Below is the text of the speech made by Matt Hancock, the Secretary of State for Health, in the House of Commons on 17 June 2019.
I would like to update the House on the actions the Government are taking to protect the public following cases of listeria in hospitals linked to contaminated food. The NHS has identified nine confirmed cases of listeria in seven different hospitals between 14 April and 28 May this year, all linked to contaminated sandwiches from a single supplier. All the known cases involve in-patients. Very sadly, five people have died. I would like to express my condolences to the families of those who have lost a loved one. I promise that there will be a full and thorough investigation, with severe consequences if there is any evidence of wrongdoing.
Lab testing indicated a link between two cases in Manchester Royal Infirmary and one case in Liverpool. Contaminated sandwiches were identified as the likely cause by Public Health England. The manufacturer—The Good Food Chain—and its supplier, North Country Cooked Meats, have withdrawn the sandwiches, and voluntarily ceased supply of all products on 7 June. They are both complying with the Food Standards Agency on a full product withdrawal. The other cases have been identified at these hospitals: Royal Derby, Worthing, William Harvey in Ashford, Wexham Park, Leicester Royal Infirmary, and St Richards in Chichester.
The risk to the public is very low, but any patients or members of the public with concerns should contact NHS 111 or, of course, 999 if they experience severe symptoms. Listeria infection in healthy people may cause mild illness but is rarely fatal. However, for certain groups it can be much more serious, as we have tragically seen. The NHS, Public Health England and the Food Standards Agency have acted swiftly to identify, contain and investigate the cause of this listeria outbreak. These deaths should never have happened. People rightly expect to be safe and looked after in hospitals, and we must ensure that we take the necessary steps to restore that trust that the public deserve to be able to hold.
This is not just about ensuring that the food we serve in hospitals is safe—the NHS served 140 million main meals to in-patients last year—but, importantly, is also about ensuring that food given to patients is healthy, nutritious, and aids their recovery. So I can inform the House that we are launching a root-and-branch review of all the food in our hospitals—both the food served and the food sold. The Government will work with the NHS to build on progress in three vital areas. First, there is eliminating junk food from hospitals. Since the introduction of the NHS action on sugar scheme, we have halved the sale of high-sugar soft drinks, and trusts are taking action to remove unhealthy food and drink items and replace them with healthier alternatives. After all, hospitals are places for good health. Secondly, on improving nutrition, new national standards for all healthcare food will be published this year. All patient menus will have to ensure that minimum patient nutrition standards are met. Thirdly, on healthier choices, we will work closely with the Hospital Caterers Association and others to ensure that healthier food choices are available across the NHS.
The review will identify where we need to do more, where we need to do better to improve the quality of food in our hospitals, and how we help people to make healthier choices. I know that this is an issue that many colleagues in the House feel strongly about, as do the public. We will do everything we can to ensure that the food we eat in hospitals is both safe and healthy.
Below is the text of the speech made by Matt Hancock, the Secretary of State for Health, at the East London Foundation Trust on 3 June 2019.
1.3 million people in the NHS.
If we were a country, we’d be the same size as Estonia. If we were a company, we’d be almost the same size as McDonald’s – but a lot better for you than a Big Mac.
Since I became health secretary I’ve tried to meet as many staff, from as many different parts of the NHS, as possible. Admittedly, meeting 1.3 million people individually is difficult.
I’ve spoken to hundreds of nurses, doctors, paramedics, porters, juniors, seniors, consultants, chief executives. I’ve tried to listen and I’ve tried to listen hard.
And what’s clear is that people are the most valuable asset the NHS has. How we invest in, and look after, our people will determine the future of the NHS.
And that future is so important because the NHS is the most valuable public service we have.
A strong NHS, and strong public services, are the foundations of a strong society. So Britain must continue to be a place where we invest in people because we believe in the potential of people to make things better.
It’s why we appointed Prerana Issar as the first ever NHS Chief People Officer. And it’s why Dido and her team have created the first ever NHS People Plan.
I am extremely grateful to both of them because taking better care of our people is mission critical to the success of the NHS.
Now, I know your time is valuable. So I’m not going to waffle on. And if you saw Good Morning Britain, you’ll know I’ve already been caught out once for too much waffle.
So I’m going to be short today. And I’m going to be direct.
I want to talk to you about 3 people. Three people who illustrate where we’ve come from, where we are now, and where we need to get to.
Recruitment, retention, and an NHS that puts people first.
The first person is a nurse. She, or he, doesn’t live in this country – yet.
They’re in the Philippines, or India, or Poland, or any other number of countries around the world.
They look to the NHS as a beacon of excellence, and of opportunity. Somewhere they can come to, to be the best nurse they can possibly be.
Somewhere they can learn new skills, earn money, and return home as a world-class nurse, or stay and build a new home and a better life here in Britain.
To that nurse I say: we welcome you, we need you, we want you to come and help us build an NHS that’s fit for the future.
Because the National Health Service has always had an international workforce, from the Windrush Generation to the Warsaw Generation.
We must never forget the enormous contribution that people born beyond these shores have made to one of this nation’s greatest institutions.
The People Plan spells out how we need a new Windrush Generation for the NHS. A recruitment drive to attract the brightest and best doctors, nurses, and clinical staff from overseas.
And I want to send a very clear message to those people: if you have the talent, the skills, and the determination to pack up your hopes and dreams in a suitcase and travel to the other side of the world, then the NHS will be your new home.
Our NHS could not provide its world-class service to patients without the hardworking doctors and nurses from other nations.
The second person I want to talk about is a British student.
She, or he, is 18. They’re getting ready for their A-Level exams – hopefully not leaving it as late as I did.
They were born in this century. Technology has shaped every part of their lives from the way they shop, eat, travel, bank, socialise, and even find love.
They have more choice at their fingertips than previous generations would have had in a lifetime.
In fact, there’s so many possibilities that it can be overwhelming. And then a parent, or a perhaps a career adviser, says: “Have you ever thought about becoming a nurse?”
And this 18-year-old thinks: “I’m good at science, I’m interested in people, caring for others would be a rewarding career.”
And then they start to look into it. They start to search online for information.
And what do they see?
Story after story about shortages, about the stresses and the strains, and only the problems.
Never or rarely hearing about the nurses who love their jobs and wouldn’t choose to do anything else, despite the difficulties.
Now, I know there are genuine problems with the system.
That’s why Dido has taken a long-term approach to the first ever NHS People Plan so we can create a new system that puts people first, and is fit for the future.
There are shortages. We use too many agency workers when we should have permanent staff.
The job has become more challenging as the population ages and demand grows.
Your roles are more complex and you need continuous training and new technology to keep up with the pace of change.
But I fear that by only talking about the problems, we risk creating a perception that a career in the NHS isn’t for an ambitious, young, British person. Particularly when it comes to nursing.
Nursing is a first-choice career. An NHS nurse has a passport to anywhere.
In fact, it’s what makes my job so difficult because we can do a lot of things to convince people to stay in the NHS, but I’m afraid we can’t compete with the Australian sunshine.
So we’re putting a record £33.9 billion a year into the NHS – and let’s not forget three-quarters of the NHS budget goes on staff.
We’re opening 5 new medical schools. We’re increasing the number of clinical training places, and we’re increasing the number of routes into nursing through apprenticeships and nursing associates.
But fundamental to delivering the People Plan, and tackling the nursing shortage in the NHS, is changing the perception of nursing as a career.
That way we can get the right number of people and the right type of people in the NHS: talented, ambitious, hard-working, committed to caring.
Third and finally I want to talk about someone who really helped me understand the retention challenge – what it means to you, on the frontline.
