Millions of heart disease and asthma sufferers to manage their illness at home in new NHS plan

Last updated at 15:46 07 January 2008

Up to 15 million people suffering from debilitating conditions such as heart disease and asthma will be given a greater role in their care under plans announced by Gordon Brown today.

New techniques will allow patients to carry out checks from home, saving them costly visits to hospital or their GPs, the Prime Minister said.

His first major speech on the NHS saw Mr Brown promise to step up reforms, claiming there would be "no no-go areas" for changes to the way the health service operates.

"The NHS of the future will do more than just treat patients who are ill - it will be an NHS offering prevention as well," he said at Kings College in London.

Under the plans patients who fail to turn up for hospital and GP appointments will go to the "back of the queue" for treatment.

Today Mr Brown also unveiled former Ofcom chief Stephen Carter as his principal special adviser.

The 43-year-old - currently chief executive at corporate communications firm Brunswick - will be responsible for advising on political strategy and report directly to the Prime Minister.

Announcing the world's first national screening programme for heart disease, strokes and diabetes, the Prime Minister will promise every adult in Britain a "health MoT" in a drive to prevent serious illness.

More than half a million hospital appointments are missed every year at a cost of more than half a billion pounds - enough to fund an extra 27,000 nurses or 8,000 doctors.

Contrary to some reports, the planned NHS constitution will not refuse treatment to those with unhealthy lifestyles. But Mr Brown does want to penalise those who fail to fulfil their "responsibilities" to the NHS.

Until now, the penalties have been unclear and some MPs have called for a system of one-off fines of around £10 for every missed appointment.

However, Whitehall sources made clear that the Prime Minister is not keen on financial penalties for patients but wants instead to punish them by delaying treatment.

Those who fail to turn up at an agreed time will see their right to be treated within 18 weeks affected. "They will go to the back of the queue," said one source.

In a series of wide-ranging interviews yesterday, the Prime Minister:

• insisted that Britain would weather a turbulent year ahead for the economy;

• signalled a new generation of nuclear power stations would be approved this week;

• pledged that all hospital patients will be screened for superbugs by next year;

• sought to placate critics of plans for ID cards and 42- day detention without charge.

The Prime Minister rejected a warning from Justice Secretary Jack Straw that the messages put forward by Tory leader David Cameron were "resonating" with voters.

He branded the Conservatives "opportunistic" and attacked them for opposing his plans to raise the education leaving age to 18 and to build three million new homes.

Mr Brown insisted he would be judged on the "long-term decisions" facing Britain - rather than a series of disasters which have seen the Tories leap ahead in the polls.

These included the loss of the personal and banking details of half the population, a new Labour funding scandal and the first run on a bank for more than a century.

"You've got ups and downs, you've got things that go right or wrong," Mr Brown told the BBC's Andrew Marr.

"Events come and they go. The question is... are you making the right long-term decisions for the country?"

The Prime Minister will today tell an audience of health professionals in London that he wants to transform the NHS into a "preventative health service" in its 60th anniversary year.

He will announce the first screening programme for vascular disease, which causes heart failure and strokes.

It affects the lives of 6.2million Britons, causing 200,000 deaths a year and accounting for almost a fifth of hospital admissions.

Officials said that the programme would extend the kind of well-being tests available to those with private medical insurance to the rest of the population.

The details are still being worked out, but party sources said that screening is likely to be offered initially to over-60s, or those judged as high risk.

The first test on offer will be an ultrasound check on men 65 and over to detect signs of abdominal aneurysm - weakening of the artery from the heart to the abdomen. It kills 3,000 men a year.

In a health MoT, doctors would check patients' blood pressure, cholesterol levels and BMI - and would test their urine for signs of diabetes.

Mr Brown will say: "Over time, everyone in Britain will have access to the right preventative health check-up."

He also used the interviews yesterday to deliver a strong warning that Britons will face tough economic conditions this year as the effects of the U.S. credit crunch spread.

There will be less money available to borrow and rates will be higher, Mr Brown said, although he insisted Britain had one of the "least volatile economies in the world".

On Northern Rock, the Prime Minister said private bids for the firm remained "in play". But he hinted that public ownership was on the cards.

That would mean the taxpayer effectively taking charge of the troubled bank and becoming responsible for its £100billion in mortgages.

The Prime Minister also indicated that an announcement would be made on Thursday on a new generation of nuclear power stations.

Despite opposition from environmentalists and MPs, Business Secretary John Hutton is expected to approve the plan.

Mr Brown also struck a conciliatory tone on ID cards, which he said will not be compulsory for British citizens.

His NHS pledges were greeted with derision by the Tories, who said that Labour first promised annual Health MoTs as long ago as 2006.

Shadow Chancellor George Osborne added that Mr Brown was waking up to the credit crunch too late.

"It's no use Gordon Brown blaming the rest of the world," he said.

"He should have used the good years to prepare us for the difficult years. But he failed."

•MPs should not award themselves inflation-busting pay rises, Gordon Brown said yesterday.

He told them to show 'discipline' and not vote themselves more than nurses and the police, whose pay has been restricted by the Treasury to keep inflation in check.

An independent pay advisory body has recommended a 2.8 per cent increase in MPs' pay.

This has caused anger among public sector workers, who have been told their own rises must stay below 2 per cent.

Mr Brown told the BBC's Andrew Marr that Government ministers would limit their pay rises to 1.9 per cent, adding: 'My recommendation is that that is what goes for MPs.

'We must show exactly the same discipline that we ask of other people. In future years, we will do better by the police, we can do better by nurses and teachers, we will do better by the Army.'

The final decision on pay will be made by MPs themselves in a Commons vote.

However, Mr Brown's comments make it much less likely they will give themselves an inflation-busting pay rise.

Pay levels for politicians are recommended by the independent Senior Salaries Review Body.

The suggested 2.8 per cent increase, followed by further inflation-matching rises, would take an MP's basic salary from £60,675 to £66,500 by 2010.

However, the average MP also claims £136,000 in expenses on top of this - costing taxpayers a total of £87million a year.