Patricia Hewitt – 2006 Speech at HR in the NHS Conference


Below is the text of the speech made by Patricia Hewitt, the then Secretary of State for Health, on 27 April 2006.

It’s a real pleasure to be here today with you, at this important conference about the future of Human Resources practice in the NHS.

I want to hear from you this afternoon so I’ve asked for as much time as the conference programme will allow for your comments and questions.

But let me place our discussions today in the context of the programme of investment and reform that we have embarked upon. Starting in 2000 with the NHS plan, what we tried to do was build a patient-led, responsive to the demands of a changing society, and robust enough to prosper into this new century. But crucially, true to the founding values of the NHS: free at the point of need, available to all of us, and funded by all of us through a progressive system of taxation.

This is a challenging time for the National Health Service and everyone working in it. So we all need to be honest and realistic about the challenges ahead, the tough decisions that need to be made – and why we are making further changes in the NHS. .

But I also think we have to be honest and realistic about what the improvements and reform have already achieved.

The facts speak for themselves.

Almost no-one waiting more than six months, and for most people far shorter than that – a target that people said was crazy when we promised it, and which the NHS delivered three months ago, in one of the coldest winters for decades.

Last year, the NHS treated more people, better and faster than ever before – and we saved more lives than ever before. 43,000 lives were saved from cancer, over 60,000 more saved from heart disease.

No wonder, in every survey, patients tell us the health service is good – and it’s getting better.

I think you and all the NHS staff are entitled to be proud of these achievements. I think you deserve more credit for them than the media sometimes gives you.

We have 307,000 more staff than we had in 1997, including 85,000 more nurses and 33,000 more doctors.

More staff – yes, and better-paid than ever before, and I make no apology for that either.

And let me make it absolutely clear: I do not believe that we have too many managers in the NHS. I am fed up with people who talk about managers as if it is a dirty word. I believe we need the very best managers in the NHS, working with clinicians and other frontline staff to deliver the very best care for patients with the best value for money.

You can’t run an organisation of 1.3 million staff and a budget which will be £92 billion by 2008, without first rate management.

Financial problems

But if things are so good, why are the headlines so bad? If the NHS is getting more money than ever before – which it is – why are there deficits, jobs being cut and some staff facing redundancy? Why are you having to make some very difficult decisions?

Most of the NHS is not in deficit. The majority of our NHS organisations are in balance or surplus. The overall deficit in the NHS is around one per cent of the total NHS budget. That’s like someone on £20,000 a year having a £200 overdraft – it’s a problem, but it’s a manageable problem.

The real challenge comes in the minority – 7 per cent of NHS organisations which are responsible for around 50 per cent of the deficit: It can’t go on.

We’ve written a very big cheque for the NHS, and we’re proud of that, But it’s not a blank cheque. It never has been and it never will be.

And that’s why I am so clear that over-spending hospitals and other organisations do have to put their house in order. You know better than I do that in the old NHS, the over-spenders were always bailed out by the under-spenders. The under-spenders were usually from the poorest communities and the greatest health needs. It wasn’t fair. And part of our reforms means that every hospital and every area has to take responsibility for getting the best possible healthcare with the best possible value for the extra money that we have asked the public to contribute.

Hospitals have to become more efficient in how it uses precious NHS resources, precious staff time. And you know how to do that.

You’ve been telling me that you just don’t recognise these headlines about mass redundancies. Cutting down on agency staff, as many of you are doing, isn’t redundancies. It’s good management. And it delivers better care for patients.

And from figures published today, the cost of sickness absence: a cost of on average £5.4 million for every single NHS Trust. We can do better by our staff, and save money at the same time.

Most places will tackle their deficits and make themselves more efficient with few or no redundancies and the more you and we can explain that to our staff, and the media, the better.

But of course there are difficult decisions. And in some hospitals, there are staff facing redundancy.

I know how devastating redundancies are. That’s why I know you are doing everything possible, working with staff representatives to ensure that the threat of redundancy is contained to as few people as possible.

You, as HR professionals, know that every redundancy is a blow to the individuals, their families, and the people they leave behind. You understand the need for sensible, sensitive management processes, and a good dose of human compassion and common sense.

That’s why we will support any staff member who loses their job to help them get new jobs and, if necessary, new skills.

Explaining this is particularly important when new medical practice and technology is making it possible to shift far more care out of hospitals and into health centres and community hospitals and even patients’ own homes.

Every one of us here believes in the NHS – funded by taxation, free at the point of need.

But not everybody believes in these principles.

Doctors for Reform demanding the introduction of social or private insurance, an end to ‘free at the point of need’.

The Daily Telegraph just last week, saying it doesn’t want progress, it wants privatisation.

If we are going to defend the NHS, free at the point of need, then we can only do so by changing to meet the huge challenges that confront every healthcare system in every developed country. An increasingly demanding public. An ageing population. Medical technology and science changing faster than ever before.

That’s why the NHS has to go on changing.

That’s why, together, we have to make difficult decisions.

But look at the prize.

But by the end of 2008, we will effectively have abolished waiting lists – the way the old NHS rationed care. We will be giving patients a more personalised service than ever before, with more choice about where you’re treated and appointments booked in advance to suit the patient, not just the provider. We will be treating far more patients in the community and in their own home. And all of it free at the point of need.

We are making some structural changes. But what really matters is cultural change.

And you are the experts.

Your job is not a back office function. It is on the front line, supporting our staff with skills they need to give the best care to our patients.

Thank you.