He’s a senior consultant at a London hospital. And he said:
Matt, when you join the NHS, everybody knows the deal: you work hard, you do everything you can for your patients and your colleagues, you put everything into the job because at the end of it you know you’re going to get a good pension, but that’s under threat. I can’t plan ahead. I’m afraid to take on extra sessions in case I get an unexpected tax bill, and if I was a few years older I’d be thinking about taking early retirement.
And then he used a graphic but typically medical metaphor to describe the effect it’s having on the NHS. He said:
Right now it’s like a haemorrhage. If we can stop the bleeding in the first 5 or 10 minutes, we can save the patient, but if we don’t, and we leave it, then we’ll be resuscitating the body.
So I understand your frustration. Getting pensions right is how we stem the flow and convince our senior staff to stay in the NHS.
So I’ve listened to you, and I’ve learnt from you, and this is what we’re going to do:
A new pensions deal for senior nurses, doctors and GPs so you have greater flexibility and control over your pension so you don’t get hit with an unexpected tax bill.
A new pensions deal that lets you take extra shifts, go for a promotion, and ultimately rewards you for your hard work and dedication, and encourages you to stay.
We’re going to work with you to change the NHS Pension Scheme so it’s fair to you, fair to the taxpayer, and leads to better care for patients because that must be our goal.
These proposed reforms recognise the unique role and importance of NHS staff. We want to ensure the NHS Pension Scheme continues to be one of the best around so we can continue to attract the best people.
But these reforms must work for you, so we will launch a staff consultation across the NHS next month.
We will have these changes in place by the start of the next tax year. This will allow NHS staff and employers to start planning for the future with confidence and peace of mind.
And it will ensure the NHS is a place where everyone is looked after, and everyone is treated fairly.
Making the NHS a better place to work: that’s where we need to get to. This plan is the first step.
But this journey requires us all to work together: every part of our health service heading in the same direction.
I’ve made it my mission to get the right technology in the NHS so we can make your lives easier, and give you back the gift of time. So you can do what you came into the job to do: caring for people.
The NHS of the future will have more tech, more robots, more AI, but it will always have people at its core.
As the march of the machines removes the jobs that can be replaced by code, so more and more as a society, we’ll need more people doing the jobs no machine can ever do: the caring, the empathy, the connection.
So, we will make the NHS a more caring employer.
We will transform the culture.
The NHS of the future will always put people first.
Because a strong NHS, and strong public services, is how we build a Britain that always put people first.
That is a place we all want to get to.
That’s the country we all want to live in.
So let’s work together to ensure the NHS is a place where everyone feels valued, where everyone feels cared for, and where everyone can fulfil their potential.
Below is the text of the statement made by Matt Hancock, the Secretary of State for Health, in the House of Commons on 13 May 2019.
I would like to update the House on the progress we have made in tackling brain cancer, including on a new innovation that is now available across England.
For far too long, tackling brain cancer has been put in the “too difficult” box, and we are determined to change that. I want to pay tribute to the Petitions Committee, which did so much work on this; my hon. Friend the Member for Mid Norfolk (George Freeman), who picked up the subject in Government as Life Sciences Minister; my hon. Friend the Member for Castle Point (Rebecca Harris), the former chair of the all-party parliamentary group on brain tumours, which brought parliamentarians together; my hon. Friend the Member for St Ives (Derek Thomas), the current chair of the APPG; and, of course, Baroness Tessa Jowell, who campaigned passionately and tirelessly while battling the illness herself, and who, sadly, passed away a year ago.
Brain cancer is the most common cause of cancer-related deaths in children and young people under 19. Baroness Jowell called for all patients to benefit from 5-aminolevulinic acid, or “pink drink” as it is otherwise known: a dye that makes cancerous cells glow under ultraviolet light, thereby making it easier for surgeons to target the right areas. Trials have shown that, when the dye is used, surgeons can successfully remove a whole tumour in 70% of cases, compared to 30% of those without.
I am pleased to inform the House that we have now rolled out this ground-breaking treatment aid across England, with the potential to save the lives of 2,000 patients every year. That is part of the £33.9 billion extra that we are putting into the NHS and the NHS long-term plan. This procedure will now be expanded to every neurological centre in England. That is a fitting testament to Tessa Jowell’s memory.
It is worth pausing for a moment to remember the courageous words that Tessa Jowell used to urge us to rise above our differences. She said that this
“is not about politics but about patients and the community of carers who love and support them. It is…about the NHS but it is not just about money. It is about the power of kindness”.—[Official Report, House of Lords, 25 January 2018; Vol. 788, c. 1169.]
That represents the very best of our democracy and of our Parliament. On behalf of all those who have died of brain cancer, all those—children and adults alike—who have campaigned, and all those seeking to do research, of which there is more to come in future, we are acting.
I want to mention three further areas in detail. The first is research. In the past, not enough research was done into the causes of and treatments for brain cancer. In the last year, the Government have made an unprecedented £40 million available to fund cutting-edge research of new treatments and drugs through the National Institute for Health Research. That will build on our outstanding reputation for neuroscience and oncology research, and increase the quality, quantity and diversity of brain cancer research. That funding was further enhanced by Cancer Research UK committing an additional £25 million to support brain tumour research. The size of those pledges will cement the UK’s position as a leading global centre.
Secondly, on our NHS cancer workforce, the number of specialist cancer staff in the NHS is set to grow as we put the £33.9 billion into the NHS over the next five years. Health Education England’s cancer workforce plan, and our upcoming NHS people plan, will set out in detail the steps we are taking to recruit a world-class cancer workforce. We made available an additional £8.6 million in the cancer workforce last year, and we aim to have 300 more radiographers start training by 2021.
Finally, on empowering patients, we have worked closely with the Tessa Jowell Brain Cancer Mission, Jess Mills and others to ensure patients are at the heart of all these efforts. The mission brings together Government, the NHS, researchers, pharmaceutical companies and patients to ensure that data is shared and disseminated properly so that more patients in the UK and around the world can benefit from what is learnt. Due to the complexity of brain cancer, we must provide joined-up care that meets each patient’s unique needs. The NHS is focused on improving care for brain cancer patients to ensure they have access to dedicated out-patient clinics and consultations, wherever they live.
I hope the whole House will recognise the important progress made over the past year in rising to the challenge set by Baroness Jowell and the families of those who have lost loved ones to brain cancer. That progress has been possible only through the collective effort of patients, the NHS, charities and industry. That work is and will continue to be collaborative.
In her final speech in the other place last January, Tessa Jowell said:
“I am not afraid. I am fearful that this new and important approach may be put into the ‘too difficult’ box, but I also have such great hope.”—[Official Report, House of Lords, 25 January 2018; Vol. 788, c. 1170.]
That hope was an inspiration to us all. We will rise to the challenge that she left us. We must not waiver in that task. I commend this statement to the House.
Below is the text of the speech made by Matt Hancock, the Secretary of State for Health, at the Royal Society of Medicine on 4 April 2019.
It’s fantastic to be here to talk about apps and innovation because, as you know, this is a subject close to my heart.
I’m pleased to say that together with Netflix, Spotify and Citymapper, the Matt Hancock app now has a combined user base of over 300 million people. And it remains the most popular app by a Member of Parliament on the App Store… as well as the only one. It’s not easy being a tech pioneer.
Sir Tim Berners-Lee, inventor of the World Wide Web, said that 30 years on from his world-changing creation, he still believes it can be improved because: “The future is still so much bigger than the past.”
I share Sir Tim’s optimism about the potential of technology because I believe in the potential of people.
Since I’ve been Health Secretary, I’ve made it my mission to get the best technology available into the NHS for one simple reason: the right tech saves lives, and makes life easier for staff.
