I agree, how can you transform BRITIANS NHS when there is already such big differences between England, Scotland, and Wales? We pay £7.10 for a prescription, which is scandlous, yet others wales and soon scotland get them FREE? It would not be so bad if it was only £3 put over £7 a disgrace. The main focus should be making sure ALL hospitals perform to a high standard in ALL ASPECTS especially having enough nurses, having CLEAN wards, and excellent patient care. Staff in hospitals cry out that they cant offer a good standard of care to patients as they are overworked, understaffed, streched too thinly and many more - its hit and miss with hospitals, there is the RVI in Newcastle is excellent, yet Sunderland Royal is pittyful, where is there such a difference in care and cleanliness?

Renewing Britain's NHS for the future. How do you renew Britains NHS, when you can only legislate for England?

i would truly like to thank the priminister and the labour governe]ment for their wonderful gift of £250.000 for the purchase of well needed equipment which will allow the children of blackpool to use the scanner that is located in the town's hospital this will save the children having to travel to preston or liverpool as in the past "that is the quote i would dearly love to have written" but the true fact is that the present day labur party / government has no interest in blackpool and as far as any investment such as above we will just have to find the money ourselves and let the children wait until there are vacancies for the scanners in preston or liverpool. and they subsequently have to travel accordgly "it is comforting to know we are so well cared for".

Amazing isn't it that we find Northern Rock has been kept afloat with £55 Billion of our(TAX PAYERS) money , only to find the incompetent bosses are pocketing huge bonuses.Maybe that money could have funded worthy causes such as this.Labour certainly shows where its priorities are....Making sure the RICH and (useless) don't suffer.They should be ashamed of themselves.You may have to find the money yourselves , but I'm sure they will be there to tax you.

Thank you! Or course screening is a very good idea. But please,please can this be done without resorting to the soul-killing regime of "targets". I have worked in a GP practice for over 30 years and I weep for the fact that wonderful GPs are no longer able to fulfil what their role implies because they are almost suffocated by the bureaucracy that the targets force on them.

Anna, You have hit the nail on the head with that one and I fully agree with you! There is far too much bureaucracy in the NHS these days which is effecting standards in patient care, cleanliness, and many more. This needs to change if there is any hope of reforming the NHS, staff want to offer excellent care, spend time with patients, diagnose illnesses properly and simply do their job but often find it can be too much strain and stress. Patients are not numbers or statistics, we are people, human beings who deserve the best in patient healthcare no matter of location.

Sorry Anna, targets and money,thats all that are important.I have said for the past 10 years the econonmy is held together on some bean counters ba;lance sheet.Mark my words things are going to be more transparent over the next 12 months and Browns economy will be on show for the con it was.

if people had a better diet that is more affordable maybe we would not have so many people with heart trouble ..we are supposed to eat 5 fruits and veg a day but to feed a family of 4 growing adults it is very difficult to buy fish instead of pies when the fish is 5.99 a piece and 4 pies are 99p .

Does this mean that you are going to give even more power to often lazy and overpaid, frequently incompetent Doctors? If so I object, having suffered the grave consequences of malpractise.

When the NHS was set up in 1948 it's intention was prevention of ill-health but the state of the nation's health was so appalling that it soon became an ill-health treatment service. It would be wonderful if more money was spent on ill-health prevention through screening and would in the long term save money. Another improvement would be to look at improving the diagnostic services. Waiting lists to see the consultant have been reduced but the next stage in the process ie referral for scans and tests, is still quite slow and causes people to say that the NHS has not improved as much as it needs to.

I had to chuckle when I heard the P.M's announcement about the NHS; as I started nursing before the NHS started, so the idea of a preventative service was a welcome thought for cost of care was prohibitive. We forget that the name was National Health Service and the G.P. was to be in charge.

