Tag: Speeches

Below is the text of the speech made by the Secretary of State for Health, Jeremy Hunt, to the 2013 National Conservative Convention on 19th March 2013.

When I became Health Secretary in September I said the job was the biggest privilege of my life.

That’s because the NHS is one of our most cherished institutions.

We can be proud that for 65 years our health service has ensured that everyone is entitled to treatment regardless of their background or income.

Over the last six months I have visited hospitals, surgeries and care homes across the country.

I have seen world-leading clinical practice, innovative use of technology and wonderful care from the dedicated doctors, nurses and healthcare assistants who look after 3 million people every week.

This Conservative-led government has shown our commitment to the NHS time and time again: by our protection of the NHS budget; by putting doctors and nurses in charge of two thirds of the budget; by funding the Dilnot proposals so people never have to sell their house to pay for social care; and by fighting to make sure vulnerable older patients are always treated with dignity and respect.

And we can be proud that our policies are making a real difference to people’s lives: on broadly the same budget as the last government, we are doing 400,000 more operations, 1 million more diagnostic tests and three million more outpatient appointments every year than happened under Labour; and 28,000 patients have benefited from the Cancer Drugs Fund they refused to set up.

Although I am proud of those achievements, I am even prouder of the contribution made by the extraordinary staff who work on the NHS frontline.

Let me give you one example: A & E departments now see 1 million more people every single year than when we took office.

I know the incredible pressures the doctors, nurses and healthcare assistants who work there are facing to deal with this surge in demand.

24/7 they do an extraordinary job and on behalf of everyone here I want to thank them for their remarkable dedication and commitment.

But it’s my job as Health Secretary not just to praise the best of the NHS but also to be honest about the failures.

If you care about something you don’t try to sweep problems under the carpet – you expose them, sort them out and make things better.

And by criticising us when we do that, Labour show extraordinary complacency about the treatment suffered by some of the most vulnerable people in our society.

As Conservatives, our instinct is to stand up for the individual. And that applies to the NHS.

We must never allow the needs of an institution to become more important than the needs of the patients it was set up to serve.

That’s why Andrew Lansley was so right to set up a public inquiry into what happened at Mid Staffs Hospital, something Labour refused 81 requests to do.

And we should never forget what they allowed to happen on their watch:

Patients left unwashed for days, sometimes in sheets soiled with urine and excrement;

Relatives having to take bedsheets home to wash because the hospital wouldn’t;

Patients with dementia going hungry with their meals sitting right in front of them because no one realised or cared that they were unable to feed themselves.

Things that make your stomach turn. And we must never allow our love of the NHS to dent our determination to hold systems and individuals to account.

So, where does that accountability lie? Most recent focus has been on Sir David Nicholson.

As a manager in a system that failed to spot and rectify the appalling cases at mid Staffs, he has been held accountable in both parliament and the media.

But he also led the campaign to bring down hospital waiting times and MRSA rates and we should not delude ourselves that Mid Staffs was all down to one man.

Others have far greater responsibility.

Like the board of the Trust, whose members astonishingly seem to have melted into thin air, some moving to other jobs in the system and others with generous payoffs.

We need to restore accountability to hospital boards. That includes an end to gagging clauses – which I announced earlier this week.

And we must look at measures to make boards criminally liable if they deliberately manipulate key patient data like mortality rates or waiting times.

We need openness and transparency and there should be no hiding place for those who hide the truth and fiddle the figures.

The Francis report rightly says that Ministers were not personally responsible for what happened at Mid Staffs.

No minister of any party would have sanctioned or condoned what happened.

But we also know from the report that the pursuit of targets at any cost was one of the central drivers of what went wrong.

And it is Ministers who are ultimately responsible for the culture of the NHS. During this period a culture of neglect was allowed to take root in which the system became more important than the individual.

The pursuit of targets stopped frontline staff treating people with dignity and compassion and betrayed what all of us believe the NHS is there to do.

Of course there is a role for targets, whether in A & E or for waiting times.

But not at any cost.

And Labour Ministers made three huge policy mistakes which contributed to the culture of neglect we are now putting right.

First, they failed to put in place safeguards to stop weak, inexperienced or bad managers pursuing not just bureaucratic targets, but targets at any cost.

This is exactly what happened at Mid Staffs, where patient safety and care was compromised in a blind rush to achieve Foundation Trust status.

Secondly, they failed to set up proper, independent, peer-led inspections of hospital quality and safety which told the public how safe and how good their local hospital was.

And thirdly, they failed to spot clear warnings when things went wrong.

The Francis Report outlines around 50 warning signs – so why did Ministers not act sooner?

If those warnings were not brought to the attention of Ministers, why did they not create a system where they were?

Instead there was a climate where NHS employees who spoke out about poor care were ignored, intimidated or bullied.

Until we have a proper apology from Labour for those catastrophic policy mistakes, no one will believe they would not make the same errors of judgment again.

This Conservative-led Government is absolutely clear about the steps we need to take to ensure accountability, compassionate care and respect for patients, particularly older people, are embedded in every corner of the NHS.

These include a proper independent peer-review inspection regime led by a new Chief Inspector of Hospitals that won’t just look at targets, but also make judgements about whether hospitals are putting patients first.

And it isn’t just about failure – we must recognise excellence.

When Ofsted started recognising outstanding schools, we saw a new breed of ‘superheads’across the education system.

We need the same in the NHS – so that our best leaders can help turn around failing hospitals.

We also need a single failure regime where the suspension of the Board can be triggered by failures in care as well as failures in finance.

And we will promote a patient-centred culture through the introduction of the Friends and Family Test.

This will ask every NHS hospital inpatient whether they would recommend the care they received to a friend or family member.

It will ask NHS staff whether they would want their own family treated in their own hospital.

Implementing these changes will be a huge challenge.

But in the end we are doing what Labour should have done but failed to do.

The party that claims to speak for the vulnerable betrayed those very same people.

And they betrayed the vast majority of doctors and nurses who want nothing more than to express the innate decency and compassion that made them give their lives to the NHS in the first place.

And once again it falls to us, the Conservatives, to deliver that vision.

