Patient choice in NHS going backwards under Cameron, says Labour

Figures reveal decline in use of electronic referral system that allows patients to choose location of an outpatient appointment

Liz Kendall, the shadow care minister, said the decline in NHS choose and book appointments highlighted a fundamental flaw in Tory health reforms. Photograph: Richard Gardner / Rex Features/Richard Gardner/Rex Features

Patient choice in the NHS is "going backwards" after new figures showed a decline in the number of people who have chosen where to receive outpatient hospital treatment, the shadow care minister Liz Kendall has said.

Just over half (52%) of NHS outpatient appointments were made through the "choose and book" service in the third quarter of this year, according to figures released in a parliamentary answer to Kendall by the health minister Dan Poulter. This marks a decline on the 57% of such appointments made in the first quarter of 2010 – the last full quarter when Labour was in office. Choose and book is an electronic referral system designed to allow patients to select the date, time and location of an outpatient appointment at a hospital or clinic.

Kendall said the decline in choose and book appointments highlighted a fundamental flaw in the reforms introduced by the former health secretary Andrew Lansley who handed commissioning powers to GPs. Lansley, who was demoted by David Cameron after the furore over his reforms, famously said his approach could be summed up in the phrase – "no decision is made about me, without me".

But Kendall said: "Andrew Lansley claimed it was no decision about me without me. But in fact what he did was fundamentally shift the power to GPs rather than really shifting the power to patients.

"The fundamental flaw in the Tories' reform is that they have failed to realise the ultimate goal has got to be giving more power to patients and families. It is really important that clinicians are leading changes but the goal is patient power, people power. That is the only way you are going to get the big and sustainable changes we need."

Kendall said the Tory approach contrasted with changes introduced by Labour. "Labour gave people a choice over where to have their operation for the first time. We also enshrined the right for patients to make choices about other local services in the NHS constitution. But under David Cameron, patient choice is going backwards. The proportion of people getting outpatient appointments at the hospital of their choice has gone down since 2010."

Jeremy Hunt, who was promoted to the post of health secretary last year with instructions to reassure voters after a collapse in trust under Lansley, is keen to portray himself as the patients' champion. Kendall said Hunt was simply seeking to "airbrush" changes that are occurring anyway.

"The Tories don't want to talk about their reforms any more. Hunt is trying to airbrush what they have really been doing for three and a half years – airbrush it out of history. But in fact we are starting to see the consequences of the changes just as we warned when the bill was going through parliament."

The shadow minister said recent closures of walk-in centres, established by the last government to provide primary NHS care at the weekends or evenings, highlighted the danger of handing too much power to GPs. Earlier this month Hunt cited the British Medical Association, which said that money had been wasted on urgent care centres located in the wrong places, to say the government was "sorting" a mess left by Labour.

Kendall said: "GPs are responsible for commissioning services. Lo and behold they are not commissioning services like walk-in centres which provide alternatives to GPs. Walk-in centres have flexibility and a range of different services – it is about fitting services around people's lives as they are now. The Tory policy is let's go back to the old family doctor. Well actually people want different kinds of services. They are championing the producer rather than the user."

Guardian