And I’ve tried to eliminate outdated, old tech like fax machines, pagers, and dial-up because the wrong tech can make life more difficult for our NHS staff.
Tech is merely a tool though, it’s people, who are, and will always be, our priority.
Because it isn’t just frustrating to be asked for the umpteenth time: “Why are you here?” because medical records don’t follow people around the system. It isn’t just inconvenient for a doctor to be stuck trying to remember multiple logins so they can type up their notes, when they should be with a patient. It’s dangerous.
And I was reminded of that this week by a lady called Dawn Wilson.
Her daughter Tamara was diagnosed with asthma as a baby. Tamara was in and out of hospital with acute asthma as she grew up. She was seen 47 times in 4 years by medical staff.
Almost every time, Dawn would have to tell the doctors and nurses Tamara’s medical history from the beginning because Dawn said: “Every time they were treating her like a new patient”. They didn’t know Tamara’s condition, what medication she was on, what her treatment plan was. Staff at 3 hospitals, 30 minutes apart, with no way of accessing the same records.
Dawn told me she felt staff thought she was being an “overprotective mother”, but she was the only link they had with the previous clinician.
On 10 April 2014 Tamara started experiencing breathing difficulties. An appointment was made to see her GP the following day but her condition deteriorated during the night. Paramedics were called, but sadly Tamara died. She was just 13 years old.
Interoperability: a word we often use when we talk about healthtech. For most people that word means very little.
The coroner said one of the factors in Tamara’s death was the lack of a “coordinating record”. Dawn told me that she believes it would have made a difference. That if our systems could speak to each other, and if Tamara’s records could have been safely accessed by all the clinicians treating her, it would have made a difference.
So when I talk about interoperability, I’m not really talking about IT. I’m talking about saving the lives of people like Tamara. I mean “clinical memory”, a clear and comprehensive record of each individual’s health history and medical needs that can be shared, in absolute confidence, between medical teams across the NHS.
It’s why getting the right tech, getting systems that can talk to each other in the NHS, matters so much. Because the only question when it comes to tech is this: does this tech save lives and improve lives?
We must drive innovation and improvement across the NHS. Combining the best of the healthcare culture with the best of the tech culture. Seeking continuous improvement to save and improve lives.
Better tech to give doctors and nurses the gift of time so they can focus on what really matters: caring for patients. Better tech to give faster and more accurate diagnosis and treatment so we can nurse people back to health sooner.
Ensuring promising prototypes don’t get stuck in endless pilots. Ensuring successful ideas spread from one hospital to another, from one trust to the entire NHS. Building systems that can talk to each other and new developers can build on. And making sure we get the basics right like data infrastructure and patient records.
So this is how we’re going to do it: NHSX.
A new specialist unit that brings together all of our tech leadership from the Department of Health and Social Care, NHS England and NHSI into one place. Setting national policy for NHS tech, digital and data. Setting standards that work across the whole of health and care.
It will be led by the government’s digital policy chief, Matthew Gould, who has a unique breadth of experience and a deep understanding of how to make digital transformation happen.
Like so many people in the NHS, we’re lucky to have him, and I want more brilliant people like Matthew to come and be a part of NHSX and its exciting, bold mission.
NHSX will have 3 early priorities:
First: ensuring tech saves time for staff so they can focus on patients.
Second: giving patients the tools to access information and services directly.
And third: creating a system that means patient information can be accessed, safely and reliably, wherever it is needed.
I want us to create a culture at NHSX that’s aspirational, hopeful, optimistic, and realistic. Full of people who respect one another and every single member of the NHS family. Fair, open, honest.
With the door always open to new ideas and new people, creating a diversity of thought, constantly welcoming innovators with an outward-looking approach: a microcosm of what excellence looks like. Radically simplifying the system for developers and NHS decision-makers.
Consistent language for all computers so patient records can be shared easily, time spent transcribing notes is cut, and human error is reduced.
Unique barcodes for every piece of clinical equipment so essential kit can be tracked in real-time, cutting waste and saving hospitals up to £3 million a year.
To test a new way of working, tech experts from NHSX will be embedded in national cancer, mental health and urgent care teams to bring the benefits of modern technology to every patient, clinician, and carer.
We will empower the best digital minds in the NHS, and create an ecosystem where healthtech entrepreneurs are actually excited about working with this innovative, creative, forward-thinking organisation called the NHS.
And the needs of our users will be at the heart of everything we do because the ‘X’ in NHSX stands for user experience.
It’s why all of our standards will be designed and developed together. That means involving everybody that uses the NHS: patients, clinicians, our tech workforce, healthtech suppliers and wider civil society.
All of our standards will be published on the web, so that anyone who wants to write code for the NHS can see what our needs are before they begin. Our regulatory approach will be designed for speed so apps can be improved quickly or removed quickly.
There’s now more than 70 apps on the NHS Apps Library helping people with a range of conditions from diabetes to breast cancer, to mental health and pregnancy.
There’s over a 100 new apps currently being assessed, including apps to help people with autism, to giving patients live information on A&E waiting times.
And we’re continually learning and improving as we roll out the NHS App across England. Working with patients and frontline staff as we connect up the app with GP practices across the country.
More than a million GP appointments a month are now booked through apps. More than 3 million repeat prescriptions are booked online now.
And that’s only with a quarter of the population currently using online medical services. So the potential is huge.
Just take diabetes: there’s 13 different apps available on the Apps Library, offering support on everything from blood glucose levels to diet, weight loss, and self-management for people with type 1 and type 2 diabetes. Living with diabetes can be incredibly tough, but the right technology can make a huge difference.
This week we announced an expansion of wearable monitors for tens of thousands of people with type 1 diabetes, helping them to monitor their own condition, and save them unnecessary and stressful trips to hospital or their GP.
So working with developers, to give people more choice over the apps and digital tools they can use, is crucial. Because ultimately this is all about people.
We care about tech because we care about people. That’s the mindset we all need to have in the NHS.
Well, imagine a future where the NHS App invites you to a cancer screening. You’ve been identified at risk because of medical information and lifestyle data you’ve chosen to share.
You arrive at hospital and an algorithm takes seconds to compare your scan against millions of images. You get the results there and then. No waiting days for the post or checking your inbox nervously. You know exactly what the next steps is: working with medical experts to develop a personalised care plan. And this could happen years before you may have gone to the GP with your first symptoms.
That’s the future I want to see in the NHS. And to get there we need something bigger than just a technological change: we need a culture change.
For too many staff, outdated NHS tech is a hindrance rather than a help. It takes up time rather than saves time. And I understand the frustration. I know the systems of the past haven’t been good enough.
If you’re a nurse, at the end of a long and taxing shift, and the thing that’s preventing you from getting home to your family is a computer that keeps on saying ‘no’, an IT system that won’t play ball, then of course, you’re going to feel like the tech is a hindrance rather than a help.
But the right tech, working in the right way, can and does release time. Because good tech is seamless. It’s something staff shouldn’t even have to think about. The only thing staff should be thinking about is their patients.
So it’s vital we get this right and I’m confident that with NHSX bringing together, driving forward, this tech transformation, we’ll start to create the culture change we need to see in the NHS: innovative, open to change, forward looking. Tech-focused only because we’re people-focused.
Believing in the power of technology because we believe in the power of people.
Below is the text of the speech made by Matt Hancock, the Secretary of State for Health and Social Care, at the Royal Society on 20 March 2019.
I’m here at the Royal Society, perhaps the greatest institution of Enlightenment values in the world.
The Royal Society has supported progressive human endeavour for 350 years, from Wren, through Newton to Einstein and Hawking.
