Rosie Winterton – 2004 Speech to NHS Chairs Conference

Below is the text of the speech made by Rosie Winterton, the then Minister of State for Health, at the Queen Elizabeth II Conference Centre in London on 6 October 2004.

It is a real honour to have been invited to speak to all of you here today.

You all know the priority that this government has attached to the improvement of our National Health Service and so on behalf of the Secretary of State, John Reid and all the ministerial team I would like to first of all thank you for the work you have done so far.

However, as I am bound to say, there is much yet to do!

In a modern society collective strength is developed through a series of interdependent networks – each of us relying on the other for the commodities and services that enable us to function effectively and to make progress.

But what makes us strong also makes us potentially vulnerable. If the bonds that hold together our society are ever broken, then the consequences for us as a society are potentially catastrophic.

And that is one of the primary reasons why such importance has been attached to the modernisation of the NHS.

That’s the reason why people like Tony Blair and John Reid are prepared to invest such political capital into it. They know, as each of us in this room knows, that the effect of inter-generational underinvestment was beginning to endanger the very existence of our precious National Health Service.

That trend has been reversed.

Investment in the NHS is now rising faster than ever. Spending has risen from £33 billion in 1997 to over £58 billion this year.

It will continue rising and by 2008, will have reached a staggering £90 billion.

Real terms spending in the NHS is increasing at very nearly three times the rate achieved under the previous Government.

Of course such investment alone means little – it’s what you do with it that counts and while I am sure that you are all very familiar with the following figures, I’m equally sure they warrant just a little repetition!

• 77,500 more nurses working in the NHS, compared with 1997;

• over 19,000 more doctors;

• 68 major new hospitals built, under way or planned, as part of the largest ever hospital building programme.

Impressive though these figures may be, we must never forget that they are only a means to an end – what do the all these statistics mean to the people who use the NHS?

Well, there are now:

• Over 284,000 fewer people on the inpatient waiting list compared with March 1997;

• Virtually no waits of over 9 months for a hospital admission – down from the previous maximum wait of 18 months;

• Over 98 per cent of people seeing a GP within 48 hours; and

• 19 out of every 20 people being seen, diagnosed and treated within 4 hours in A&E departments.

There has been a 23% reduction in heart-related deaths since 1997, and a 10% reduction in the rate of premature deaths from cancer since 1997.

Such progress is a real testament to the commitment of government, the leadership of all of you and the sheer dedication of the 1.2 million people who work so hard to ensure that our National Health Service remains the envy of the world.

Well, everyone except the press it would seem!

Don’t worry; I’m not going to enter into a long and bitter tirade against some of the frankly disgraceful ways in which the media has portrayed our service.

It wouldn’t make any difference anyway.

But what I will say is this:

The fact that such extreme examples of personal or organisational failure make the front page of the newspapers should, paradoxically, give us grounds for optimism. It is precisely because these cases are exceptional that they do make the front page – the norm is good services – the exception is a failure.

Let’s never see the day when the exception of good service makes the news because that would clearly mean that the norm is failure.

Equally, such incidents present all of us with a reminder that while great progress is being made – a great deal remains to be done.

In June, John Reid set out plans for the next four years.

Built around continuing investment and reform, waiting times are set to fall to weeks not months. And for the first time, we will target long waits for tests and scans.

This is about helping the NHS become the service we all want it to be – one where patients are rightly offered greater choice and flexibility over when, where and how they are treated, but where we preserve and protect the fundamental principle that care should be provided free at the point of use and on the basis of need rather than ability to pay.

We will also extend the greater personalisation of patient care to people with chronic and long-term medical conditions. Some 17.5 million people have their life dominated by conditions that cannot be cured – diabetes, asthma, heart failure, and some mental health problems. Providing them with the personalised support and care that they need and deserve, to live fulfilling lives, will be a priority.

We will do this by providing thousands of community matrons, rolling out the Expert Patients Programme across the country and ensuring that the new contract for GPs delivers the best care for patients.

The very reason we are able to celebrate such remarkable progress is because you have made things happen, through strong and clear local leadership.

You have successfully harnessed the creativity and skills of your Boards, your staff, your partners and your communities to get behind this transformation.

The improvements have been hard won.

The management challenges are complex and demanding, requiring attention to detail.

The leadership task has required you to help everyone involved understand and hold on to the wider vision of improved health and transformed care – to keep the future clearly in view as we grapple with today’s issues.

