• 2 weeks ago
Health Secretary Wes Streeting gives reassurance over the state of the National Health Service during a speech at the NHS Providers annual conference in Liverpool. He says, “the NHS is broken but not beaten. Every day there are outstanding episodes of care being delivered by dedicated people working with some of the best science in the world.”

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00:00When it comes to the condition of the NHS today, the Darzi diagnosis is clear.
00:05The NHS has not been able to meet its most important promises to patients
00:09since 2015. A&E waits are causing thousands of avoidable deaths, 50 years
00:15of progress on cardiovascular disease has gone into reverse, 345,000 people are
00:20waiting more than a year for mental health treatment, that's more than the
00:24entire population of Leicester. And as the performance of the NHS has
00:28deteriorated, so has the health of the nation. Adults are falling into ill
00:33health earlier in life and children are less healthy today than a decade ago.
00:38ARA's conclusion was that the state of the health service is heartbreaking and
00:43I'm yet to hear anyone seriously contest this analysis which was entirely based
00:48on the data. Of course that didn't mean my conservative predecessor didn't try
00:53but she was left resorting to pointing out Lord Darzi was shock horror, a Labour
00:59minister in an attempt to discredit the author and his work, conveniently
01:03forgetting, impolitely I might add forgetting, he did work for conservative
01:07led governments too, not to mention three decades of experience as one of our
01:11country's top surgeons. It's not just the Conservatives, there are others who
01:15argue that pointing out the state of the service is demoralizing for staff and
01:20risks deterring patients from accessing care. Well in my experience, not just as
01:26a patient, but in the last three years talking to frontline staff and NHS
01:30leaders, most people appreciate the honesty and recognise that the biggest
01:35barrier to patients accessing care is long waiting times. And as I've argued
01:39before, a culture that puts sparing political blushes or protecting the
01:44reputation of the NHS above protecting the interests of patients is one that
01:49stifles inconvenient truths being spoken to power, that silences
01:53whistleblowers and that ultimately puts patient safety at risk. Now in the last
01:58few years I've come to know many of you in this room and the last four months
02:03I've toured the country talking to leaders and frontline staff, so I think I
02:08know you well enough to know that you share my view that honesty is the best
02:11policy, that you agree with the Darzi diagnosis and that you share my optimism
02:16that the NHS is broken but not beaten. Every day there are outstanding episodes
02:22of care being delivered by dedicated people working with some of the best
02:26science in the world. As Arrow put it, the NHS is in critical condition but its
02:31vital signs are strong. Our collective challenge is to take the NHS from the
02:36worst crisis in its history, put it back on its feet and make it fit for the
02:41future. The budget was important, the Chancellor gave us the investment we
02:46need to arrest the decline, begin fixing the foundations and start turning the
02:51service around. The NHS was the standout winner, we're delivering the largest
02:56health capital budget since Labour was last in power and the biggest cash
03:01uplift in day-to-day spending of any government department. There have been
03:07two predictable reactions to this. The first says that the NHS is getting too
03:13much money, that this is a black hole that consumes ever-increasing amounts of
03:17taxpayers cash and that the NHS will complain that it's never enough. So right
03:23on cue some NHS leaders popped up in the newspapers, aided and abetted by the
03:28health think tanks to complain that this isn't enough. Well one of the luxuries of
03:32leading a think tank is that you don't have to engage with the choices and
03:36trade-offs that government does. The Chancellor had to raise more than 40
03:42billion pounds to plug not just the 22 billion pounds hole we walked into in
03:46July but also to fix the foundations so that our economy and our public services
03:51can recover from years of mismanaged decline. When the Chancellor announced
03:57the settlement for my department she joked about how unpopular it would make
04:01me around the cabinet table and the truth is at the cabinet meeting in which
04:05she set out the contents of her budget I did feel uncomfortable. Not because I
04:10was worried about the opinions of the people in the room because they support
04:13the NHS and the investment but because I am worried about the jobs they have to
04:19do. As I look around the cabinet table I see a Justice Secretary who inherited
04:25overflowing prisons, a Work and Pension Secretary who inherited more than 4
04:29million children living in poverty, a Defence Secretary charged with securing
04:33our nation at a time when there is a ground war in Europe as well as constant
04:38and emerging threats of cyber warfare in a more dangerous and unpredictable world.
04:42So every penny of extra investment that goes into the NHS was a penny that
04:48didn't go towards child poverty reduction or extra prison places or
04:52bolstering our armed forces and more than that every penny that's spent on
04:56treating sickness is a penny that doesn't go on preventing illness and you
05:01know as well as I do that around only 20% of the nation's health is affected
05:05by the NHS. The rest is dictated by the poverty that we live in, the damp on our
05:11walls, the food we eat, the air we breathe and so on. So you can't pretend to care
05:16about the social determinants of ill health if you only ever ask for more
05:20money for the NHS. So then the argument goes we must do both and of course that's
05:26right but the choices and trade-offs aren't just about spending money but
05:30raising it. The tax burden in this country is at record levels. We chose
05:35rightly in my view not to hit working people in their pay slips. The extra
05:41investment in the NHS as well as other public services meant asking employers
05:45and the wealthiest to pay more and you'll have seen in the past few weeks
05:49that there are those who disagree with the Chancellor's decisions and that's
05:53the nature of tough choices. We stand by our decision to prioritise the health
05:58service. Healthy businesses depend on a healthy workforce and a strong economy
06:02depends on a strong NHS. But if you want to know where the average taxpayer
06:06stands on NHS spending it's quite straightforward. They welcome the
06:11investment but they worry it won't be spent wisely. They agree with a central
06:17argument we made at the last general election that investment must be matched
06:21with reform. We entered government with the public finances and the public
06:26services in a far worse state than they were when Labour last went from
06:31opposition to government. Tight fiscal constraints mean that reform needs to do
06:36a lot more heavy lifting. But even if we'd inherited the strong economy and
06:41public services we saw at the height of new Labour we would still need to reform
06:46our public services because we're standing in the foothills of a
06:50scientific and technological revolution that is changing the world around us.
06:53Citizens are used to choice, voice, ease and convenience at the touch of a button.
06:58We expect everything faster. Unless our public services are modernised to meet
07:03the needs of our people they'll become increasingly redundant and irrelevant to
07:07people's lives, unable to meet their needs. The failure to reform the state to
07:11meet the needs of the people is one of the fertilisers of populism we see
07:15across liberal democracies. The other is a failure to ease the pain in their
07:21pockets. So we need to address both with NHS reform that delivers better
07:26outcomes for patients and better value for taxpayers' money. By now you'll be
07:31familiar with the three big shifts that will underpin our 10-year plan for
07:35health from hospital to community, from analogue to digital, from sickness to
07:39prevention. These shifts are not radical new ideas but delivering them truly would
07:45be. They're necessary to tackle the challenges of our growing ageing society,
07:50rising levels of chronic disease and rising cost pressures, as well as to
07:55seize the opportunities of a scientific revolution in which AI, machine learning,
08:00genomics and data offer us the chance to transform our system of healthcare to
08:05one that can not only diagnose earlier and more accurately and treat more
08:09quickly and effectively but also predict and prevent illness. But we're not waiting
08:15for the 10-year plan in May to get cracking with reform. Over the last few
08:20years I've regularly heard the criticism of the top-down nature of the
08:24NHS. It can be a difficult criticism for those at the top to hear. But for the
08:29last four months I found myself at the top of the system, at the peak of the
08:34mountain of accountability.

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