Today, we address a new scientific breakthrough: genomics.
And celebrate the world-leading achievement of the 100,000 Genomes Project.
100,000 whole genomes that have been sequenced to help diagnose and treat rare diseases.
So many families closer to a cure or a treatment.
And I know some of those families are here this morning. Renewed hope. Not feeling alone, but part of a community.
With the knowledge their genetic data has helped others.
That impulse to help others: someone we’ve never met before, someone we’re probably never likely to meet, caring about the fate of a stranger.
That inspires me.
I talk a lot, as Health Secretary, about the need to harness technology to improve and save lives.
This past week, that’s been brought directly home to me.
Last week I took part in a different genomic exercise – a predictive polygenic risk test.
I wanted to find out whether I was at high risk of any diseases, and how it would make me feel.
I was really looking forward to it. The process was simple and easy: spit in a tube, send it off. I waited a couple of weeks while my sample was analysed by a team at Oxford University.
On Friday, I got the results. And I have to admit, I started to feel pretty nervous.
It struck me that I was about to find out how likely I am to get 16 serious diseases.
I’d already chosen only to get tested for diseases I could do something about.
Even so, it’s a big moment.
First, they told me the good news. For most of the diseases, my risk was below average.
I’m particularly lucky with heart disease.
I’m in the 3% of the population with the lowest genetic risk. Maybe that’s why Grannie lived to 103.
Then the bad news. The test also showed that, despite no family history, I’m in the worst 20% for prostate cancer.
I have around a 50% higher risk than average.
I was obviously worried when I was first told this.
But while it’s not good news, it’s good news to have.
Death from prostate cancer is more treatable if diagnosed early.
But prostate cancer can be a silent killer, and tragically, so many men don’t find out until it’s too late.
But it doesn’t have to be.
It may sound weird but I’m now absolutely delighted.
Thank God for genomics!
I’ve already booked a blood test, and obviously I’ll be on alert as I get older.
I’m going to make certain I don’t miss any screening appointments in the future.
I also found out an important lesson: it really matters how the results are presented.
You need an expert to help you make sense of the data, and you need a clinician to tell you what it means medically.
And the reason it’s so important is that predictive genomics is not about absolutes. It’s about risk factors. And your genes are only one part, and usually not even the biggest part, of the risk.
Even more important, we’ve got to be crystal clear about the different role, different science and different ethics between predictive, polygenic tests like this and diagnostic whole genome sequencing.
I believe both have a huge role to play in the future of healthcare, but they are very different.
Predictive testing has big implications for screening: genomics can make cancer screening more targeted and more effective.
By using predictive testing we can help people at higher risk earlier.
I see it as a game-changer for cancer screening in the NHS, and I’m determined that we harness this technology to save lives.
So for me, it’s personal that we’re writing the first National Genomics Healthcare Strategy, which my brilliant Lords Minister, Baroness Blackwood, is developing.
I’m delighted Nicola has consented to my sharing her story.
Because Nicola’s life has been changed by genomics too, in a different way to mine.
Nicola has the rare disease Ehlers Danlos. But she wasn’t diagnosed for 30 years, going through test after invasive test from childhood into adulthood, being referred to doctors who each tried to do their best, but without much success.
Until finally, she was referred to a neurologist, with experience of EDS, who recognised the symptoms and was able to diagnose her.
Today, with whole genome sequencing Nicola could have been diagnosed within a couple of weeks.
Her story shows the power of the other type of genomics.
For rare diseases, whole genome sequencing is life-changing because it is a diagnostic test of absolute certainty, and early diagnosis can have a massive, immediate impact on improving someone’s chances.
So many people have felt there’s no way forward if they have a rare disease. That’s why whole genome sequencing has been so revolutionary – and it holds the key to unlock new cures and treatments.
Whole genome sequencing raises other, new ethical questions.
Imagine you discover you have a single gene disease that can be inherited.
Imagine the impact not just on that person but their children.
The positive potential on people’s lives is massive.
But the sensitivity of that information is so acute.
To make all this happen, there are 3 areas I want to address today, each vital to success.
First, rolling out the science.
I’m very proud we lead the world in genome technology.
This year we’ve started our Genomic Medicine Service within the NHS, and we have a new ambition of sequencing one million whole genomes, and 5 million partial genome tests like the one I’ve had done.
Our science budgets are growing, and rightly so.
And we’ve got to get the data rules right.
After all, genomic sequencing is really just revolutionary amounts of data.
It’s why I’m so frustrated at data blockage.
We can’t currently test for all cancers, because too often, the data is locked away.
Sometimes there are good ethical or scientific reasons, and strong privacy rules are vital.
But it’s outrageous that too often, anonymised data, paid for by taxpayers, donated by the public, can’t be used for research.
We will unlock that data because we know it saves lives.
Second, getting the ethics right.
Understanding the human genome raises profound new ethical questions, and we need to get the ethical rules right, both for diagnostic and predictive genomics, and even more so when it comes to the emerging science of editing the human genome.
Understanding our genetic code also raises issues around privacy and consent.
We’ve already made some progress here, when in October we updated the Code on Genetic Testing and Insurance to ensure people don’t wrongly have to disclose their genomic data when they take out life insurance.
For diagnostic genomics, the area most in need of ethical rules is how, and with whom, information is shared.
When it comes to editing the human genome, that raises major new ethical questions.
I don’t believe in a blanket ban on genome editing research.
Not when it offers the hope of tackling terrible genetic diseases.
But I fully understand, and recognise the real and genuine concerns and fears, that people have, and we must put in place an ethical framework to govern it.
These are just some of the vital ethical questions that we need to address together as a society.
After all, the reason we care about the science is so we can improve and save lives.
Science is founded on the noble Enlightenment principle of progress driven by rational inquiry and objective reality.
But we need to take people with us.
Proving something scientifically true is not the same as proving to people that it’s a good thing.
We must listen to concerns.
Understand rational, and sometimes irrational, fears.
We need a clear framework so that we, as a society, can make active choices over how the science is used.
I think our ability to do that in this country is one of our hidden strengths.
We often talk about how we are world-leading because of our universities, our open, outward-looking culture, our environment for enterprise.
But we are also world-leading in developing the ethical framework within which science can be applied with confidence.
And we build the institutions that make it real.
We reject the laissez-faire approach of some, and the authoritarian instincts of others.
Instead, we apply liberal values: open, enquiring yet sceptical, and with a firm focus on the benefit of mankind.
For Britain, ethics is a competitive advantage.
That is how Britain has forged our leadership role in so many areas of innovative science over the years, and we must do so once again.
The third thing we need to get right is operational.
I’m delighted we are taking up genomics in the NHS. The new Genomic Medicine Service is a world first.
And I’m very excited that the new £100 million children’s hospital we’re building in Cambridge will mean we can do even more to identify and treat children with rare diseases through whole genome sequencing.
But there’s more to do.
How do we train up doctors and nurses so they understand genetic data, including these new predictive tests, and are able to explain it in a way that helps people make the best decisions?
And we can’t just ignore it.
After all, thousands of people are already taking predictive tests, and many are now turning up at their GP surgery with their results in hand.
We need to harness the power of this new technology to diagnose and prevent illness, and that means using it right.
Some people say we shouldn’t encourage the ‘worried well’.
I feel that’s the wrong response.
We need to understand that people will have genuine concerns and we must give them the help and support they need to make sense of their genetic data.
Of course, that also means supporting our GPs and frontline clinical staff. We must get the right numbers in place – we now have record numbers of GPs in training, and we’re putting in the biggest rise in primary and community care in a generation.