And make sure that throughout our NHS no individual is too small, too unimportant, or too irrelevant to matter.

That is our mission – let nothing stand in our way.

Below is the text of the speech made by the Secretary of State for Health, Jeremy Hunt, on 13th March 2013.

In 1953, when the NHS was just five years old, two men named Smith took a flight from LA to New York. They started chatting.

One Mr Smith was the head of American Airlines. He was having a nightmare coping with the explosion in demand for airline travel.

Back then it could take 3 hours to book a single ticket. They were dependent on the amount of work that 8 people huddling around a single rolodex could manage and they had reached their limit. Mr Smith was desperate.

The other Mr Smith worked for IBM.

That chance encounter transformed the industry.

It led to a new computer system that allowed any travel agent anywhere in the country to know which seats were available on any flight, book and issue a ticket all in a matter of minutes.

The implications were massive. Flying went mass-market – and American Airlines became one of the most successful airlines in the world. And we are still using the same system 60 years later – with the internet allowing us all to become our own travel agents.

But think how history would have been different if the man from IBM had been sitting next to a Mr Smith from the NHS.

What they introduced to the airline industry 60 years ago, we still haven’t done for health and social care today. While they innovated, we stagnated. The revolution that has transformed so much of our daily lives is only just starting to touch healthcare.

Today I want to talk about the importance of innovation, of thinking differently and of finally harnessing the power of technology for the improvement of patient care and patient experience.

The NHS today

Very recently, the Francis Report into the appalling abuses of care at Stafford Hospital highlighted one of the biggest challenges facing the NHS. The need not only for high quality treatment, but for genuinely patient centred care.

I am clear that our response to that report must be about getting the culture and values right in the modern NHS as about regulation and systems.

In the end, that boils down to basic human interaction, to the care and compassion that is at the heart of what the NHS stands for. That is at the heart of the reason why so many people – our great doctors and nurses – dedicate themselves to the care of others.

If we are to give them the time and space to deliver on those core NHS values, if we are serious about putting patients in the driving seat, then we need to embrace the time-saving efficiency and productivity that technology and innovation can unleash.

We also need to recognise the improvements in patient safety that technology makes possible. Whether real time information on hospital mortality rates, comparative data on surgery survival rates or the simple availability to a doctor of a patient’s prescribing history before medication is administered – all should make closer the zero-harm NHS that is such a priority in the wake of Mid Staffs.

Let’s be clear though: technology is a means to an end, not an end in itself. But if we ignore what it makes possible, we ignore the biggest single opportunity in front of us to transform the delivery of healthcare away from a medical model into a patient and person-centred approach.

Patient Records

One thing that, more than anything else, will drive innovation is electronic patient records.

Paper records can only be in one place at a time, only seen by one person at a time. So they’re no use to a patient on holiday in Gloucester if his file is in a Godalming GP surgery.

Or to an ambulance driver picking up a frail elderly woman in an emergency who, if he had her notes, could see she was a diabetic with a heart condition who had a fall last month.

They’re no use to a hospital doctor who might not be aware of a patient’s other medication and prescribe drugs incorrectly – potentially lethally – because the notes have got lost.

Unaware of a patient’s full history, complications arise in surgery.

Diagnostic tests are repeated unnecessarily.

And patients find themselves having to repeat their medical history over and over again, sometimes several times on the same day in the same hospital.

But with an electronic record, all sorts of things are possible.

Which is why I have taken what Sir Humphrey would call the ‘brave’ decision to ask the NHS to go paperless by 2018. And to acknowledge explicitly that the last government was right to see the potential of electronic records but tragically wrong in the way it tried to implement them.

We will learn the right lessons – in particular avoiding top down Whitehall driven solutions in favour of locally determined solutions which work to national standards.

Global best practice

Many of the organisations here today offer new ways of using that information to improve care.

Whether it’s doctors and nurses being able to access the right information, giving patients control over their own care, or enabling vast amounts of anonymised data to be used to further research into new drugs and treatments. The potential for fully electronic records is huge and is about to be realised.

In Denmark, people can see all their hospital records online, and this year will be able to see their GP records too.

In America, military veterans, who have their own healthcare system not unlike the NHS, can download their own health records. Something that almost 20,000 veterans do every month.

In Sweden, over 85% of prescriptions are transferred from doctor to pharmacy online.

We have great things happening here in the UK too – like King’s College Hospital on track to become paperless this year, and where nurses use iPod Touches to record and monitor a patient’s vital signs at the bedside.

Or Maudsley Hospital’s MyHealthBox, the first time anwhere mental health patients have been given online access to their hospital and GP records.

Or Newham University Hospital that has reduced missed appointments by 11% through use of Skype for diabetic outpatient appointments.

But, we need to go much further, much faster. And we should not underestimate the size of the prize. With a paperless NHS, we may well be the largest fully online health economy in the world – with massive implications for improved patient safety, genuine patient empowerment and self-management as well as scientific research.

Announcements: Johnson and Johnson

Britain has a global reputation for research. We have world-leading universities and some of the greatest scientific minds. We have well established, high quality R&D, manufacturing and supply chain expertise. And, of course, we have the NHS.

This all makes the UK a natural focus for global investment in innovation and the life sciences.

And with a global healthcare market worth around 6.5 trillion dollars, the potential value to the UK in terms of economic growth and development is enormous.

So I’m delighted to announce one such investment today.

Johnson & Johnson’s Innovation Centre, here in London, will spearhead a multi-mullion pound drive to seek out and develop some of the ‘golden discoveries’ being made as we speak.

They will support and develop promising new breakthroughs in our universities, our SMEs, our research councils and our big research charities.

Johnson & Johnson’s Chief Scientific Officer, Paul Stoffels, said, this “is part of [their] broader innovation strategy to advance human health through collaboration with the world’s leading scientists and entrepreneurs.”

And they’re doing it right here in England, where they have access to the finest health service and the finest people in the world.

Unlike the big investments of the past, this isn’t about vast sums spent on shiny new offices and laboritories, it’s about focussing investment in new ideas, fresh thinking and new products.

Being flexible and moving fast.  Just like many of the small companies here at Expo.

