Website of the Department of Health

This White Paper is an important new stage in building a world-class health and social care system. It meets the health challenges of the new century, and adapts to medical advances while responding to demographic changes in our society and increasing expectations of convenience and customer service from the public who fund the health service. These proposals, part of the Government's wider reform programme, will allow us to accelerate the move into a new era where the service is designed around the patient rather than the needs of the patient being forced to fit around the service already provided.

This White Paper builds on these principles and the significant progress, achieved through increased investment and reform, within the NHS over the last few years. There are 79,000 more nurses and 27,000 more doctors than in 1997 with more in training. Waiting lists and waiting times are dramatically down, helped in part by giving patients more choice and encouraging new providers within the NHS. The flexibility and freedoms offered to foundation hospitals have helped them improve care and service.

Deaths from cancer have fallen by 14 per cent, from heart disease by 31 per cent. Acute and emergency care in our hospitals has been transformed. Thousands of people in every community owe their lives to the extraordinary medical advances of recent decades and to the dedication of NHS staff.

The challenge for the NHS now is to maintain this progress while ensuring that GPs have the capacity to expand their services and respond to new demands from patients. To do this we will continue to refocus the system to meet these challenges. That is why GPs are being given greater control over their budgets and will be more accountable for the money they spend.This will allow them to acquire for their patients services from a broader range of providers within the NHS, voluntary and private sector. Crucially this is matched by greater choice for patients so they can take advantage of the new range of services on offer.

These reforms will also provide doctors, nurses and other staff with the ability and the incentives to tackle health problems earlier. It will lead to the greater emphasis on prevention and early intervention needed if we are to continue improving the nation's health. It will also meet the clear public preference for as much treatment at home or near home as possible. In both cases, it means a more efficient use of resources. This White Paper looks to see how we develop and expand these services.

It is also clear that we can make better use of the skills and experience of those working in the NHS to improve care, cut delays and make services more convenient. We want, for example, to expand the role of practice nurses and local pharmacists and encourage GPs to offer longer surgery hours.

While there has been real progress in the NHS, there is one area where improvement has not been fast enough. It is still the case that where you live has a huge impact on your well-being and the care you receive. These health inequalities remain much too stark - across social class and income groups, between different parts of the country and within communities. The new emphasis on prevention will help close the health gap; so will encouraging GPs and other providers to expand services in poorer communities.

These changes will be matched by much better links between health and social care. We will cut back the bureaucracy so local government and the NHS work effectively in tandem, and give customers a bigger voice over the care they receive.

All this will encourage local innovation, including the use of new providers, where necessary, to meet local needs. We want change to be driven, not centrally, but in each community by the people who use services and by the professionals who provide them.

Meeting these challenges will require a sustained shift in how we use the massive investment we are making as a country in health and care services.

None of this will be easy. Nor was slashing waiting lists, but the NHS has risen magnificently to this challenge. By giving frontline professionals and the public more say and control over the services they provide and receive, I am confident that we will continue building a high-quality health and social care system which meets the future needs and wishes of the country.

Tony Blair
Prime Minister