If we encourage people to take better care of themselves, that means patients and clinicians, together, can prevent problems from arising.
This will save the NHS time and money in the long term.
It’s as Sir Nilesh Samani said:
Genomic medicine is set to revolutionise the prevention, diagnosis and treatment of many of the UK’s most devastating diseases…
Identifying someone’s genetic risk could lead to more personalised treatments that might stop a disease ever developing.
And I feel that very strongly, because I’ve now personally seen the potential benefits.
And this isn’t just about physical health, but mental health. For some people there will be a big psychological impact from finding out news they weren’t prepared for.
We already provide support and counselling to people, but we must ensure that provision keeps pace with the expansion of predictive testing.
Get all this right and I’m certain we can build consent and trust, and put genomic science on the strongest possible footing.
One of your esteemed Royal Society fellows, Bertrand Russell, once said:
To conquer fear is the beginning of wisdom.
Fear is the enemy of progress.
The Enlightenment – science and reason, allied with a mission to help people – led to the biggest ever leap forward for humanity.
We need to renew that spirit of progress.
And I believe we can defeat fear by building trust.
Listening, learning, improving.
Always wanting to make things better.
Progress that puts people first.
Caring about technology, because we care about people.
Below is the text of the speech made by Matt Hancock, the Secretary of State for Health and Social Care, on 20 February 2019.
I want to talk today about Lauren Phillips.
Lauren wasn’t always going to be doctor.
She was a talented violinist. She had been invited to join the Bristol Symphony Orchestra. She had huge talents and amazing opportunities. She had choices.
She also had a powerful vocation. She came from an NHS family. Her father is a doctor. Her uncle and aunt are doctors. Her mother works for the NHS.
Lauren’s father, Jonathan, said: “She chose medicine over music because she had a strong sense of social justice and felt she could help people and give something back to society.”
So that vocation, plus her remarkable talents, led her to becoming a doctor at Southmead Hospital in Bristol, a hospital that I know well.
But the job took its toll. The hours. The work-life balance. The pressures.
It wore her down. Gradually, Lauren became more withdrawn, and then one day she didn’t turn up for work.
Her car was found a 100 miles away on a beach in Devon. Her body has never been found.
Lauren’s father said:
During the short time she worked for it the NHS succeeded in sapping Lauren’s strength. Undermining her self-confidence. Attacking her professionalism. And devaluing her commitment.
It was not there to give her the help and support she needed to stay alive.
He’s right. And I want to apologise. As Secretary of State, and on behalf of the entire leadership of the NHS, I’m sorry.
I want to say sorry to Lauren’s parents, and the families of every other member of the NHS family, who we didn’t do enough to help when they needed us most.
We can never know all the reasons why someone decides to take their own life. But, hand on heart, it’s impossible to say we did enough to care for Lauren.
Across the NHS, we don’t do enough to care for our carers. And for that I am sorry.
Now, I don’t want anyone to point fingers and blame people.
That’s not what Lauren’s father wants either. He knows first-hand the unique difficulties of being on the NHS frontline. But he also believes, as I believe, that “you can’t look after your patients, unless you look after your own wellbeing”.
Instead, there is something else I want us to take from this tragedy. I want us to take resolve to make the changes needed so we can care for our carers, not just in pockets, but throughout the NHS.
So I welcome today’s report from Health Education England. And I look forward to working with the NHS to put the recommendations into practice.
There’s no silver bullet. But just because there’s no one solution, let’s not fall into thinking there’s no solution.
There are 3 things in particular from the report I want to draw out.
First, something that Lauren’s father said has really stuck in my head.
Jonathan believes just being able to play the violin with an orchestra would have made an enormous difference to her mental and emotional wellbeing. But Lauren couldn’t commit to a few hours a week for rehearsals because she never knew what hours she was going to be working.
I felt that was shocking, and desperately sad. Rota practices like these are antediluvian.
I have doctors in my family who sometimes can’t make an incredibly important event, not because they’re unexpectedly stuck caring for a patient whose life is on the line – that happens and is an important part of the job – but because the ‘rota says no’.
Now, we’ve changed the rules at a national level to allow for modern, smart rotas. Well-led trusts have embraced those changes, but they haven’t been rolled out everywhere. And that has got to change.
Second, the report makes it clear that we need to place as much importance on the care of the carers as the patients.
I firmly believe this is the right thing to do.
Adam Kay recently said that working in the NHS: “You’re forced to build an emotional forcefield because no one is caring for the carers.”
He’s right. I pay tribute to the work Adam has done to highlight some of these problems, using humour to make people listen. I was actually reading Adam’s book when I became Health Secretary, and it’s shaped how I think of things.
But I didn’t reach the last chapter until after I was in this job. And the anguish and the pain in that last chapter hit me like a kick in the stomach.
So thank you Adam. Keep fighting the good fight. Because no one should have to build an emotional forcefield around themselves. And no one can do their job properly if they do.
And the third thing I want to draw out is that, to recruit and retain more staff, we need to change the culture of the NHS.
Why is it that when 1.3 million people have devoted their lives to caring for others, the collective system is uncaring to some? We need to change a culture of carrying on regardless, not asking for help, not looking for signs of burn-out among our colleagues, thinking everything’s OK as long as someone turns up for work and does their job.
That isn’t good enough.
No one, no government, no party owns the NHS. We’re merely custodians, looking after it, to pass it on, fit for the future, to the next generation.
I feel that duty every morning when I awake. Because I care. I care deeply about the NHS.
It’s been there for me, and my children. It was there for my grandparents.
Staff at Southmead Hospital, where Lauren worked, saved the life of my sister.
The tragedy of what happened to Lauren has a personal poignancy for me, because Lauren could have been one of the A&E doctors when my sister was brought in with a serious head injury. And my whole family owe a huge debt of gratitude to Lauren’s colleagues.
It horrifies me that those brave doctors and nurses, who face trauma every day, could be going through what Lauren went through.
So, throughout the NHS we must act, and I promise you, I will do all I can to protect and pass on this great British institution to future generations in a better condition than I found it.
And the only way we can do that is by caring better for our carers.
By looking after the people who look after us.
By making sure that when somebody needs help, there’s someone they can turn to, someone they can talk to.
By valuing our NHS staff.
By building a just, caring culture.
Apologising when we get it wrong, and learning from our mistakes.
Because the NHS isn’t run by people, the NHS is people.
And I will do everything in my power to give you the support you deserve.
Below is the text of the speech made by Matt Hancock, the Secretary of State for Health and Social Care, on 11 February 2019.
This place has always looked to the future. Charles Darwin, Edward Jenner, Alexander Fleming: all fellows of this great institution, all coming together to “share knowledge” to “benefit society”.
I’d like to thank another great fellow – Dr Eric Topol – for the amazing work he, and his team, have done to benefit the NHS.
They’ve looked to the future. They’ve looked at genomics, digital medicines, AI and robotics. They’ve looked at the potential of new technology to save lives and improve the nation’s health and wellbeing.
And they’ve looked at how tech can help staff, make their lives easier, and what we need to do to help our NHS workforce prepare for a digital future.
The Topol Review is a forensically thorough analysis of what we need to do and how we should do it. But I’d like to take a moment to focus on the why.
Why do I care about getting the right tech in the NHS? Why should we all care about getting the right tech in the NHS?
It’s not about having the latest gizmos. It’s because the right technology saves lives. Every major technological leap, from penicillin, to vaccination, to MRI, has meant more lives saved.
I’m confident that our children and grandchildren will look back at genomics, AI and robotics in the same way. They’ll be the ones asking us why, if we fail to seize this opportunity.
As Dr Topol says, we’re 10 years behind in some fields. If we just made better use of today’s tech, we could save more people.