NHS Commissioning Board App Library

For as well as the big giants who push forward the bounds of innovation, we also need the small, disruptive companies. Often close to their customers, often led by people fresh from the coalface of NHS care, outside the traditional structures they bring energy and fresh thinking to age-old problems.

So to help harness what they can offer the NHS Commissioning Board have today launched the Health App Library. Aimed initially at the public, it will play host to new mobile phone apps developed by companies large and small that can help to improve healthcare in myriad ways.

These apps will do everything from helping people to get trusted information on their condition or to find relevant clinical trials, to making it easy for patients to create and manage their own care plans with their doctor using their own medical records.

As the father of a one year old daughter, I am particularly interested in the e-Red Book, allowing parents to keep accurate and up to date records of their child’s early development online.

But you will find many other apps in the Library, all with the knowledge that they are clinically safe.

Innovation, excellence and Strategic Development (IESD) Fund

Finally I can today announce the government is helping small groups – community groups, social enterprises – to play their role in improving care through the Innovation, Excellence and Strategic Development Fund. Today, a further 49 with benefit from grants totalling £5.5 million.

This will cover a wide range of innovations, from tailored online psychological support for people with skin conditions, to phone apps to help people with disabilities gain greater independence, and support for children and young people to access and take control of their own mental health services online or through their phones.

Conclusion

Expo showcases why I am so optimistic about the future of health and social care. Creative people bringing new ideas, new perspectives, new approaches.

It is the opposite of the old top-down, command and control NHS. It shows the future.

A future of an NHS freed from the shackles of top-down bureaucracy where our excellent doctors and nurses can quickly find the solutions that work for them and their patients. Bringing speed and creativity to wards and consulting rooms across the country.

Technology is a big part of this. Not a holy grail or silver bullet. But a way of turning the pyramid upside-down, so the NHS is led by the people it was set up to serve – its patients.

Bill Gates said, “Never before in history has innovation offered promise of so much to so many in so short a time”.

When it comes to taking advantage of that promise of what innovation, let’s put healthcare at the front of the queue. Thank you.

Below is the text of a speech made by the Secretary of State for Health, Jeremy Hunt, to the Policy Exchange on 16th January 2013.

In 1953, when the NHS was just five years old, two men named Smith took a flight from LA to New York.  They started chatting.

One Mr Smith was the head of American Airlines.  He was having a nightmare coping with the explosion in demand for airline travel.

Back then it could take 3 hours to book a single ticket.  They were dependent on the amount of work that 8 people huddling around a single rolodex could manage and they had reached their limit.  Mr Smith was desperate.

The other Mr Smith worked for IBM.

That chance encounter transformed the industry.

It led to a new computer system that allowed any travel agent anywhere in the country to know which seats were available on any flight, book and issue a ticket all in a matter of minutes.

The implications were massive. Flying went mass-market – and American Airlines became one of the most successful airlines in the world. And we are still using the same system 60 years later – with the internet allowing us all to become our own travel agents.

But think how history would have been different if the man from IBM had been sitting next to a Mr Smith from the NHS.

What they introduced to the airline industry 60 years ago, we still haven’t done for health and social care today.  The revolution that has transformed so much of our daily lives has only just started to touch healthcare.

Today I want to talk about why we need to embrace that revolution with enthusiasm – but also the pitfalls if we get it wrong.

The NHS today

Right now, one of the biggest challenges facing the NHS is the Francis Report about the appalling abuses of care at Stafford Hospital, shortly due to land on my desk.

I am clear that our response to that report must be about getting the culture and values right in the modern NHS as about regulation and systems.

Technology is not the answer to this. It can never replace human interaction, nor the care and compassion that must be at the heart of what the NHS stands for.

But today, I want to argue that it does have a role to play if we are to give doctors and nurses the time and space to deliver on those core NHS values.

The clearest example of this is patient records.

Because they are mainly paper-based, they can only be in one place at a time, only seen by one person at a time.

So they’re no use to a patient on holiday in Gloucester if his file is in a GP surgery in Godalming.

Or to a paramedic picking up a frail elderly woman in an emergency who, if he had her notes, could see she was a diabetic with a heart condition who had a fall last month.

They’re no use to a hospital doctor who might not be aware of a patient’s other medication and prescribe drugs incorrectly – potentially lethally – because the notes have got lost.

Unaware of a patient’s full history, complications arise in surgery.

Diagnostic tests are repeated unnecessarily.

And patients find themselves having to repeat their medical history over and over again, sometimes several times on the same day in the same hospital.

International comparisons

Other countries are making great strides.

In Denmark, people can see all their hospital records online, and this year will be able to see their GP records too.

In America, military veterans, who have their own healthcare system not unlike the NHS, can download their own health records.  Something that almost 20,000 veterans do every month.

In Sweden, over 85% of prescriptions are transferred from doctor to pharmacy online.

Here in the UK we too have some interesting pioneers.

King’s College Hospital, for example, is on track to become fully paperless by the end of this year.

The drive comes from the clinicians who demand to have the right information in the right place at the right time.  They’ve introduced electronic prescribing, and nurses use an iPod Touch to record and monitor a patient’s vital signs at the bedside.

Maudsley Hospital’s ‘MyHealthLocker’, gives their patients online access to their hospital and GP records, a world’s first in mental health.  They can also feed back on their care plan, helping them to take control of their own healthcare.

And Newham University Hospital is piloting using Skype for diabetic outpatient appointments that don’t require an examination.

Missed appointments are down by 11%, patients don’t have to travel and the quality of care is improved.

But today I want to argue that we need to go much further, much faster.

So today I am setting a new ambition for the NHS.

I want it to become paperless by 2018. The most modern digital health service in the world.

Patients will be at the heart of this change – which means allowing for those unable or unwilling to engage in technology.

But between the NHS and social care, there must be total commitment to ensuring that interaction is paperless, and that, with a patient’s consent, their full medical history can follow them around the system seamlessly.

Challenges

This will be a profound change with huge impact, impossible to underestimate. And with profound change come profound challenges.

First, unsurprisingly, is money.

If Labour failed to do this with their billions, how can we hope to do it on a much more limited budget?

