Published on 13 Nov 2012

Government publishes mandate for health service

The government has published its first-ever mandate setting out its ‘ambitions’ for the NHS, what the Health Secretary Jeremy Hunt describes as its priorities for the the health service.

The objectives of the mandate include improving standards of care and not just treatment, especially for the elderly and vulnerable; better diagnosis, treatment and care for people with dementia; better care for women during pregnancy, including a named midwife to provide one-to-one care.

There will be, as the prime minister has already announced, a friends and family test from next April so patients will be able to give feedback on the care they receive in hospitals. And by 2015, patients will be able to book GP appointments online and order a repeat prescription.

Mental and physical health will be given equal priority. There will, also, be emphasis on preventing premature deaths from cancers and heart diseases. The mandate is the document given by the Government to the new NHS Commissioning Board, which will in turn pass it down to the commissioning groups who will be in charge of purchasing the care on behalf of patients.

Mr Hunt said the document sends a signal that the government is ‘optimistic’ that the NHS can improve. The NHS chief executive, Sir David Nicholson, went further and said the mandate was the most ambitious document he had seen and was ‘more radical than the structural changes that have been seen’.


The intentionally slim-line document is meant to be understandable by the public. And to this end it lacks a lot of detail including how the government will be held to account if they do not fulfill the ‘ambitions’ in the mandate.

Mr Hunt did say that in the end it will be his head on the block and that he will be voted out if the public does not feel this mandate has been met. But there was no answer on repercussions should GPs or the commissioning board not deliver.

He did say that what they did not want to do was to performance-manage from behind desks in Whitehall and to that end they had limited themselves to specify outcomes, for instance, reducing cancer deaths, and not to say what the process should be.

There is a plan that by 2015 everyone should be able to find out how well their local NHS is providing the care they need by the publication of results. But there will be no new national IT projects after the spectacular failure of the attempt to introduce a system by the Labour government.

NHS managers have welcomed the document. The NHS Confederation said that it was “really important that the government avoided stuffing the mandate to the gunnels with detailed targets for every condition under the sun.”

Labour said it was nothing more than a “wish list”. The Shadow health secretary, Andy Burnham said the government had put the NHS on a “fast track to fragmentation”.  The launch also came as the Royal College of Midwives warned that the NHS is short of 5,000 full-time midwives and the Royal College of Nursing claimed that the ‘NHS was sleepwalking into crisis’ and that 61,000 frontline posts are in danger or have been axed in England.

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6 reader comments

  1. paul mcnab says:

    All empty,unfunded,purely aspirational “feel good” rhetoric from a cynically uncaring bunch of rich kids who are out of touch with the real-world-NHS. This government does not deliver on its promises,yet alone its public statements of intent, but is a government that dismantles and decimates services and systems that impact hugely upon the ordinary person in the street… cf,the Armed Forces,the Police Force, the Welfare State,Education,Farming and Agriculture,Housing, Employment Law to name but a few. With such a track record,one would be insane to think anything is going to improve.

  2. Charlotte says:

    I’m a student nurse and think this is a great idea, there is always room for improvement. However, experiencing first hand what actually goes on in healthcare settings, the fundamental question of funding is still not being addressed. The government cannot simply keep making cuts, cuts of funding, jobs and services without repercussions let alone improvements! Instead of trying to privatise the NHS, we need to listen to the unions and bodies that represent the people that work in it and the patients who experience it. Pencil pushers in government can walk around a hospital and pretend to be taking an interest, when they know absolutely nothing of the hardships faced by staff daily!

  3. billy howard says:

    what complete and utter nonsense mr. hunt has just uttered on ch.4 news. the nhs cannot function without adequate staffing. recently i visited a relative in hospital, to my horror i found the sinks on the wards 75% full of toilet waste. on other wards windows jammed, when i made enquiries, i was told budgets had been cut right accross the board including maintenance contracts. i spoke to two nurses with 25yrs service between them, they were almost in tears when they told me how low morale was amongst medical staff. they told me they had never experienced conditions so bad, they spoke about bullying by management accross the board, they are afraid to speak up for fear of the consequences, they said the only hope for better heathcare is for the general public to lobby for the medical staff, as one of them said “i can’t be in four places at any one time, but that is what is expected of myself and my colleagues” i thought conditions such as this only happend in third world countrys, not true, its happening in our nhs today. wake up mr. hunt and remember the nhs belongs to the people through their subsciptions, not the gov.

  4. Lynda Davies says:

    I am epileptic, although drugs have kept me clear of fits for a long time now. I give thanks every day for the wonderful NHS that allowed me to live a life like everyone else. Today I learnt that one of the drugs that has given me so much is discounted, My doctor didn’t mention this and prescribed as usual although they knew about this. I am trying to find out what I will take in it’s place it should be the generic version but may be tablets which haven’t worked for me in the past. I am terrified and the GP surgery say they no longer take appointments for the doctor, only for a triage nurse who will decide if I need to see the doctor. Of course I need to see the doctor, I need him to know how important it is for me – the patient that I am given the correct treatment. What on earth is happening to our once wonderful NHS that this sorry outcome of privatisation has brought about. Mr Hunt please remember we are people not dots on a balance sheet and abandon these changes there was nothing wrong with the NHS until the ConDems came to power and started privatising it for that is what it is.

  5. Lynda Davies says:

    I meant discontinued in my previous post – sorry

  6. Patrick says:

    Quote: “Mr Hunt said the document sends a signal that the government is ‘optimistic’ that the NHS can improve”

    That’s funny – I thought it had – dramatically improved – by the end of the last Government and things have deteriorated since. Having – in this household – had to wait 6 weeks for a simple blood test from the GP and another 6 weeks for an equally simple Ear Syringing (though the problem has solved itself, which is obviously what they were hoping for) and also finding it near impossible to actually see a Doctor because of new regimes of appointment allocation set up at the surgery – for us, the NHS is rapidly falling apart!

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