So I care about tech because I care about people. I care about our NHS staff and our NHS patients. And I care about getting this right. Because I know the consequences when we don’t.
There’s something that Dr Umesh Prabhu said that has stayed with me. It’s the reason why he devoted his career to becoming an NHS medical director and an expert in patient safety.
When he was a consultant, he made a mistake. There were 2 babies with the same name on his ward. His junior doctor picked up the wrong case notes and when Dr Prabhu was brought the wrong x-ray, he discharged the wrong baby.
Two days later that baby boy was admitted to another hospital with severe brain damage. The baby’s step-father had stamped on his skull. X-rays showed the baby had multiple rib fractures, some of which were old.
As you can imagine, Dr Prabhu was devastated. Here was a man who cared deeply about his patients, who had made helping people his life’s mission.
That tragedy had a profound effect on him. He vowed to change the system, to put in place safety protocols and ways of working that would mean a simple mix-up couldn’t lead to such devastating consequences again.
Thankfully, thanks to his efforts, much has changed in the NHS since that happened. But it hasn’t changed enough.
Dr Prabhu says human beings make 5 to 7 mistakes every day. Everybody makes mistakes. Doctors and nurses will make mistakes, despite their best efforts and intentions.
That’s why, for me, getting the right tech ‒ tech that works, tech that helps our medical staff, that makes their lives easier, that reduces the chance of human error leading to human tragedy ‒ is so important.
I care passionately about giving our medical staff the right tools to do their jobs. I understand their frustration at systems that make their jobs more difficult. I get how a tough day becomes even tougher because something won’t work like it’s supposed to.
Digital tech has the potential to transform our health service in the future, but the right tech, right now, will improve lives, and save lives. So the work must begin now.
We’re going to have a chief information officer or a chief clinical information officer on the board of every local NHS organisation within the next 3 years.
Getting the right leadership, people who understand tech, who have tech skills themselves, involved in management decisions is vital to getting the right mindset in place. It’s the first step to training up staff, building up digital capability in hospitals and GP surgeries.
So I’m delighted to launch the Topol programme for digital healthcare fellowships. This programme will give clinicians the skills to make a practical difference to their local NHS organisations and start them on a career path to become CCIOs and CIOs. That way, those leaders can help train and prepare our workforce for a digital future.
And here I’d like to quote from the report: “There is a need to raise awareness of genomics and digital literacy among the health and social care workforce. This requires development of the skills, attitudes and behaviours that individuals require to become digitally competent and confident.”
So, the Prime Minister and I have asked Baroness Dido Harding to take forward a ‘workplace implementation plan’. She will build on the recommendations in the Topol Review:
all healthcare professionals should receive core training in genomic literacy to help them understand the basis, benefits and ethical considerations involved
we need to create a career pathway from undergraduate to specialist, a digitally enabled health system with a culture of continuous learning, and we need to support the educators, and the development of the whole workforce
Of course, we want the NHS to be world leaders in digital healthcare, so we need to attract the brightest and the best into our health service, we need to increase the number of clinicians, scientists, technologists and specialists.
But if we want to see transformative change in the NHS, then we need to embed digital skills into every level, and every part of it.
We must invest in training up the existing workforce. Staff must have the opportunity to learn about digital technologies and develop the necessary skills. They must have ongoing training.
The government is putting a record £20.5 billion a year into the NHS – the longest and largest cash settlement in its history.
It’s a once-in-a-generation opportunity. To seize that opportunity and build a better, more sustainable health service for the future, we must ensure our NHS workforce have the right tech and the right tech skills.
Because, thirdly, and finally, I’d like to bring it back to why – why we’re here today.
That’s not a metaphysical question ‒ I’m afraid I can’t answer that one for you ‒ but why I’m here today is because I want us to harness the power of digital technology, to shape it as a force for good, because I want to help the NHS cut costs and save lives.
When we talk about the importance of data management and inter-operability, most of the public won’t know what we mean.
This is what I mean: right now, Tesco has more sophisticated and more efficient systems than the NHS. They know who you are through loyalty cards, where you shop through store IDs, and what you buy through the items scanned at the checkout.
That wealth of information means they can run their operations with just-in-time deliveries and market their goods to shoppers with personalised discount vouchers.
In the NHS, we don’t have anything like that. We don’t use common identifiers to identify patients, we don’t know which hospitals a patient has been to, we don’t know which medicines have been put into them. We don’t even know what we already know!
Of course, there are security and privacy concerns over sensitive medical data and that data has to be managed carefully and with consent. But the NHS is missing out on valuable information. Information that could make NHS services more efficient and safer.
A world in which a hospital can’t pull up a patient’s GP record to see the reason for stopping and starting medications is downright dangerous. True inter-operability means having the right systems and the right standards.
We have learned the lessons of the past. We don’t need the same system across the NHS, but we need the same standards so machines can talk to each other and data can be exchanged.
Six acute NHS trusts have taken up ‘Scan for Safety’, a standard methodology using standardised naming conventions and proven technology to identify and monitor patients, and track products and places.
I want to see this taken up by the entire acute sector. As the review says, we can have the most advanced tech, but we won’t see the benefits unless we have real inter-operability. So staff have to make scanning a routine part of their working day.
It takes seconds, but saves hours. If adopted across the NHS, the time saved would equate to almost 400 extra nurses.
As Dr Topol says in the report: “Wherever possible, the adoption of new technologies should enable staff to gain more time to care, promoting deeper interaction with patients”.
Because, ultimately, this is about people. It’s about doctors like Dr Prabhu. It’s about babies like that little boy.
For tech to succeed, for tech to fulfil its potential and deliver on its promise, then human beings are absolutely critical to making it happen. We need a culture change as much as we need a technological change.
So, let’s work together towards a digital future that works for people, that puts people first, that helps the NHS do the job it is there to do, ensures the NHS is always there, for all of us, for generations to come.
Below is the text of the speech made by Matt Hancock, the Secretary of State for Health, at the Royal Society of Medicine, on 6 February 2019.
“Trust me, I’m a doctor.” A phrase so reassuring that it’s a punchline.
We trust doctors and nurses more than any other profession. It’s a bond of trust that is both implicit and unspoken. You see us at our weakest, our most vulnerable. You hold our lives, and the lives of our loved ones, in your hands.
I was reminded of this unspoken bond of trust last week on a visit to The Princess Alexandra Hospital in Harlow. I met a mother with her newborn. Everything had gone well with the delivery and she was looking forward to taking her healthy baby home.
The visible joy, and relief, in her face is something every parent has felt. I’ve felt it myself with all three of my children.
We trust nurses and doctors, we trust the NHS, with something more precious to us than life itself. You have saved the lives of people I love.
We trust you because we know that you’ll do everything you can to help us. That you won’t give up on us. That the safety and life of my child is as important to you as it is to me.
But we can’t take that trust for granted. It has to be earned, and it must be protected. I think that’s why, when that trust is forsaken, the shock is so profound. When I learned what happened at Gosport, I was shocked.
Families had entrusted their loved ones into the care of doctors and nurses. Elderly relatives, at their most vulnerable and frail, were failed by a system that took that trust for granted. Think about your grandmother, your grandfather: how would you feel if the people you trusted most had let you down?
I get it. I understand. As Health Secretary, I’m sorry to those families in Gosport, Liverpool Community Hospital, Mid Staffs and everyone else who has been let down. But I’m not here today to point fingers and blame people.
Instead, we must learn the right lessons about creating a caring, compassionate culture, about protecting and renewing the bond of trust between the public and the NHS – our nation’s most loved and respected institution.
