Jeremy
Hunt, Secretary of State for Health, speaking today at Conservative Party
Conference in Manchester said:
(Check
against delivery)
“We have a great team at
the Department of Health so let me start by thanking them: the wise Philip
Dunne, the savvy Steve Brine, the smart James O’Shaughnessy, the street-smart
Jackie Doyle-Price and our perfect PPS’s Jo Churchill and James Cartlidge.
Sometimes something
happens that reminds you how lucky we are to have an NHS.
That happened right here
in Manchester in May.
When that bomb went off
at the Arena, we saw paramedics running into danger, doctors racing to work in
the middle of the night, nurses putting their arms round families who couldn’t
even recognise the disfigured bodies of their loved ones.
One doctor was actually
on the scene picking up his own daughter when the bomb went off. Thankfully he
found her – but instead of taking her home he quietly dropped her off with
friends and went straight to work at his hospital – without telling colleagues
a word about where he’d been.
It was the same heroism
after the London attacks too. So let’s start by thanking all those superb NHS
staff for being there when our country needed them.
Of course they’re there
for us not just in national emergencies but in personal ones too.
When you’re losing a
loved one, when you’re sick unexpectedly, when you’re knocked sideways by a mental
health crisis – the NHS is there. A National Health Service and a national
symbol of British professionalism and British compassion.
But it only exists
because of its people. So today I want to recognise that supporting NHS staff
is one of our most important priorities.
We need more doctors. So
last year I said we’d increase the number of doctors we train by a quarter, one
of the biggest ever increases.
We also need more
nurses. So today I can tell you we’ll increase the number of nurses we train by
25% – that’s a permanent increase of more than 5,000 nurse
training places every single year. And we’ll do that not just by increasing
traditional university places, but also by tripling the number
of Nursing Associates so
people already in the NHS can become a registered nurse after a four year
apprenticeship without having to do a traditional full time university course.
Derby, Wolverhampton and Coventry Universities have already offered to run
apprenticeship nursing courses on hospital and community sites and others will
follow, always making sure we maintain the high standards required by the
nursing regulator. We’ll also launch a new initiative to encourage nurses who
have left the profession to come back.
Our NHS is nothing
without its nurses: we need your skills, we need your compassion and with today’s
announcement we are backing the biggest expansion of nurse training in the
history of the NHS.
For nurses, as for all
of us, pay and conditions matter. I’ve already said we’ll decide next year’s
pay awards after listening to the independent pay review bodies. But there are
other things we can do today.
Nurses look after us –
but they also have their own families to look after: kids at school, a mum or
dad with dementia, a partner coping with cancer.
If we’re to get the best
out of them we need to be much better at supporting them with their own caring
responsibilities.
They need to be able to
work flexibly, do extra hours at short notice, get paid more quickly when they
do and make their own choices on pension contributions. So today I’m also
announcing that new flexible working arrangements
will be offered to all NHS employees during this parliament. And we’ll start
next year with 12 trusts piloting a new app-based flexible working offer to their
staff.
And like many people,
NHS staff can also struggle to find homes near work they can actually afford.
So from now on when NHS land is sold, first refusal on any affordable housing
built will be given to NHS employees benefitting up to 3,000 families.
And there’s one more
group who are understandably a bit worried at the moment and that’s the 150,000
EU workers in the health and care system. Let me say to them this: you do a
fantastic job, we want you to stay and we’re confident you will be able to stay
with the same rights you have now – so you can continue being a highly valued
part of our NHS and social care family.
I became Health
Secretary five years ago. It’s a long time ago – but I’ll never forget my very
first week.
Someone gave me the
original Francis report into Mid Staffs to take home to read. I was gobsmacked.
How could these terrible things really happen in our NHS?
The Chief Executive of
the NHS told me I’d better get used to the fact in hospitals all over the world
10% of patients are harmed. Another senior doctor told me there were pockets of
Mid Staffs-like problems everywhere. And academics told me that 3.6% of all
hospital deaths were probably avoidable – that’s 150 deaths every single week –
causing immense heartache to families as we heard so powerfully from Deb just
now.
People like Deb – and
what a privilege to listen to her this morning – made a choice.