I here so much about the NHS these day this is not right that is not right, there is nothing wrong with the NHS or the nurses or doctors side of it, its the cleanliness of the NHS that is wrong, the carpets that hold the germs, the cleaning people with the dirty mops, I have seen this and watched this when on my visits, one bucket of water cleaning a whole department. you tend to see more of this when one is in a wheelchair. We must get rid of the carpets from hostitals, of course it is nice to feel at home when on a visit to a clinic, but finding carpets in wards is a no no. And this nonsence of free care in one part of the uk and not in the other, just to have the english hate the scots, for this is what is happening. By the way I am a BRITISH, note the word british. i don't want to be disliked because I am a scot.

Tragically, a great deal of our investment in the NHS has been wasted on bureaucracy, 'modernisation' and constant restructuring. The Tories did immense damage to the NHS by introducing the internal market but instead of simply scrapping it, Labour has continued to let civil servants and politicans interfere. The concept of 'choice' has proved unpopular, because people actually want reliability and excellence. Rather than more gimmicks and change we should leave the NHS alone, aim to reduce bureaucratic costs and make sure that as much of our funding as possible actually reaches patients. And we should address the scandal of charging for social care which makes a nonsense of the 'free' NHS. If the Scots can get rid of charges for personal care, why can't we in England?

This Government has poured money into the N.H.S. and yet many people are frightened to go into hospital because of dirty wards resulting in further illness or even death. The blame lies with those who run the Health Service, The Trusts founded by the last Tory Goverment. They decide where the money should go and organize the hospitals and who should run them. They have immense power from selecting which private companies should run services from catering to cleaning. They are Empire builders on a grand scale but patients come last. If Gorden Brown really wants to help patients then he should scrap The Trusts and and go back to how it was before the Heath Government brought in Local Government Reorganization. Before that County Councils and Regional Authorities ran hospitals etc. I know it would be difficult to go back but why not let hospitals and G.Ps administer themselves again. Which is more important that the N.H.S. should be for patients or armies of bureaucrats who put patients last. If this results in increase of unemployment then perhaps the private companies who have benefited from the funds which should have gone to patient care should help Trust employees. No one wants unemployment to increase but if this results in a Health Service for patients which will cost less anyway then it is the only way.

There would be plenty of monetry provision in the NHS if they would stop using PFI funding. This is just filling the very deep pockets of a few individuals and taking the money out of the NHS. Here in South East London we are fighting to keep our A & E, maternity, pediatrics and intensive care departments at our local Queen Marys Hospital just so the local PFI funded hospitals can pay their enormous debts. Paramedics can do a great job but from personal experience let me tell you that lives will be lost if they have to go on longer journeys without being stabilised at the local hospital. Our other hospitals in the area are already overcrowded so where will they put the extra cases - put up marquees in the car parks! It is all very well having these smaller units dotted about, but no provision is made for longer journeys to hospital - not everybody has a car.

I recently attended Yeovil hospital with my 86 year old mother after a very bad fall. She was in a neck brace and could not move. She was not offered an emergency button or any consideration for her age. We attended the hospital for 6 and a half hours and she was not offered a drink in all that time. The cleaning staff mopped "arround my seat" not very hygenic. I think Mr Brown needs to get back to basics and the old ways of care- respect and cleanliness. Until this comes about in hospital we will never get a good service of care. It does not take a degree to care for people just a good heart. The lady in the bed next to her was 101 had been there since 5 30 until one. Had a blood transfusion and had her arm in plaster. Again no emergency button was given to her so that she could get assistance, no drink or food. Please please Mr. Brown look into these matters and put them right or I for one - a keen labour supporter- will not be voting you in again!

I am a CAD drawer working in London. I believe that the Labour party could have easily stabilised the housing market, and probably still can. By making all estate agents government run, giving them a salary not based on how many houses sold or the price obtained. The reason for this is in my option estate agents have been artificially increasing house prices for the last decade without any checks done on them.

I am a GP. What Gordon is saying is not new, we have been doing it for 25 years and can show that it does work. What WONT work is if this is done in some sort of "MOT's for people" That would just be a gimmick. We also do ultrasound screening for aortic aneurisms and that works too.

