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Tories pledge to deliver manifesto ­ and more

I read with interest your front-page article where Tony Blair is indicating that GPs may well face fewer targets. This would obviously be welcome and indicates his trust and support of general practice.

I am, however, confused by the bit where he is reported as stating 'I can't justify putting in extra money without saying, look, here are some outputs we need'.

It is unclear from the article whether this is policy regarding general practice in particular, England in particular or general policy. In my opinion it appears a reasonable statement but I am unconvinced how well this is being implemented across the health service.

In Wales there was a report published last autumn looking at NHS waiting times in Wales. Volume 2, in particular points 4.34 to 4.36, make Mr Blairs' comments a little confusing. I quote:

·4.34... 'some trusts lacked consistently available information about waiting time initiatives, and were unable to provide information about the number of patients treated and the sums paid to staff to deliver the initiatives'...

·4.35 ... 'the Welsh Assembly Government had little information about the outcomes achieved through the £36 million it provided to run waiting time initiatives'...

·4.36... 'the Welsh Assembly Government also failed to link the provision of waiting time initiative funding to specific reductions in waiting times'...

Obviously £36 million of taxpayers' money is a relatively small amount compared with the billions currently spent on health.

However, this sum of money is larger than that invested in primary care for enhanced services at a time when documents such as the Wanless report are calling out for 'pump priming of community services' to enable them to take some strain away from the acute sector.

It would appear from the report that neither the Welsh Assembly Government nor the NHS Trusts within Wales are able to give any indication of 'some outputs we need'.

In this light I wonder if Mr Blair would like to comment as to whether:

a) his comments were only related to primary care;

b) his comments were only related to England; or

c) he has concerns over the ability of the NHS management systems within Wales to effectively manage the Welsh Health Service.

Dr Sean Young



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