We shouldn’t forget that local hospitals and local GP practices spend their own money on technology all the time.  We just need a much more ambitious vision as to how to make that money and that investment count.

Every NHS organisation, including all 266 NHS trusts, has a major incentive to do this because the savings are so enormous – £4.4 billion annually according to today’s PWC report – that money, released to spend on better care, can go a long way towards helping them deliver health services sustainably in a time of real financial pressure.

Second, there is the objection that this should not be a priority because we want nurses talking to patients not looking at iPads.

But how many times do we see a nurse station in a ward with nurses unable to catch your eye because their heads are buried in paperwork?  Proper investment in technology means more contact time with patients – which is why the Prime Minister announced a £100m fund to help nurses take advantage of it.

Then there is the objection that patients don’t want technology. It’s true that only 3% of people book GP appointments online.  But 29% say they want to.

Before online banking became available, were customers marching in the streets, demanding that banks put their accounts online?  Of course not.  But that didn’t stop people going online in droves – with 80% of us, including a third of pensioners, now banking online .  Never let it be said that this is only something of interest to younger generations.

Then there is the critical issue of data security, which Fiona Caldicott is reviewing right now. Clearly we need protocols so that people can be comfortable that their data is only being accessed when necessary and with their permission.

But if the banks can make people confident that their money is safe, we must surely be able to develop a system that keeps medical records safe too.

Then there is the importance of the doctor-patient relationship.  There will be many times when only a face-to-face meeting will do.

But allowing repeat prescriptions to be booked online will free up much more time for such meetings, as well as offering a better and more convenient service for patients.

Finally, people say that we’ve been here before.  That Labour tried it and failed. The truth is that Labour had the right idea but the wrong approach.

Labour’s Connecting for Health became the NHS equivalent of ordering an aircraft carrier. A project that became over-centralised, over-specified and ultimately impossible to deliver.

What works – and you can see this everywhere – is local solutions, local decisions and local leadership.

Most systems won’t necessarily need to be replaced, just updated or adapted so they can talk with each other.  A thousand different local solutions linking together using common standards.

If this sounds incredibly complex, it’s actually very  commonplace.  It’s why your Blackberry can talk to my iPhone. It’s why all of those apps on our phones integrate so seamlessly.  It’s why you can use any computer, phone or tablet and log on to the internet to catch up on the latest news or watch a video on YouTube.

Things don’t have to be the same.  They just have to be compatible.

Why do it

Today’s report by PWC confirms what we already know.  That the right sort of technology, used in the right way, can release billions of pounds to be re-invested in better, safer care – and millions of hours of staff time for better patient care.

And it can do something else too.

Over a million people have some form of contact with the NHS every 36 hours and have done so for over 60 years.  This produces mind-boggling amounts of data that, if properly utilised with the right safeguards, can help improve treatments, unlock new cures and transform the face of modern health and social care.

The challenge

The stakes are high.  But already we have made real progress in preparing the NHS for a paperless, digital future.

In November, I announced in the NHS Mandate that by March 2015 everyone who wants it will be able to get online access to their GP record, as well as book appointments with their GP and order repeat prescriptions online.

E-consultations, like those in Newham, will also become much more widely available.

Today I can confirm that the NHS Commissioning Board have agreed that hospitals should be able to share digital data from April 2014, and to adopt paperless referrals from April 2015.  It is currently working on detailed guidance to help local NHS organisations make the leap.

This follows on from other recent steps:

Changing the standard NHS contract to insist that providers comply with defined information standards.

Setting up ‘care.data’, a service to give local commissioners timely and accurate information on the performance of providers.

From this summer, we’ll begin to publish huge amounts of clinical data on a wide range of surgical procedures, everything from vascular surgery to bariatric surgery.  Bringing unprecedented transparency to great swathes of NHS performance.

And to drive all of this, from 2013/14, the NHS number will become a patient’s primary means of identification within the health and care system, enabling all of their records, wherever they are held to combine around the individual person.

Conclusion

So, to conclude, technology is not a holy grail or a silver bullet for all the challenges facing the NHS.  It must always be a means to an end and not an end in itself.

But properly adopted, it has the potential to play a central role in facing up to the core challenge of dealing with an ageing society in which patients insist on a more personalised service.

As Bill Gates said, “Never before in history has innovation offered promise of so much to so many in so short a time”.

Well, health needs to be at the front of the queue in taking advantage of that promise – and I am determined it will be.

Thank you.

Below is the text of the speech made by the Secretary of State for Health, Jeremy Hunt, to the King’s Fund on 28th November 2012.

Our health and social care system faces many challenges and we rightly have lively political debates about all aspects of health policy.

But sometimes problems are so deep-seated that when they surface no one really believes they can be solved. Or even worse, we stop noticing these problems because they have become so much part of the fabric.

And then you have to defeat the defeatism as well as dealing with the issue itself.

1. The normalisation of cruelty

Today I want to talk about one such problem, perhaps the biggest problem of all facing the NHS.

The crisis in standards of care that exist in parts of the health and social care system.

Just look at what has come to light in the last few years:

• Patients left to lie in their own excrement in Stafford Hospital, with members of the public taking soiled sheets home to wash because they didn’t believe the hospital would do it.

• The man with dementia who was supposed to be monitored every 15 minutes who managed to leave a Pontypool hospital and drown;

• The residents kicked, punched, humiliated, dragged by their hair, forced through cold showers at Winterbourne View.

• The elderly woman with dementia repeatedly punched and slapped at Ash Court care home.

• The cancer patient at St George’s, Tooting, who lost a third of his body fluid, desperately ringing the police for help, because staff didn’t listen or check his medical records.

Isolated incidents? Well, sadly not. But as well as the depressing regularity of these stories, the most worrying thing is the fact that in certain institutions this kind of care seems to have  become “normal.”

In places that should be devoted to patients, where compassion should be uppermost, we find its very opposite: a coldness, resentment, indifference, even contempt.

Go deeper, and look at the worst cases – like Mid-Staffs and Winterbourne View – then there is something even darker. A kind of normalisation of cruelty, where the unacceptable is legitimised and the callous becomes mundane.