So thank you for all you are doing – your commitment, your focus and time and your enthusiasm to make what I know will amount to a lasting legacy.

The Prime Minister’s message to you today paid tribute to your role in making a very real difference to the lives of so many people. I echo that. As Minister of State at the Department of Health, I have had many opportunities to see for myself just how far-reaching the improvements are for all patients and service users.

I also want to say a few words about the public service values that will guide the NHS on the next stage of our journey; and, in particular, how I see these values impacting on the work of Boards as we broaden our focus to embrace health and inequalities as well as improvements in services.

For me, the test of our progress goes beyond the statistics, impressive though they are.

It is about how well we are doing to improve the care and treatment of people who are socially disadvantaged or less well off; the care and treatment of people of different ages, ethnicity or gender; and the care and treatment of people who are marginalised or stigmatised in our society. It is about how we are tackling the inequalities in our healthcare system. I am sure these are your tests too.

A central tenet of the NHS is that care for all means care for all.

Not just some.

And care delivered according to need, rather than ability to pay. This is not a new value, but one that is still not felt or experienced by everyone using our services.

Equally important is that we must put people at the heart of all we do. This means listening to those we serve and acting on what we hear – a key role for Boards.

It means offering choice. Not choice between good and bad – but rather choice between excellent and excellent.

It means ensuring that care is personal to every individual. It means strengthening partnerships to deliver a more person-centred and value-driven pattern of care.

The next stage of our journey is all about local action and how that satisfies our quest for improved health, improved services and improved care.

Locally, between you, you can release the energy, power and innovation not just of your fellow leaders or the staff in your own organisations, but of local communities, local partners and local people as well.

We have different strengths and perspectives.

But we are all bound by the same values.

Our partners in local government can draw on their detailed knowledge of local communities and their experience of working through influence to deliver improved outcomes. Primary Care Trusts, by forging wider partnerships, can help raise ‘health’ higher on other agendas, such as Housing and Transport. Providers of care touch the lives of thousands of people every week, and can have a direct impact on the quality of life for many, many people.

And together, the more we share the challenge of modelling the way we want all employers to behave in promoting health and wellbeing – giving staff the strong signal that we value them and take their health seriously – the more this will have a direct influence on how they work with local communities, families, patients and service users.

So, through partnership and shared enterprise, based on the core NHS values, you are well equipped to develop and communicate a compelling local vision of how care will improve in your community.

You are equally well placed to practise what you preach in the way it is delivered.

Now is the time to use Local Strategic Partnerships and other partnership mechanisms to the full.

The time to construct a shared agenda and shared leadership.

The time to pay attention to the wellbeing of our own staff and their health.

And the time to focus ever more on listening to our communities and acting on what they say.

Good partnerships always require the trading of priorities and the need to transcend organisational boundaries.

We need – together – to devise better ways of creating incentives and rewarding effective partnership between health and social care, across the public sector, with communities and within healthcare.

We know that at local community level many people do not make distinctions between the Council and the Primary Care Trust or the different management arrangements in the Primary Care Trust, the surgery or the hospital. Frankly, they couldn’t care less!

They just see us all as part of public services and expect us to work together.

And where we show them that we can do this well, the reputation of the whole public sector benefits.

So, together, we should build a high trust system and avoid fragmentation.

We should stand united through our shared values and use the greater independence, localism and partnership to really benefit users and patients.

The next few weeks and months will bring new opportunities through the White Paper on public health and also through the developing vision for adult social care.

We have some immediate challenges to guard and enhance the reputation of the NHS – not least the cleanliness of our buildings, the quality and safety of the care we give, the way we support our staff, the way we demonstrate efficiency in the use of taxpayers’ money, the way we introduce new technology into clinical practice, and the critical importance of continuing to deliver on our targets.

You will play a key role in guiding your part of the NHS on this journey.

You will also be able to set the compelling vision for the future, building on local issues and priorities, in partnership with each other and with all those who can impact on the health of our population.

And I wish you well in this next stage of reform.

Finally, I want to use this opportunity to articulate a message on behalf of the whole government, through you, to all the people who work in our health service.

It’s a simple message, but one that we perhaps don’t use enough.

Thank you.

Thank you for what you have done.

Thank you for what you will do.

Thank you for all the times you have done that bit extra and thought that no-one had noticed.

And thank you for being great ambassadors for not only our National Health Service…. But also our country.

Thanks for listening.