Kenneth's surgery is doig a great job but not all surgeries have his dedication and I would like to see prostate problems being investigated as breast examinations are. Also I would like to see our young doctors given a fair chance when they apply for their next job instead of the disaster experienced last year. I have a vested interest as my granddaughter is an SHO and although she went to Cambridge and Oxford and passed her surgical exam first go, she has spent six months in New Zealand because she could not get a job last August and doing a job there which was below her skills. However, she has been offered a job back at Torbay Hospital as acting Registrar in A and E, but this isn't a training job so hopefully she will be more successful applying for a post for August 2008. Come on Alan and Gordon get your act together and sort out this ongoing problem.

I feel as though doctors concentrate more on over-prescribing drugs than diet advice and prescribing exercise regimes. When we try to eat healthily, food labelling is confusing and misleading and we don't have time to read every single of every item at the supermarket. These foods are often high in sugar, salt and fat and that includes the healthy options. Could there not be a subsidised gym and class memberships for example and clear and honest labeling on our foods rather than an over-relience on pills? The goverment would do us all a favour by getting shot of some of the pen pushers as well.

We have Cancer and Eye Drugs available in Scotland denied by NICE to the English. Cervical Smear tests denied to women in the teenage and early twentys in England despite being available in Scotland. We have a Prime Minister Elected by the Scots, in charge of Englands Health Service, not his own in Scotland, that he has no say what so ever over. We have larger class sizes in English Schools, and smaller expenditure on Englands Health Service than any where else in the UK. Brown never mentions England when he talks about Health and Education even though these departments outside of England are not his concern. This is just more empty speel from a discredited Government. Give the English at least the same level of Health Care that has been awarded the rest of the UK.

Am I the only person in the country who is totally satisfied by the performance and dedication of our doctors and nurses,,, the nhs lost its way the day they allowed contract working, you straight away introduce a middle man who also wants his cut of the dough for supplying poorly paid immigrants to do a very poor job of a life saving neccessity such as cleanliness on the wards, or better still common sense. Too many top brass creaming the funds away without the basic skills of how to barter ect. At least with this new idea Gordon came up with,,,ya! das is correct, Gordon! The NHS will know where it is going to be best to spend their money in the future and how much money they will need, I feel I have had my monies worth from the NHS but also feel that money could have been better spent should we get rid of the hoi polloys and teach the ones who know how to barter and get the best deal. My accident and emergency has moved 7 miles up the road but since ambulances can now provide excellent trauma care it wont make any difference at all to those who would make it or those who would sadly die, they would have died anyway! Why not just have bigger ambulances with a mini operating theatre and a cut and shut surgeon on board ready and waiting. If it costs more then let all the citizens of this country pay more for it, and all those non citizens have thier country pay for them as every other country does

Barter with who, what the hell do you mean barter, and your wrong only a doctor can do trauma. Ambulance can save your life, they can also put you in a hospital bed, they did with me. But still this barter what is this.

There is no easy way to criticise, but I will. All this stuff the party are doing seems fine but the root cause is this unending effort to business everything up! The NHS a national state body and vote chasing by threatening to fine hospitals, produce league tables and other similiar tactics just seems like a way to distance accountability. Take it in hand and make it react to the needs of the country as a whole, it is an organisation that does need central control. We could surely set up national supplies agreements and stop wasting money. Lose the million and one managers, listen to the clinical staff (as in when they said don’t take the cleaners out of ward staff). NHS is the product of a dynamic socialist dream it’s a shame to see it being broken by the weakness that is the cancer in the party today. There you have…..the Labour Party?

I totally agree Andy; the first and most fundamental reform of the NHS that is required is to stop considering it as a business. People will still support a tax increase if it is ring-fenced for the NHS, and if they can see definite improvements in services for all diseases, and not just the headline grabbers.

I too am a little concerned about prevention and/or cure. I am Epileptic, have sever Asthma, High Blood Pressure and GORD so will I be a burden on the NHS and have to try and fund myself or will I still be able to be taken care of? Although I do agree that the NHS does need some sort of reform as long as it is for the better for patients not MP's or budget.