Because the other thing I was reminded of last week is that leaders create the culture. Because after I spoke to that new mother I spoke with the Chief Exec, Lance McCarthy, and I asked him what they do when things go wrong. What’s his approach to mistakes?
And he gave me a brilliant answer. He said: “If we’ve made a mistake, then we’ve made a mistake. We should be open and honest, and apologise. And not be afraid to apologise because of any potential legal action.”
As Secretary of State, that’s exactly what I want to hear. Because we all make mistakes. We should strive to avoid them, of course, but the fact of a mistake isn’t the biggest problem. It’s how we respond to them and how we learn from them, that’s what’s most important. And we must never let our fear of the consequences, stop us from doing the right thing.
So what Lance has done at his Trust is introduce a ‘behaviour charter’. Patients, their families and medical colleagues know what they can expect: openness, honesty, trustworthiness.
That way when mistakes do happen there’s an honest conversation: this is what went wrong, we’re sorry, this is what we’re doing to fix it.
It’s not an admission of liability. It’s an acknowledgement that we can do better. It’s often the first step towards acceptance for the patient and their family. And it’s a vital part of the process of continuous improvement we need to see everywhere in the NHS. Taking responsibility, learning the lessons that need to be learned, continuous improvement.
And what Lance has found is that clinical negligence claims haven’t gone up at his trust since they introduced this new charter. In fact, Lance believes, when people feel like they’ve been treated with honesty and candour, they’re less likely to resort to legal action.
The simple act of saying sorry maintains the bond of trust with the public even when things don’t go as planned. But this isn’t just a moral issue for the NHS ‒ as important as that is ‒ it’s a financial issue as well.
Compensation pay-outs have quadrupled from half a billion to £2 billion pounds a year over the past decade. That is unacceptable and it’s clearly unsustainable.
If we don’t do something about the growing number, and value, of clinical negligence claims, it threatens to swallow up the record £20.5 billion a year we’re putting into the NHS, and derail our Long Term Plan to transform the health service.
And that infuriates me, because it’s an injustice for taxpayers and our hardworking NHS staff. This is a once in a generation opportunity to put our health service on a forward footing so we can look to the future with confidence.
We can’t afford to let it go to waste. There is a moral and financial urgency to act. We must improve patient safety, so there’s:
less paperwork for medical staff and more time for patients
faster resolution for those who are wronged
more money for frontline NHS services and less taxpayers’ money going to lawyers
That’s what I want to see. That’s the approach we’ll be taking in our new patient safety strategy.
Creating a more just culture in the NHS, a more open, honest and trustworthy culture, starts at the top. Getting the right leadership is vital. We need more people with clinical backgrounds and more people from outside the NHS.
We need to ensure they get the right support, training and development so they can lead their organisations effectively and create the right culture for staff and patients.
How do we strengthen this leadership? How do we encourage more inspirational leaders into the NHS? And how do we ensure we can hold to account that leadership once in place?
First, and perhaps counter intuitively, I think we must cut the turnover rate at the top. To improve leadership in the NHS we must fire fewer people and attract the best talent. NHS leaders have some of the toughest ‒ yet most rewarding ‒ jobs in the country. So let’s support them to do the job they need to do ‒ and that will encourage more to step up.
Next, we need to have a better structure, both to support and hold to account. Today we’re publishing Tom Kark’s review into how we can improve NHS leadership. I’d like to thank Tom for his work on this and I welcome his recommendations.
Kark recommends that all directors must meet minimum competency standards to sit on the board of any health organisation, and where training is needed to meet those new standards, then it should be made available
He also recommends a central directors’ database where information about qualifications and employment history can be easily accessed
These new recommendations will ensure the fit and proper persons test is met and that unqualified or unsuitable staff can’t just move somewhere else in the NHS. We accept these recommendations in full and will get on with implementing them immediately.
I’ve asked Dido Harding to consider the further recommendations, and how we can implement these recommendations, throughout the health service.
Third, we’re working with the Healthcare Safety Investigation Branch and NHS Improvement to give more support to families when things go wrong.
A new family engagement model will ensure relatives play an integral part in any investigation, that their concerns, and their complaints, are listened to and acted on.
Nobody should feel like they’re being fobbed off or a nuisance. We must give families all the information in an open and transparent way. And ensure they’re treated with sensitivity and compassion before, during and after any investigation.
That’s the same approach we’ll be taking when independent medical examiners start being introduced across England from April. Every death will be scrutinised by either a coroner or a medical examiner.
Medical examiners will be someone bereaved families can talk to about their concerns. They will ensure investigations take place when necessary, help detect and deter criminal activity, and promote good practice.
This new system will be overseen by a new independent National Medical Examiner. And training will take place to ensure a consistency of approach and a record of scrutiny.
Finally, we need to encourage whistleblowing. Despite our best efforts, mistakes happen. We’re all human, we’re all fallible. Any doctor who says they’ve never made an error isn’t telling the truth. And the truth is more important than any one error.
Mistakes should be seen as an opportunity to learn and improve, not a need for cover-up and denial. Honest feedback is a gift.
So whistleblowers are doing the NHS a great service. Someone, who has the courage to speak up and put their head above the parapet, should be encouraged and embraced. Yet, sadly, all too often, they’re ignored, bullied and worse: forced out.
Making someone choose between the job they love and speaking the truth to keep patients safe, is morally abhorrent and operationally foolish. It’s an injustice I am determined to end.
We must change the way the system views whistleblowers: from a problem, to part of the solution. We must embed a ‘learn not blame’ culture in every part of the NHS, and ensure there are protections for staff and the public who speak up to save lives.
So we must get the right leaders to create the right culture. A just culture, an open, honest and trustworthy culture. A culture of learn not blame. Saying sorry when we get it wrong, earning the public’s trust, never taking it for granted. Encouraging and supporting people with the bravery to speak up.
There’s no one solution to patient safety. It’s a series of steps. It’s a path of continuous learning and improvement. There will always be more we can do, and we must always keep striving to do better.
I want Britain to be the best country in the world to be born. That begins with making the NHS the best – and safest – place in the world to give birth. I want every parent to experience the same joy the mother of that newborn did, thanks to our brilliant NHS. Thanks to our brilliant NHS staff.
So let us renew that bond of trust with the public. Make it a public, spoken, bond of trust: we will always be open with you, we will always be honest with you.
When things go right and when things go wrong, you can always trust the NHS to be there for you and your family.
Below is the text of the speech made by Matt Hancock, the Secretary of State for Health and Social Care, on 30 January 2019.
It’s great to be here today at this global forum with such a global audience. And somewhat of a relief.
When George called and asked me to be part of a project that’s very close to Elton John’s heart, I have to admit I feared the worst.
Luckily for us all, it wasn’t a musical collaboration, but Sir Elton’s other great passion. And it’s a passion that I share and fully support.
I pay tribute to the work Sir Elton John has done over so many years, and to the Evening Standard for your leadership and campaigning and support.
HIV and AIDS are challenges that we must rise to together. The injustice, the unfairness, and the sadness they have brought and bring to this day must be tackled by us all.
They are global challenges that require global solutions and global co-operation. But I’m here because every global solution starts locally.
Just up the road from here, in Soho, is the building where perhaps the most important, and most successful, public health campaign in history was born.
In 1986, one of my great predecessors, the Health Secretary Norman Fowler, faced a controversial health challenge. A lot of people felt helpless and there was a lot of tension.
Instead of flinching, he did the right thing and brought together medical experts and the finest minds in ad-land with one clear aim: to stop people dying of AIDS.
I was 7 years old. And I still remember the advert that came out of that meeting. I guess many of you do too.
