Alan Milburn – 2002 Speech to the NHS Chief Executives’ Conference

Below is the text of the speech made by Alan Milburn, the Secretary of State for Health, on 13 February 2002.

Thank you for coming – and for all you do day in day out in the service of others.

I have called this summit today to discuss with frontline nurses, health visitors and midwives together with your representatives how we can build on the progress that is taking place in building up the NHS after decades in which it was run down.

Today for all the problems there are in the NHS – and which are very real – there are real signs of progress. The NHS Modernisation Board made this very point in its annual report just four weeks ago. Figures published at the end of last week showing fewer patients dying following surgery, more patients getting heart operations and more patients surviving cancer confirmed that progress is underway. Today the figures we are publishing on growth in staff numbers reinforce that the NHS is moving in the right direction.

There is of course a long way to go. After decades of neglect it will take time and effort as well as sustained resources to bring about the sort of modern health service both patients and staff want to see. There will be ups and downs along the way but the NHS is on the road to recovery. The investment and reforms that are going in are starting to pay dividends.

Nowhere is the impact of rising investment more important than on staff numbers. Shortages of staff are the biggest constraint that the NHS faces in expanding services for patients. NHS staff are the health service’s best asset. Every patient knows that. Every politician and every newspaper should know it too. At a time when the NHS – and those working in it – face an almost daily barrage of hostility from those who want to talk down it down in order to run it down, it is worth remembering a few simple truths.

The NHS is staffed by people who give their all in their service of others. Overwhelmingly they provide high quality care to patients. In recent years NHS staff have been leading the way in reforming NHS services so that they are designed around the needs of patients.

NHS staff then deserve our admiration and they require our support. You cannot be on the side of NHS patients unless you are on the side of NHS staff. And you certainly cannot be on the side of NHS patients unless you are on the side of rising investment in NHS staff.

That is now underway. It is only five years ago when the number of nurses in training and the number of GPs in training were both falling. Now both are rising. And rising quickly.

The number of qualified staff already working in the NHS is rising quickly too. The census figures being published today are good news for NHS patients. Between 2000 and 2001 there was a net increase in the number of nurses working in the NHS of over 14,400. This is the biggest increase on record. It means that the NHS Plan target of securing an extra 20,000 nurses in the NHS by 2004 has been met ahead of schedule. The NHS Plan is not only on target. It is ahead of target.

The number of hospital consultants, health care assistants, qualified scientists, therapists and allied health professionals has also risen sharply. Although GP numbers have risen less quickly they too are up on the previous year’s increase and the number coming through training is at an all time high.

But it is the rise in nurses, health visitors and midwives that is most dramatic. Many are people who have returned to nursing. People like Karen Gronhaug who is with us today. Karen is the 10,000th nurse to have come back to the NHS over the last few years.

Together with the further big increases in nursing staff already in the pipeline it is now clear that the corner has been turned on nurse recruitment. Now however is not the time for complacency. There should be no resting on laurels. Instead I now want to build on the progress that has been made. The NHS still needs more nurses.

We will continue our recruitment campaign – indeed we will launch the third year of it later this month – but I believe it is now time to switch the emphasis from nurse recruitment to nurse retention. We cannot have nurses coming into the NHS through the front door but find more leaving through the back door. Our objective then must be to improve the working lives of nurses to make nursing an even more attractive career.

That is the reason for today’s summit. To give nurses and their representatives a proper say in the future of the profession. To provide a forum where we can work together to make nursing a career of choice for thousands more people.

This is the first in a series of summits I will be holding with people working in the health service to hammer out ways of improving staff working lives. Over the next few months there will be similar events involving doctors, allied health professionals and support staff.

There is much on which we can build. In recent years there has been a concerted drive to improve the working lives of NHS staff. Nurses pay has risen – but I know that there is more than we need to do. We have made a start in helping nurses with housing costs but there is more help needed still. The same is true for childcare and flexible employment where we need to build on the progress that has been made so far in allowing nurses to better balance their family and their working lives. The status of nursing has never been higher – but more nurses need help to break through the glass ceiling that still holds too many back. Better training and development could help many more nurses fulfil their potential. Many nurses are already taking on new roles and have got new powers but more would like to do so.

Reforms like these hold the key to a better health service both for staff and for patients. Breaking down demarcations and liberating the talents of staff means faster better care for patients. Most people now recognise that what the NHS needs is not just more investment but far-reaching reform. My offer to people working in the NHS is this: we will continue to provide the sustained resources the NHS needs in exchange for the continued reforms it must have. We will work in partnership with those who are serious about reforming the NHS to make it a better place for patients to be treated and a better place for staff to work. There is a long way to go – but we can now build on the progress that is underway.