David Oliver: Time for an honest patient's charter?

The parliamentary act that led to the NHS’s creation set out what the public could expect—a universal service based on need, free at the point of delivery. Since then, the government has repeatedly set out standards that the public should expect. We had John Major’s “patient’s charter,” then NHS standards for four hours in emergency departments or two weeks for investigation of suspected cancer. The NHS constitution strengthened the founding principles.The government response to the Francis inquiry guaranteed fundamental standards of care. The Care Quality Commission explicitly inspects services for “responsiveness.” The current government has promised the same quality of care across all seven days. Such promises are a kind of government contract with the people: “Elect us, pay your taxes, and in return this is what you can expect the NHS to provide.” I welcome them, when they have a realistic chance of delivery. I also welcome continued high levels of public pride in the NHS and decent levels of user satisfaction. 8 I welcome the consistent rating of the NHS as one of the most equitable, fee-free, and efficient health services in the world. And it’s miraculous that we continue to deliver so well on national waiting time targets, such as those for emergency departments.