The National Health Service British Prime Minister John Major announced a new Citizen’s Charter in July 1991. This implied a change of attitude for the NHS: patients should be seen as customers with rights, rather than people who should be grateful for treatment, however long the wait. From April 1992 hospitals would have to set standards for maximum waiting times.

This followed on from the 1989 NHS White Paper, Working for Patients, which was designed to achieve:

raising the performance of all hospitals and general practitioners (GPs) to the level of the best (significant differences existed in measured performances)

patients receiving better health care and a greater choice of services through improved efficiencies and effectiveness in the use of NHS resources

greater satisfaction and rewards for NHS staff.

In subsequent years, how did this impact on NHS strategies?

In 1997 a Labour government was elected and it set about changing the Conservative philosophy, dismantling and replacing a number of strategies.

What was the Labour approach? How have these changes impacted upon performance measurement?
Can the relative success of the NHS ever be evaluated effectively without imputing political concerns?