can build a shared vision and create a social care environment right for the 21st Century. Our vision includes proposals on individual budgets; developing new models of care including telecare; and how to better support carers and build the capacity of the voluntary and community sector to engage in the wider agenda of social inclusion. It also emphasises the need for social and health care to work together better to support those with complex needs.

This Government has demonstrated our belief in strong public services through sustained real terms investment in health and social care. The values that underpin these vital public services remain unchanged: in particular, the founding principle of the NHS that healthcare should be funded through general taxation and available to all on the basis of need not ability to pay. But, we must not be tied to old structures and ways of delivering these services. As society progresses and public expectations change it is vital that we reform services to meet growing needs whilst delivering maximum benefit from the public funding with which we are entrusted. Only through reform will we deliver the high standards of quality and responsiveness that are demanded of modern health and social care services.

Rt Hon Patricia Hewitt MPSecretary of State for Health

Published by The Stationery Office, price £26.35

Front cover & contentsChapter 1: IntroductionChapter 2: Delivering better public services - progressChapter 3: ExpenditureChapter 4: InvestmentChapter 5: The NHS Plan - A Plan for Investment, A Plan for ReformChapter 6: Breakdown of Spending ProgrammeChapter 7: Activity, performance and efficiencyChapter 8: Managing the Department of HealthAnnexes

• Department of Health: Departmental Report 2005 browsable version
• Download Cover & Contents (PDF, 620K)
• Download Chapter 1: Introduction (PDF, 106K)
• Download Chapter 2: Delivering better public services - progress (PDF, 405K)
• Download Chapter 3: Expenditure (PDF, 301K)
• Download Chapter 4: Investment (PDF, 173K)
• Download Chapter 5: The NHS Plan - A Plan for Investment, A Plan for Reform (PDF, 867K)
• Download Chapter 6: Breakdown of Spending Programme (PDF, 597K)
• Download Chapter 7: Activity, performance and efficiency (PDF, 309K)
• Download Addendum - The attached graph replaces the figure 7.7. shown at paragraph 7.75 in chapter 7 of the Department of Health's annual report 2005. (PDF, 11K)
• Download Chapter 8: Managing the Department of Health (updated 4 August 2005) (PDF, 140K)
• Download Annexes (PDF, 1022K)
• Download Departmental Report 2005 in full - Please note this is a large file (updated 4 August 2005) (PDF, 4438K)
• Download SBI/DR questionnaire (DOC, 98K)
• Download SBI and DR questionnaire glossary (PDF, 20K)