As I have bipolar disorder and epilepsy, both not too well controlled, I see a consultant psychiatrist monthly and a consultant neurologist 4-monthly. I also attend a day centre. I and others like me would suffer terribly if money were taken from the "cure" budget for a "prevention" service and these services were taken away. Sitting at home and feeding back my mental and physical condition via a computer is no replacement for face-to-face care. Also, if money to purchase care is given to the service user, it will be limited and may not pay for all the healthcare needed, let alone the "social" care.

After ten years it is amazing that Britain and the NHS needs renewing. After ten years it is this government which is solely responsible for the state of the NHS. Certainly prevention is better than cure but what about all those for whom cure is the only option. Screening programmes, improved lifestyle etc etc take many years to have a real significant impact on ones health. It is the here and now which concern most of those who rely on the NHS. Having waited now for almost two years for something as simple as a hearing aid I can only comment that GB's fine words have in my case fallen on increasingly deaf ears Labour Party member for almost 50 years but more disillusioned by the day.

I remember when the NHS started 1948 - it transformed the lives of the ordinary working class people in this country and it was very expensive, but when the Tories got back they didn’t dare discontinue it, or they would have been annihilated at the next election. However, New Labour is proud of the fact it has no socialist principles to hold it back, they all have a great income and expenses and a pension scheme most of us would give an arm for. So now the NHS is just a political tool, which the leaders can hit each the over the head with. All politicians would like the money it costs, used for tax cuts or paying for another war some where. So when Mr Brown says: “People tell me of the truly excellent experiences of care when they get into the NHS, of the nurses and doctors dedicated to their care -- but at the same time of their frustrations with access to services, with a service too often centred on the needs of the providers rather than those of patients”, what he means is that all those doctors and nurses dedicated to care would be better off employed by a private (probably US) company. Eventually no state owned hospitals or other facilities will exist at all, because a future government will do a Thatcher and sell them off. Then the British people will be at the mercies of the private sector, who will eventually charge so much that the chancellor of the day will say we can’t afford it, and the public will be told to take out insurance for anything bar minimum health care. There’ll be no objections from New Labour MPs, because it’s for sure they‘ll have special arrangements to cover members.

I object strongly to the claim that this screening programme would be a world-first. I grew up in East Germany, and every citizen was thoroughly checked every year. This was done via school class visits to a designated doctor, and for adults through their site physician. Yes, for all of you who wonder what that is, many company sites in East Germany had their very own GP for staff, supported by appropriate nurse and reception staff and properly equipped. And just for the record, flue jabs were compulsory everywhere. The doctor came to our school, and every class had to march through to get theirs. The only excuse accepted was if you just had a cold. And then they would come back two weeks later to get you, too. So please, dear government of the day, don't be so smug. After all, you just reinvented the wheel, and the bad old socialist bloc serves as inspiration. We also had lung screens, the first age 18 or thereabouts, and every 10 years subsequently. I never got to my second one. We also got most of our immunisations in kindergarten or school with the required medical staff coming into the nursery or school, so no extra time off for parents from work to take children to their GP.

Whilst I am aware there are many facets and political complications to healthcare I would like to draw attention to a perhaps poorly understood concept within the NHS. Access to quality pharmacy service is an essential. I believe that the current government control of the network of pharmacies does a disservice to the UK population. Currently a new pharmacy can only open should the local health authority deem it necessary. Public convience is not considered and the system is set up on an antiquated set of rules. It is time to lift the restrictive practice on this industry. Allow the best service to survive rather than the existing second rate service which is completely protected and has no need to compete or improve should it choose not to. New, young and enthusiastic pharmacists have no environment in which to develope their own skills. They are stiffled by the multiples who control the majority of the network of pharmacies. There may still be a significant number of independants but proportionally they fulfil a small % of the overall national pharmacy business. Free the market place and improve the service !