There’s a simple test every layer of the health and social care system should be applying. And that is to ask: is this the care I would wish for myself, or for a loved-one?

Care as you would wish to be cared for. In Winterbourne, in mid-Staffs, in Pontypool, Tooting, Ash Court, this principle was utterly and horribly abandoned.

2. Betrayal of the majority

It’s really important to stress that this is not the picture in most of the NHS or social care system. But the outstanding care that you see in so many institutions – even those under severe financial pressure  – shows why we must face these cases with anger, and not with resignation.

Because they betray the outstanding men and woman who have given their lives to the NHS and caring professions – and who make this job for me the biggest privilege of my life.

People like the nurse I met at St Thomas’ who was looking after a terminally-ill patient who had lost touch with his family 20 years earlier. This nurse looked the family up on Google and arranged to fly the patient back to Ireland so he could spend his last two weeks reunited with them.

The Care Home Manager at Rathmore House in Swiss Cottage, caring for people with advanced dementia.  The manager who lives every day just to try to get a smile out of patients with advanced dementia even though, she says, they won’t remember the next day.

The GP who works 15 hour days trying to work out care plans to stop her frail elderly patients being unnecessarily admitted to A & E.

So many people represent NHS values at their finest. In every fibre of their body, they care as they’d wish to be cared for. And they are the ones most let down when we fail to tackle poor care head on.

3. Why good care matters

Nor should we make a false dichotomy between good treatment and good care. The King’s Fund, generously hosting us today,  has always championed a rigorous evidence-based approach to healthcare issues. They know good care directly supports good outcomes.

Veena Raleigh’s work for the Kings Fund this month showed the link between good care and good outcomes across GP practices, what she described as a “strong association” between patient satisfaction and clinical performance on the Quality and Outcomes Framework.

Consistent with this, a Lancet study in 2001 concluded that doctors who adopt a warm, friendly, and reassuring manner are more effective than those who don’t.

And the Commission on Improving Dignity in Care has shown that when elderly people are not treated with compassion and respect this can affect their recovery, even if the clinical treatment itself is excellent.

The argument is clear: good care means healthier patients and stronger balance sheets – yet too often the message isn’t hitting home.

4. Stronger accountability from managers

So what are the solutions?

Let’s start at the top. We urgently need to strengthen corporate and managerial accountability for the care provided.

Yet too often managers have seen their priority as financial or clinical outputs. Incentives in the system have driven people to focus on quantitative input measures rather than the basic human right to be looked after with dignity and respect.

Most managers get this – indeed their passion for the highest standards of care is why they have chosen to become managers in the NHS or care sector. But too many do not. Buried in spreadsheets, they become blind to the realities of what’s happening day-on-day inside their organisations.

It’s this whole culture of ticking the box, but missing the point which is what we have to put right.

And we have to be much clearer about the consequences that will follow if leaders fail to lead, and fail to drive high quality care throughout the organisation.

Just as a manager wouldn’t expect to keep their job if they lost control of finances, why should they if they lose control of care?

The same is true for owners and Boards of companies. Accountability must stretch to the top. And when we publish our response to Winterbourne View we will set out in detail how we intend to achieve this.

5. Greater transparency

Secondly, we need to know much more quickly where the problems are.

Next year we will roll out the “friends and family” test across the NHS. For the first time hospital users will be asked if they would recommend the care they received to a friend or close member of their family. NHS staff will also continue to be asked anonymously whether they would recommend their organisation to their own families.

This is the closest measure we can get to “care as you would wish to be cared for”. And we will publish the results.

So that’s a very important first step. But we need to do much more.

As an MP I know how well each school in my constituency is doing thanks to independent and thorough Ofsted inspections. But I do not know the same about hospitals and care homes.

Given the scale of the problems we’re uncovering, it’s now clear we need to have a proper independent ratings system.  It is not acceptable to deprive the public of the vital information they need, or remove the pressure for constant, relentless improvement in standards.

I am not advocating a return to the old ‘star ratings’ but the principle that there should be an easy to understand, independent and expert assessment of how well somewhere is doing relative to its peers must be right.

So this week I have asked for an independent study to be done as to how this might be achieved in a way that does not increase  bureaucracy.

I want to see a system that will provide – like Ofsted does for schools – clear, simple results that patients and the public can understand;

That will be – like Ofsted – an engine for improvement, driving organisations to excel rather than just cover the basics;

A system that gives greater certainty that poor care gets spotted and addressed before standards collapse.

When I receive the results of that study, I will consider it carefully alongside the Mid Staffs report from Robert Francis. I will then announce to Parliament how we intend to resolve this issue.

6. Better training

The final and equally important side to all of this is staff development. The King’s Fund and many others have shown that staff who feel engaged and valued in an open and supportive working environment deliver better care and support for patients.

And yet in these highly charged, busy, stressful environments, too many are left ‘not waving but drowning’, cut adrift from the help they need to do their jobs well.

And again the consequences can be profound. One well-respected study from 2006 found that hospitals with better supported staff provided better care and had lower mortality rates.

An incredibly powerful finding, which shows that a lack of staff support, ultimately impacts on patients’ survival chances.

Staff in healthy organisational cultures, given the space to process the difficult emotions that caring throws up, will provide better, safer care.

So what is in train to support them?

New standards for senior managers issued by the Council for Healthcare Regulatory Excellence – echoing the need for respect, compassion and care for patients at the heart of leadership and governance.

A leadership qualities framework for adult social care published by my department which will do a similar job for care organisations

Next week, we have the launch of the new Vision for Nurses, midwives and care staff following the £40m in leadership development programmes for nurses, midwives and registered care home managers announced by the Prime Minister in October.

Next month – the establishment of the Professional Standards Authority to make sure the professional regulators do their jobs and protect the public effectively; and the beginning of a new era of medical revalidation, making our systems the best in the world for supporting doctors and ensuring standards;

And then early next year – the first ever national set of standards and a code of conduct of conduct for health and social care support workers are published.

All of this is underpinned by:

an NHS Mandate explicitly saying quality of care should get the same attention as quality of treatment, and emphasising the pledges to staff in the NHS Constitution

And a new organisation – Health Education England – entirely focused on the education, training and development of the health workforce.

