Jeremy Hunt MP is the Secretary of State for Health.
Our party has a proud tradition of supporting the NHS. Conservatives have been responsible for the NHS for more of its history than any other political party. In fact, although a Labour government set up the NHS in 1948, it was a Conservative health Minister, Sir Henry Willink, who first presented a White Paper to the House of Commons in 1944 arguing for the establishment of a National Health Service. Still today, we are determined to be the true party of the NHS because we are the ones with the courage and vision to make the changes that will sustain its values in a changing world.
That vision is for a fundamental shift in power from a bureaucratic system where power sits in the hands of managers and politicians, to a democratic system where the most powerful people are the one million patients who use the NHS every 36 hours. The truth is that decades of building processes around system targets and objectives has too often de-humanised what should be the most human organization we have. It’s profoundly shocking that 800 people die unnecessarily every month as a result of sub-standard care or error in hospitals in 21st century Britain. In the words of Steve Hilton, we need our health service to become ‘more human.’
As with any problem, the first step is an honest diagnosis through sometimes painful transparency. That’s why I introduced straightforward, Ofsted-style ratings for hospitals, care homes and GP surgeries through a tough new inspection regime. As a result, 21 Trusts – 15 per cent of the total – have been put into special measures. Between them they hired over 1000 extra doctors and nurses, and an independent study suggests up to 450 lives could have been saved as a result of this process – with seven already exiting special measures and dramatic improvements across the board. We have also become the first country in the world to publish surgeons’ success rates.
Nigel Lawson famously described the NHS as a national religion. The problem with religions is that when you question the prevailing orthodoxy, you can end up facing the Spanish Inquisition. NHS orthodoxy was that criticism should not be made public because it would ‘damage morale’. We now see that was wrong. Our transparency revolution is becoming a ‘Reformation moment’ for the NHS, as the public appreciate that a system with the confidence to be honest about failings is a system that does something to put them right.
Part of that honesty is facing up to the fact that 6000 people die every year due to the lack of seven-day care. No one could possibly say that this was a system built around the needs of patients – and yet when I pointed this out to the BMA they told me to ‘get real.’ My message to the BMA is that there are 6000 reasons why they, not I, need to get real, and today I am announcing that we will reform the consultant contract to remove the opt-out from weekend working for new starters.
Just as Labour’s 2004 GP contract gave family doctors significant salary increases at the same time as allowing them to opt out of out-of-hours care, under Labour consultant pay increased by nearly 50 per cent between 2001 and 2005 at the same time as they introduced an opt-out of evening and weekend work. That decision to cave to the unions led directly to a 5 day culture that has had catastrophic consequences for patients: we are putting this right as a moral and clinical priority.
But our vision is not just about improving the status quo. A mere 2,500 years after Hippocrates said ‘the patient is the best doctor’, we have the chance to make NHS patients the most powerful patients in the world.
Within the next five years our electronic health records will be available seamlessly in every care setting. You will be able to access them, share them, and mark preferences on them. New medical devices will mean an ambulance arrives to pick us up not after a heart attack but before it – as it receives a signal sent from a mobile phone. Heart rates and blood pressure will no longer be simply a matter for the doctor – patients will know them and monitor them too. With 40,000 health apps now on iTunes, these changes are coming sooner than most people realise, and it is no exaggeration to say that the impact of these innovations will be as profound for humanity in the next decade as the internet has been in the last.
The future is here, and the NHS must grab the opportunity. Real patient power is not just about knowledge – it is being able to act on that knowledge so that those providing care feel real consequences. So I am also announcing today that from next year, all GPs will be asked to tell patients not just which hospitals they can be referred to, but the relevant CQC rating and waiting times as well. Because those ratings now include patient experience, safety and quality of care, patients will for the first time be able to make a truly informed choice about which local service is best for them.
This transition to patient power will dominate healthcare for the next 25 years. We cannot resist the democratisation of healthcare any more than we can resist democracy itself. But we can choose whether we want the NHS to be the leader of the pack, turning heads across the globe, or a laggard always struggling to embrace innovation adopted earlier elsewhere. This Government’s vision is to have the world’s most transparent health system supporting the world’s most powerful patients: it’s time to get real to the opportunity and rush to embrace it.