GPs continue to discriminate against mental health service users despite report by David Woolf QC. What steps are being taken to ensure that mental health issues do not preclude genuine access to public sector health care?

Screening consumes resources and will usually result in many more false positive results than true positives. As it is easy for screening programmes to do more harm than good, there are clear criteria that must be met before it is appropriate to introduce or extend them. If “a major extension of diagnostic procedures” is intended, it would be good to hear what new information has come to light to make previously inappropriate tests appropriate, and what evidence exists to show that using the resources this way will improve our health more than using them in other health programmes.

Heart disease, the most preventable health threat facing Britain today, is costing the economy £29bn a year. Rising rates of obesity, an ageing population and the soaring prescription bills for heart drugs such as statins mean that the bill is likely to rise in the future. In the first study of its kind to calculate the financial burden of cardiovascular disease (CVD), analysts found that the UK is spending more healthcare money on the condition than any other European country. They said that more effort and money should go into preventing CVD through diet and exercise rather than current policies which have focused on improving access to drugs. In Britain, more people die of coronary heart disease and strokes than cancer. Peter Weissberg, medical director of the British Heart Foundation, said: "This study should stimulate policy-makers to reconsider public health measures to reduce the massive burden of cardiovascular disease in the UK. "The unfortunate thing is that we know much of this disease burden could be reduced or even abolished with appropriate public health measures such as reducing smoking, increasing opportunities for exercise and improving the nation's diet. "Although it might be expensive to provide facilities such as playing fields and gyms, today's research shows that it is much more expensive not to." http://news.independent.co.uk/health/article484112.ece

Reform of the NHS is all well and good but what about the crazy situation we have at the moment? In order to achieve government targets one cannot book an appointment with our local doctor. One has to keep trying day after day to get an appointment on the same day - and all so that the local health centre can report that 99% of all patients are seen the same day!!! RIDICULOUS,... What about serving the sick?????

Nice to see that it's Britain's health service that will suffer this time, and not just England's.

I really like the sound of this - top stuff!

I welcome this move, it seems to make sense and if it helps prevent people developing life-threatening diseases, then surely it's a good investment? Private providers won't be providing it - not sure I understand the comment about America etc - seems misguided. It will be an NHS service, available at your GPs as well.

You do need to check before you write, the deal will be provided by the well clinic Brown intends opening, this will be provided by the private health care, especially those provided by the American health care. The NHS will only provide a service if no private provider is available. These are the walk in clinic all ready provied by Blair. This is why Labour has not released any funds to the NHS.

I agree with you Daniel, but I treat everything Brown says with suspition.He has a history of publicly saying things that have hidden agenda's underneath.

Will the PMs plans to have NHS services cover prevention extend to children's services or just to the big headline issues (stroke, diabetes, cancer)

Well no it already says what the criteria is people over a certain age, those suffering illness or disability, people who have a family history, not many children are going to die of heart conditions unless they have a history of the problems in the family they yes they will be asked to attend. But the English are worried because in Scotland and Wales and NI, people are now getting free proscriptions, so Brown wants to give the English something. The biggest problem of course he has offered no extra money to the NHS mainly because he is going to ask private providers to do this, and I bet it will be our American friends who end up making the money out of this. Seems we are to help America out of trouble with the financial problems. Good Old American Labour.

It's good that Broqn is finally adding some flesh to his NHS talk. The Tories trying to steal the NHS from Labour is a vile crime, and we have to ensure it stays put. Labour invested it, Labour saved it from Tory mismanagement. Why let it go down the tube again?

It seems that thie nice sounding preventive medicine approach is yet another way of following the American dream. Dream that is for private healthcare companies to make big money out of the UK population. There are advantages of preventive work, but my experience in the US is that it makes people over-anxious, with unnecessary tests and even false positives. As an earlier respondent says, the increase in infectious outbreaks in hospital has a lot to do with removing the orderlies from the ward staff and using hourly paid agency staff who have not loalty to the ward & just want to get the job done quickly as they are paid badly & are not part of the wrd team. Keep the NHS public.