Instead of drawing a
line under their personal tragedies and moving on they chose to dedicate their
lives to campaigning, reliving their sadness over and over again, just to make
sure other families wouldn’t have to go through what they did.
They also made my mind
up for me: my single ambition as Health Secretary would be to transform our NHS
into the safest healthcare system in the world where this kind of thing never
happened.
But where on earth do
you start?
The first thing is to be
honest about where the problems are. My kids are 3, 5 and 7 and as a Dad I know
exactly how good all the local schools are – thanks to Ofsted. We had nothing
like that in health – so against a lot of opposition in 2013 we became the
first country in the world to introduce the Ofsted system to healthcare, giving
independent ratings to every hospital, care home and GP surgery.
The results were, to say
the least, a big surprise. Look at this.
14 hospitals got an ‘outstanding.’
We assumed it would be the famous teaching hospitals, but in fact it was often
trusts no one had really heard of outside their area. Like Western Sussex,
under the inspiring leadership of Marianne Griffiths, which has the best
learning culture I have seen anywhere in the NHS. Or in mental health
Northumbria Tyne and Wear which I visited on Friday and is blazing a trail on
the safety of mental health patients.
Then we asked ourselves
a difficult question. Is quality care just something you have to buy? Of course
money matters – you need enough nurses on the wards and that costs money. But
it turned out to be a more complex relationship.
All Trusts are paid the
same NHS tariff. But on average the ‘good’ or ‘outstanding’ trusts were in
surplus and the ‘requires improvement’ and ‘inadequate’ ones were in deficit.
Why’s that? Because poor care is about the most expensive care you can give. If
someone has a fall and stays in hospital an extra week, it’s not just terrible
for them it costs us more too.
But our biggest worry
was what would happen to the trusts we put into special measures. Would they
get trapped in a vicious circle of decline? 35 trusts went into special
measures – nearly one in five of all NHS trusts – and so far 20 have come out.
What happened?
Take Wexham Park
Hospital in Slough. When they went into special measures, the CQC said their
care was unsafe, 6 of their 8 clinical areas needed improving and if you asked
staff the majority said they would not recommend their own care to a friend or
member of their family. Think about that: the staff themselves said their own
hospital’s care was not to be trusted.
Two years later under
the extraordinary leadership of Sir Andrew Morris and his Frimley team things
were transformed: all 8 clinical areas were good or outstanding, more than two
thirds of staff started recommending their own care and the Trust became one of
only 8 in the country to go straight from special measures to being rated
‘Good.’
And we learned perhaps
the most important thing I have learned as Health Secretary. The staff in every
Trust going into special measures were exactly the same as the staff coming
out. In other words it wasn’t about the staff, it was all about the leadership.
We also learned that you
can’t impose quality or safety from above – it has to be part of a culture that
comes from the bottom up. And that starts with openness and transparency.
Let me show you that
works.
After Mid Staffs we were
worried about staffing levels on wards. But rather than a top-down edict
telling Trusts to recruit more staff, we did something simpler. We just asked
every trust to publish every month the number of nurses employed in each of
their wards. What was the impact?
This is the total number
of adult nurses employed in the NHS. And you can see in the first two years
from 2010 they went down by just under 5,000. Then we introduced ward by ward
transparency and what happened? The blue line is the number of nurses Trusts
planned to recruit. The green line is what they actually recruited. In other
words once we started being transparent about nurse numbers the NHS ended up
with 18,000 more nurses than it planned. And the public noticed – inpatient
satisfaction over this period rose to record highs.
We also introduced
transparency in areas like mental health, our major priority under Theresa May’s
leadership. We are leading probably the biggest expansion of mental health in
Europe right now. But progress across the country has been patchy – so we are
using transparency to make sure that wherever you live mental health conditions
are always treated as seriously as physical health conditions.
So by shining a light on
problems, transparency saves lives. But it also saves money.
Every time someone gets
an infection during a hip operation it can cost £100,000 to put right. So under
the leadership of Professor Tim Briggs we started collecting data on infection
rates across the country. What did Tim find? He found that our best hospitals
infect one in 500 patients. But our least good ones it is as many as one in 25
patients.