7. Addressing the challenges

So a lot is happening. Of course there will be those looking at this and saying “Can we really do it?”; “Is it realistic to expect organisations to invest more in people and in the quality of care at a time when money is so tight?”

There are indeed financial pressures in a period of rising demand and flat budgets.  But as the CQC said last week, most Trusts and care homes deliver excellent care despite a tough financial environment. So there is absolutely no excuse for those that do not.

But it is also wrong to equate better care with more money. More accurate would be to say what today’s Kings Fund report states plainly: it is bad care that costs more – including the £1.4 billion spent on unnecessary emergency admissions.

What about staffing levels and in particular the reduction in nursing numbers?

As people stay in hospital for shorter periods, and indeed 80% of hospital appointments now do not involve an overnight stay, patterns of care change.

But if quality of care is really to be as important as quality of treatment we should be clear that changes to workforce numbers must not compromise the care provided.

8. Conclusion: widening the circle of compassion

In surveying the broad sweep of the universe, Einstein once spoke of people shedding their individual perspectives and ‘widening the circle of compassion’ if humanity was to progress.

In the health and social care universe, which can be every bit as unpredictable and complex as the world around it, the same message rings true.

In its sixty-fifth year, pitted against its biggest ever challenges, we need an NHS that is always searching, always improving, always striving to do more for patients.

We take for granted improvements in medicine, in surgery, indeed in life expectancy. But none of this is real progress unless we are also treating our citizens with the dignity and respect they deserve.

Widening the circle of compassion. Denormalising the unacceptable in those rarer cases. And living the principle of care as you would wish to be cared for everywhere.

The founding ideals of the NHS expect no less.

Below is the text of a speech made by the Secretary of State for Health, Jeremy Hunt, to NCAS on 25th October 2012.

Thank you Sarah [Pickup, President of ADASS].

The importance of local authorities

I think it’s appropriate that the very first speech I give as Health Secretary – the first beyond the confines of the Conservative Party conference – is not to an audience of doctors or nurses, but to local authorities.

The word I have heard more often than perhaps any other in my first month is “integration.” Our National Health Service is an extraordinary organisation of which we are all deeply proud.  But by itself, it’s not enough.

And given the challenges of an ageing population, our single most important partner is without question local authorities. The success or failure of health and care very simply rests on the success or failure of my relationship with you – and in particular the progress we make together towards building a sustainable system.

Dilnot

So before I go any further, let me talk about funding.

How we pay for social care – both as a government and as individuals – is one of the big questions of our generation.

The current system is entirely inadequate.

It’s not sufficient, it’s not sustainable and it can be deeply painful for many, many people.

Forcing them to sell the home they have lived in, had children in, made so many memories in.  It’s one of the worst things about being old in this country.

So I am so proud that next year’s Care and Support Bill will introduce deferred payments meaning that no one is forced to sell their home in their lifetime to pay for care.

A historic change.  But we need to go further in three areas in particular.

Firstly the Dilnot cap, which we strongly support and are committed to introducing as soon as we are financially able. We need to build a society where it is as normal to make provision for your social care as it is for your pension – and until we do so we will never have a truly sustainable system.

Secondly by working with you to help you deal with the huge pressures created by the cuts in your budgets that have come at a time of rising demand. The support for adult social care budgets that has come through the Department of Health – over £7 billion in this spending review period – is a mark of our commitment. But I recognise that for many councils significant efficiency savings will be needed on top of that.

So we need to do something else, a third vital step. Which is to forge innovative partnerships between local councils and local NHS services that build more sustainable services to keep people healthy and in their own homes for longer. The new structures of the Health and Social Care Act, with clinically-led CCGs, local authority responsibility for public health and health and well-being boards, will provide the catalyst to make that happen – and it will have my enthusiastic support.

20th century health

When we look back over the last hundred years or so, this country has made incredible progress in health.

From the start of the 20th century to the early years of the 21st, life expectancy has basically doubled.

The causes are many.

One, certainly, is our NHS.  But it is far from the only one.

Better housing, clean water and sanitation, better working conditions, food quality standards, even road safety – all had a huge impact.

And you have played a key role in every one of them.

But there are more gains to be had, through:

•    Better, more appropriate housing,

•    By health and wellbeing becoming an integral part of planning, of transport and of education,

•    By being better at reaching the poorest, the most vulnerable and the hardest to reach in our communities.

Integration

Now, the last couple of years have inevitably been dominated by a debate on structures.

But structures are only a means to an end.  What really matters is better health and care outcomes.

And for that we need a culture of cooperation across health and social care, with a person’s individual needs at its heart.

The old structures simply haven’t worked well enough.

•    GP practices not talking to hospitals.

•    Hospitals not talking to each other.

•    And the divide between the NHS and local authorities sometimes beggaring belief.

This lack of openness, of communication, of trust… means that too many people simply fall between the cracks.

All too often those with the loudest voices and the sharpest elbows – or at least those who have parents or children who have them – get the best treatment.

Of course, we can point to examples of excellent, integrated care.

Like Blackburn with Darwen Borough Council, which, with the local NHS, now provides free leisure facilities for everybody – that’s right, for everybody.

The result?  The number of people doing the recommended amount of exercise has gone up by almost half [up 46% from 16.3% to 23.8%].

And in Liverpool, where by bringing NHS staff together with social workers in integrated care teams, they have been able to cut unplanned hospital admissions and length of stay in hospital by a quarter.

Good things happen when the NHS and councils come together.

But where this happens, it happens despite the system, not because of it.

You can’t design care around, say, a child with cystic fibrosis or a woman with breast cancer –her chemo- and radiotherapy, her drugs, her nursing visits, her social care, her mental health – if there is no meaningful contact between her GP, her consultant team, her local authority and her social care provider.

That’s the great opportunity presented by Health and Wellbeing Boards and by Healthwatch, both of which go live in April.

Bringing people together to improve the health of their community and the quality of care within it.

Looking at the needs of local communities and working out how to meet those needs.

Figuring out how to work together – councils, NHS, providers and the public.

But also making sure that Health and Wellbeing Boards do not become ‘just another committee’.