There was a volcano erupting, a tombstone with the word ‘AIDS’ carved into it in huge letters and a very scary voiceover from John Hurt warning the audience: “don’t die of ignorance”.
And it worked. I, for one, was terrified. I didn’t know what AIDS was – but, like everyone else, I found out.
That campaign saved lives. His decision showed that governments can make a difference.
It was imitated around the world. It stayed true to Fowler’s principle of “fighting the disease, not the person”. And it continues to inspire us about the power of public health interventions.
The Terence Higgins Trust found that countries who were slower to act still had twice as many HIV infections as the UK more than 2 decades later.
Thanks to that campaign, my generation grew up knowing AIDS was a potential death sentence.
That doesn’t have to be the case anymore. Thanks to medical breakthroughs, public health campaigns, breaking down stigma and better education, AIDS is no longer a death sentence here.
I feel proud that Britain has made such progress. But when I think about what’s going on elsewhere, I feel anger that our progress is not yet reflected around the world.
Just look at the statistics: 1.8m children are still living with HIV. Every week, 7,000 young women become infected with HIV.
In 2017, 940,000 people died of AIDS-related diseases. That’s equivalent to all the people living in Manchester and Liverpool.
The fight against HIV is indistinguishable from the fight for equality and the fight against discrimination.
Let’s not pull our punches: discrimination costs lives. Discrimination on gender or race or sexuality makes it harder for people to seek protection and help.
As Oscar Wilde said: “The road to freedom has been long and smeared with the blood of martyrs, and the fight’s not over yet.”
For a generation, the road to justice has been smeared with the blood of those who suffered the injustice of HIV. We have it within our grasp to end that discrimination and to end HIV, and we must not fail.
Britain demonstrated global leadership on AIDS with that ad campaign in the 1980s. And we are determined to do that again.
So today we’re redoubling our commitment to act with a new global campaign.
I’m delighted this campaign is a joint effort between us in health and my brilliant colleague Penny Mordaunt in international development.
Because what the success of that campaign 30 years ago proves to me is that what we do in this city, in this country, can resonate around the world. It can make a difference.
What we do locally in London, in Delhi, in Nairobi, in Maputo, in Kiev, in Atlanta, in other cities, has an impact globally.
We’re all part of the global solution to this global challenge, and none of us have all the answers or can do it alone. So I’m delighted to announce we’re putting in money.
In a minute, Penny will explain what we’re doing internationally, and the money we’re putting in to help other nations.
But setting an example matters. So I’d like to, just for a moment, to share with you a new world-leading initiative here in the UK.
Today we’re setting a new goal: eradicating HIV transmission in England by 2030. No new infections within the next decade, becoming one of the first countries to reach the UN zero-infections target by 2030.
This goal will be stretching it because it means preventing infections in higher-risk and harder to reach groups. But it is a realistic aim.
Part of our approach is our HIV Innovation Fund, which will support 13 local innovative initiatives to reduce the risk of people contracting or passing on HIV, reduce stigma and reach hard-to-reach communities.
Another part will be to review how we commission sexual health services, to make sure they are available to all.
And we’re going to increase access to PrEP for people in high-risk categories. We’re going to double the number of people who can receive the potentially life-saving HIV prevention drug.
The NHS is halfway through a 3-year clinical trial into PrEP, but we’ve decided to expand it early to include 26,000 people because the need has been far greater than anticipated.
From the ultra-local to the truly global, that’s the approach we must take to eliminate AIDS.
Each nation may be at a different stage, face different challenges, possess different resources, but we share the same goal.
And let us just allow ourselves to dream that one day we can bear witness, within a generation, of going from ‘don’t die of ignorance’ to an AIDS-free world.
That goal is now within our grasp. Let us work together to achieve it.
We will fight prejudice, we will fight wrong, we will fight evil, whether the evil of an indiscriminate virus or of an evil discriminatory heart.
We will champion the dignity of all human beings and the dignity of the human spirit. Let us pledge together: we will do our part and we will not fail.
Below is the text of the speech made by Matt Hancock, the Secretary of State for Health, in Davos on 24 January 2019.
The purpose of the World Economic Forum is to bring together world leaders and big business to solve the world’s most difficult problems.
One of these problems is antimicrobial resistance, where the world has come together over the last 5 years, but so much progress needs to be made, to stop an otherwise terrible future.
As health secretary responsible for one of the most advanced healthcare systems in the world, I could not look my children in the eyes unless I knew I was doing all in my power to solve this great threat. When we have time to act. But the urgency is now.
Each and every one of us benefits from antibiotics, but we all too easily take them for granted, and I shudder at the thought of a world in which their power is diminished.
Antimicrobial resistance is as big a danger to humanity as climate change or warfare. That’s why we need an urgent global response.
The UK has taken a global lead by setting out a 20-year AMR vision explaining the steps we must take nationally and internationally to rise to this challenge. It fits into a pattern of work across the world to keep this driving forward.
The plan incorporates 3 things we all need to do: prevention, innovation, and collaboration.
First: preventing infections is vital. We have today set a target in the UK of cutting resistant infections by 10% within the next 5 years.
We’re going to cut antibiotic use by a further 15% within 5 years by only using antibiotics when absolutely necessary. Everybody can play a part in only using antibiotics when they’re really ill.
And we’re going to work with the livestock industry to build on the amazing 40% reduction in antibiotic usage in just 5 years – 71% in chicken farming, while increasing productivity by 11%.
We’re going to do it through immunisation, better infection control and working with doctors, vets, farmers and patients to prevent unnecessary prescription of antibiotics.
Second: innovation. There hasn’t been a single, new class of antibiotic since the 1980s.
No new innovation in the most basic bedrock of every health service in the world – shocking. And deeply troubling.
Any health secretary or minister, who doesn’t lie awake at night worrying about that last pack of antibiotics, must have a prescription to some seriously strong sleeping pills.
We know the reasons why. Compared to expensive new cancer or heart drugs, putting time and money into developing new antibiotics is commercially unattractive for pharmaceutical companies.
And under the traditional model of revenue linked to volume, there is an added disincentive for pharmaceutical companies with a product that must be conserved.
So we need a new model, one that works with, and incentivises the pharmaceutical industry.
And this is where the NHS, because of its unique position, can take a global lead in pioneering a new payment system, one that reflects the true value of antibiotics to society.
At the heart of it is changing the way we think of antibiotics from a medical product to a medical service.
It’s a service that we all rely on: patients, doctors, and pharmaceutical companies.
So within 6 months, the NHS is going to start work on paying for the service, and security, of having access to critical antibiotics when we need them, rather than hoping there’s a product we can buy in the future.
We’re going to be more of a Spotify subscriber than a vinyl record shopper.
We will pay upfront so pharmaceutical companies know that it’s worthwhile for them to invest the estimated £1 billion it costs to develop a new drug.
We will work with the industry to develop the next generation of antibiotics, ones that are available and accessible to all.
But the only way this system can incentivise innovation globally, is if it is expanded globally.
Which brings me to my third and final point: collaboration.
I am proud of the work the UK has done to secure antimicrobial resistance on the global agenda. We’re playing our part both at home and on the world stage.
Because we recognise that none of us can stand alone against AMR. It won’t be solved by one nation, no single action or intervention.
It is a fight that requires continued collaboration, across borders, now and in the future.
I’ve been meeting health ministers from across the world here to agree further action, and next week the UN inter-agency co-ordination group are publishing their draft recommendations on the next steps needed to tackle AMR.
Hopefully that will take us one step closer.
It is a challenge, I believe, we can rise to if every step forward, we push ourselves further. Together, I’m convinced that with a proper plan we can achieve that goal.