Putting that right is
now saving hundreds of millions of pounds as well as reducing untold human
misery. So never let it be said you can’t afford safe care – it’s unsafe care
that breaks the bank.
Now what’s been the
overall impact of this focus on safety and quality? We all know the pressure
the NHS is under. But despite that the proportion of patients being harmed has
fallen by 8% and 200 fewer patients harmed every single day.
Staff are happier than
ever with the quality of their care and the proportion of the public who agree
their NHS care is good is up 13%.
This July an independent
American think tank, the Commonwealth Fund, said the NHS was the best – and
safest – healthcare system in the world. That’s better than America, better
than France, better than Germany and most importantly ahead of the Ashes better
than Australia.
But – and there is a ‘but’
– we still have those 150 avoidable deaths every week.
Twice a week somewhere
in the NHS we leave a foreign object in someone’s body.
Three times a week we
operate on the wrong part of someone’s body.
Four times a week a claim
is made for a baby born brain damaged.
We may be the safest in
the world – but what that really means is that healthcare everywhere needs to
change.
In America Johns Hopkins
University says medical error causes 250,000 deaths a year – the third biggest
killer after cancer and heart disease. Conference I want the NHS to blaze a
trail across the world in sorting that out.
So we have big campaigns
right now to tackle e-Coli infections, reduce maternity harm, make sure we
learn from every avoidable death and most of all keep our patients safe over
winter.
But we need to do
something else too: and that’s get much better at supporting doctors and nurses
when they make mistakes. Everyone makes mistakes – but only doctors and nurses
have been brave enough to choose a career where the price of those mistakes can
sometimes be a tragedy.
And when that happens no
one is more devastated, no one keener to learn and improve than those same
frontline staff.
But we often make that
impossible. They worry about litigation, the GMC, the NMC, the CQC, even being
fired by their trust. Unless we support staff to learn from mistakes we just
condemn ourselves to repeat them – and that means dismantling the NHS blame
culture and replacing it with a learning culture. The world’s largest
healthcare organisation must become the world’s largest learning organisation –
and it’s my job and my mission to make that happen.
Now next year the NHS
has an important birthday. Like Prince Charles and Lulu it will turn 70.
Here are the words of
the Health Minister who announced its formation back in 1944. [VIDEO]
Nye Bevan deserves
credit for founding the NHS in 1948. But that wasn’t him or indeed any Labour
minister.
That was the
Conservative Health Minister in 1944, Sir Henry Willink, whose white paper
announced the setting up of the NHS.
He did it with
cross-party support. And for me that’s what the NHS should always be: not a
political football, not a weapon to win votes but there for all of us with
support from all of us.
So conference when Labour
question our commitment to the NHS, as they did in Brighton, just tell them
that no party has a monopoly on compassion.
It’s not a Labour Health
Service or a Conservative Health Service but a National Health Service that we
built and are building together – as I’ve said many times.
And the next time they
question our record, tell them we’ve given our NHS more doctors, more nurses
and more funding than ever before in its history.
Tell them when they left
office the NHS wasn’t even rated the best in Europe, let alone best in the
world as it has been twice on our watch.
And most of all tell
them that if they’re really worried about the NHS being destroyed, then there’s
one thing they can do: ditch Corbyn and McDonnell’s disastrous economic
policies which would bankrupt our economy and bring our NHS to its knees.
Because the economic
facts of life are not suspended for the NHS: world-class public services need a
world-class economy and to ignore that is not to support our doctors and
nurses, it’s to betray them.
However unlike Labour we
don’t make the mistake of saying the challenges facing the NHS are only about
money.
If they were, we wouldn’t
have had Mid Staffs, Morecambe Bay and all those other tragedies that happened
during bumper increases in funding.
As Conservatives we know
that quality of care matters as much as quantity of money.
So when we battle to
improve the safety and quality of care we are making the NHS stronger not
weaker.
And we’re reinforcing
those founding values of the NHS we just heard, namely that every single older
person, every single family, every single child in our country matters – and we
want all of them to be treated with the same standards of care and compassion
that we’d want for our own mum or dad or son or daughter.
That, conference, is why
we’re backing our NHS to become the safest, highest quality healthcare system
in the world and we will deliver the safest, highest quality healthcare system
in the world. Thank you.
ENDS
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