The work has already begun.  And I want to thank all of you who are involved making this happen.

NHS number

And while I’m on the subject of integration, can I give a plug for the NHS number? We have long spoken about using people’s NHS number to join up their records across health and social care. So I have a challenge for you.  If your council is not using the NHS number, please find out what needs to happen for it to be adopted.  It will be at the heart of the data exchange necessary for effective integration to be a reality

Priorities

As Health Secretary, I have been very clear about my four key priorities.

•    Giving Britain some of the best survival rates in Europe for the big killer diseases: cancer, stroke, heart, liver and respiratory disease.

•    Building a health and care system where quality of care is as important as quality of treatment.

•    Dramatically improving the care for people living with long-term conditions like diabetes, asthma or arthritis – who currently account for more than half of GP appointments and nearly ¾ of hospital admissions.

•    And transforming our care for people dementia so we become one of the best countries in Europe to grow old.

Let me talk about the last one.

A million people will have dementia by 2020. It already affects one in three over 65s.

But shockingly our system diagnoses less than half the people who have it, even when access to good drugs can help stave off the condition for several years.

There are some great examples of excellent dementia care.

Like Manchester City Council’s Shore Green Extra Care Housing Scheme.  There, they use technology and modern building design to reduce the impact of people’s dementia and memory loss.

Or the Meri Yaadain project in Bradford, raising awareness of dementia among the South Asian community.

Or Hampshire County Council working with businesses and others alongside the Alzheimer’s Society and Andover Mind to help them become more dementia friendly.

Dementia Compact

Earlier this year, we launched a Dementia Care and Support Compact.  An agreement – a commitment – by social care providers to deliver first rate care and support for people with dementia and their families.

In March, when we launched, 10 organisations joined up.  Today, we have 42, covering some eighteen hundred services across the country.

If you’re from a provider that cares for those with dementia – and if you haven’t yet heeded the call – please consider signing up.

That’s not an order.  It’s a heart felt request.  Because by making dementia care a priority, you will doing perhaps the single biggest thing that can transform the care of older people for whom you are responsible.

Just as I am asking the NHS to do, I ask all of you all to look at how you operate, at how you behave.  To be inspired by new ideas and to ask yourselves what more you could do.  And then to make that change happen.

Scandal of poor care

Because the need for change is urgent.

The best dementia care in England is exemplary.  But the worst is nothing short of scandalous.

We’ve all seen the reports – of people with dementia being criminally abused by their care-workers or drugged-up with a chemical cosh just so a care-assistant can get a good night’s sleep.

These may be extreme, isolated events but they do highlight a culture where those with dementia are not getting the dignity and respect they deserve.

The Prime Minister’s Challenge on Dementia sets out an ambitious plan to build a dementia-friendly society.

Yes, to invest in research and better treatment.  But more than that.

•    to end the stigma of dementia.

•    for people to feel comfortable talking to their GP if they think they have symptoms.

•    for people to feel in control of their condition.

•    for people with dementia to lead as near a normal life for as long as they can.

•    for those who care for them to feel supported and confident.

•    In short, for our communities to become dementia-friendly.

If we are to succeed, local authorities must take the lead.

And we will make sure we will give you every possible support.

Dementia friendly environments

So today I can announce that we are making £50 million available to support you and your NHS colleagues to create dementia friendly environments.

Carers tell us time and again that when it comes to hospitals, care homes, or other settings, it’s often small things – whether clear signage, light and airy rooms or good handrails – that make a big difference.  Whilst you could say that this is not a huge sum of money relative to the scale of the challenge, if it helps make some of the small things better it will be transformational.

Conclusion

Finally let me mention the one missing ingredient that will make the difference between success and failure.

Because it isn’t just about money or structures.

Most important of all is leadership.

Dementia friendly communities, better public health outcomes, deep and meaningful integration of NHS and social care services – none of this can happen without leadership.

Your leadership.

You are the ones who will make Health and Wellbeing Boards hot-beds of new ideas.

You are the ones who will work with your colleagues in the NHS to drive change.

You are the ones who will lead the charge on public health.

You are the ones who will ensure that people can lead a full and independent life, supported and cared for with humanity, dignity and respect.

You will make the difference.

I will play my part.  But real success will come from inspired local leadership. And I want to support you every step of the way.

Thank you.

Below is the text of a speech made by the Secretary of State for Culture, Media and Sport, Jeremy Hunt, at Telford Sport College Conference on 9th February 2011.

Introduction

I must admit to being somewhat terrified standing before you.

I went to a sport-mad school. Sport was compulsory. And I was absolutely useless at it.

I never made a first XI or a first XV. In fact like many people who showed little promise, I was banished to the cross-country running team.

And then something strange happened.

We had an annual whole school cross-country race, divided into a senior and junior course. My birthday is in November and all my classmates with earlier birthdays were promoted to the senior school race, with just me left behind.

And to the total astonishment of everyone in the school, including me, I won the junior school race.

That was the high point of my sporting career.

But looking back on it, it was also a defining moment of my school career. Because the experience of unexpectedly winning a race transformed my confidence and in many ways turned me into a different person.

For better or worse, I doubt I would be standing here today had I not won that race.

Paying tribute

So let me start by saying this: thanks to your work, thousands of young people up and down the country are having similar experiences.

On their behalf I want to thank each and every one of you.

There was yet another reminder of the power of sport a few weeks ago, when Newsround asked young people to nominate their favourite role models and post them online.

You can probably guess some of the names that came up – Cheryl Cole, Justin Bieber, Emma Watson – but there were two things that I found striking.

First, the number of children who chose sporting role models – people like David Beckham, Rebecca Adlington, and Tom Daley – and who talked about how much they admired them for their dedication and hard work.

Second, the number of children who nominated not celebrities but the people who support and inspire them every day: their teachers, headteachers, and coaches – exactly those roles that many of you perform or inspire others to perform.

Embedding progress

But in thanking you, I also want to recognise that the last few months have been extremely challenging.

I don’t want to rake over the coals of the debate we had in the autumn. Suffice it to say it has been an incredibly testing period across the whole of government as we seek to put our finances on a sustainable footing.

