The Conservatives today signalled an end to targets in the NHS, relying instead on patient power to improve the service.

The policy, presented today by David Cameron, the party leader, and Shadow Health Secretary Andrew Lansley, should be popular with doctors, who complain that the target culture introduced by Labour since 1997 has undermined professional responsibility and distorted care.

But it is not a policy without risks. The NHS has shown that the only real drivers to which it responds with any alacrity are central targets. That is how waiting times were brought down, cancer and cardiac care improved, and the NHS’s finances restored after it ran into a deficit.

By comparison, the Government’s flirtation with patient power has been relatively unsuccessful. Patients now have the right to go to any hospital they want for elective treatment, but few take up the chance. GPs are lukewarm at best about patient choice, and often do not even offer it unless prompted.

The Conservatives argue that what is lacking is the kind of hard information patients need to make their choices - such as which hospitals have the best record in treating stroke. The NHS gathers reams of information, but not much of it bears on important issues such as this.

The Conservatives would extend the use of techniques such as Patient Reported Outcome Measures (PROMs), already used in the private sector and beginning to find their way into the NHS. Patients fill in forms before and then six weeks after their operations, designed to assess how their quality of life has been improved.

But the Tories will also extend the measurement of outcomes using other methods so that patients have a rounder picture of the quality of services on offer. The aim is to drive quality up and save thousands of lives.

When the UK is compared with other countries in its performance on the number of lives saved from conditions amenable to treatment, it does significantly worse.

Raising NHS standards to the European average would save 38,000 lives a year, Mr Cameron will say this morning.

The policy has the virtue of appearing radical without alienating any of the big beasts in the forest, such as the British Medical Association. Nobody is going to decry an attempt to raise quality.

But it is questionable whether sufficient of a market for care exists within the NHS to make patient power work. If patients had power, stroke treatment would already be better than it is, rather than lagging behind almost all conmparable countries.

But stroke treatment has never had a target attached, or a National Service Framework. So it has languished, deserted by a service that does little until it is told.

The structure of the NHS also militates against patient power. Unlike in systems funded by insurance, few NHS patients really feel that have an entitlement. Care is delivered as if by a beneficient charity, not a service patients have paid for in their taxes, and from which they ought to have certain expectations.

Changing this near-feudal attitude will take more than tinkering with data. It will probably need a reform of the funding arrangements, too.

But Mr Cameron has no intention of offering up a policy as radical as that. It would be a hostage to fortune, enabling Labour to claim that the Tories were planning to dismantle the NHS.

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