I want to thank Sue Campbell and Steve Grainger in particular for their powerful advocacy of the work you do.

Their enthusiasm and passion for school sport has been vital in helping us to create a structure that will retain and build on the best of what we have now.

Not without change. Not without improvement. Not without having to live with fewer resources.

But – yes please – with the extraordinary commitment and dedication so many of you have shown over many years towards getting more children and young people to play competitive sport.

The package we have in place will put £47 million from this year’s sport budget towards helping you to embed the best elements of your work and secure staff roles to the end of the summer term.

Even at a moment when he is actively looking to slim down other compulsory obligations on schools, Michael Gove has confirmed that PE will remain a core part of the National Curriculum.

And over a transitional period of the next two academic years, £65 million of funding from his department will allow secondary schools to release a PE teacher for one day a week – to help organise competitive sport in primary schools and foster good practice.

Meanwhile, the Department of Health will provide up to £6.4 million to secure the future of Change4Life Sports Clubs in secondary schools.

And to extend this model into primary schools – creating further opportunities for those children who are the least active.

At the same time, funding from my Department and from the Lottery will allow the establishment of a new nationwide School Games – opening up massive new opportunities for thousands of young people to take part in competitive sport.

And now there is new funding available – from the Department of Health and Sport England – which will pay for hundreds of new School Games Organisers working three days a week – or more if schools view this as a priority and are able to increase that funding.

Their role will be to help as many schools as possible sign up to the School Games.

They’ll help you to set up intra- and inter-school competitions – making sure that the links are there to Change4Life clubs and sports clubs, that there is a range of sports that all can enjoy, and that those children turned off by sport are turned on to it.

I hope and expect that many current competition and partnership development managers will consider taking on these roles.

And because you need to have clarity on this as soon as possible, we will announce more details on the funding mechanisms for these posts in the very near future.

Delivering broader benefits

Why do we value school sport? Let me give you my top five reasons.

Firstly because regularly taking part in physical activity brings huge benefits in terms of health and wellbeing.

Secondly because with more than 1 in 7 children classed as obese, sport is a vital part of the drive against childhood obesity.

Thirdly because participation in sport has been proven to reduce the chances that at-risk teenagers will commit anti-social behaviour.

Fourthly because organised physical activity helps to boost concentration and feeds through directly into improved academic performance.

And last but not least because competitive sport in particular prepares people for life in a way that little else comes close to.

It helps young people develop confidence, the inner confidence that comes from stretching yourself to the limit and achieving what you never thought possible.

It teaches you teamwork and the notion of an identity that extends beyond ourselves as individuals.

And it teaches you to win with grace, yes, but also to lose with dignity. And in today’s highly competitive world, learning to lose is equally as important as learning to win.

Shakespeare said: “Sweet are the uses of adversity.” But I never forget Churchill who said that “success is the ability to go from failure to failure without losing your enthusiasm”.

Quite a useful saying for politicians to memorise…

The ‘School Games’

It was the founder of the modern Olympics, Pierre de Coubertin, who said: “The important thing in life is not the victory but the contest; the essential thing is not to have won but to have fought well”.

And it will be our new School Games tournament – inspired by the London 2012 Olympics and Paralympics – that will be at the heart of our new approach to competitive sport.

Of course, we are not starting from scratch. Thanks to you, there are already plenty of great examples of strong, well-developed competitions for children and young people.

Not least the UK School Games – where I enjoyed meeting many of you in Gateshead last year.

We want to build on this success rather than replicate it, and to do so in a way that allows every child the chance to take part, compete, and discover their hidden talents.

We want to do it with a new tournament that will help drive up interest in competitive sport right where it matters most – within schools themselves.

And we want to set this up in time for the Olympic and Paralympic Games as a key part of the sporting legacy they will leave behind.

Because this is not about a one-off event in 2012, but about what happens each and every year from now on.

Starting this academic year, all schools will have the chance to hold an annual School Games Day – the culmination of a broad-ranging programme of intra-school competition.

We expect around 500 schools to pilot a School Games Day this year, with a national roll-out in time for 2012.

And our goal is that these will be different – and better – than current school sports days.

Indeed our ambitions for the School Games are so high that some schools may not initially be willing to make the commitment to be part of them.

But let me give you three specific ways in which we want them to be a transformational shift:

Firstly we want each School Games Day not to be a “one off” event, but the finals of a broader programme of competitive intra-school sport taking place throughout the school year.

Secondly, drawing on the inspiration of the 2012 Paralympics, we want to make sure that this is a scheme that will offer disabled children as many opportunities as non-disabled children.

And thirdly, drawing on the nationwide festival of culture that will accompany London 2012, we want every School Games to have a cultural element.

Opening and closing ceremonies, for example, that could involve the school band or orchestra.

At the next level – what we call Level 2 – there will be a rolling programme of leagues and tournaments promoting more competition between schools at a town or district level.

As a former Shadow Minister for Disabled People, I am very proud of the fact that, for many areas, this will be the first time there has been an inter-school Paralympic-style competition in their area.

I had a chance to discuss this with some of you last night, and I was enormously impressed by your commitment to seizing this opportunity to take a huge step forward for the disability agenda.

From there, the most successful children and young people will progress to Level 3:

Up to 60 new, county or city-level ‘Festivals of Sport’ that will showcase the best of local competitive sport in the inter-school finals.

We will be piloting this in nine regions this summer: London, Manchester, and Lincolnshire, North Yorkshire, Cornwall and the Black Country, Hertfordshire, Kent and Tyne and Wear.

Finally – at level 4 – the most talented young sports people will have the chance to represent their schools in a high-profile, national event.

In the long term, this event will take place in September.

But next year we want to offer these young sports people the chance to compete in the brand new Olympic Park – even ahead of the athletes themselves.

That’s why the first national final will take place in May – precisely the moment when we can give your efforts the highest profile in the run up to the opening ceremony on July 27th.

By doing this we can create a direct link between the achievements of our most promising young athletes at the School Games and the achievements of Team GB in the Olympics and Paralympics.

And use their example to inspire all schoolchildren with the excitement and benefits of competitive sport.

I look forward to working together to create a fantastic legacy for young people through the School Games.