Yesterday we took the advice of senior NHS leaders and announced that we are moving ahead with the introduction of new contracts for junior doctors from this August.  We have had a difficult dispute with the doctors union over these contracts.  Despite negotiating for nearly four years, guaranteeing that all doctors’ pay will either increase or be maintained, and offering a series of compromises to agree a negotiated solution, the BMA refused to budge at all on their insistence that they get premium Saturday pay rates higher than other NHS staff and other industries.  In that scenario, our only options were to back down on reform in the face of union opposition, or press ahead with action to improve the safety of weekend services for patients.

But that difficult decision was just one part of a much wider reform process of transforming the NHS so that we reduce unnecessary deaths and make sure patients come first every time. This consists, firstly, of our wider programme to reform services across the NHS so that patients can be guaranteed the same standards at the weekends as during the week.  Junior doctor contract reform to improve medical cover at weekends is just one part of that: we also have to reform the consultants’ contract, improve other services such as pharmacy, physiotherapy and diagnostic tests so that people can get all the treatment they need at weekends, and increase GP access seven days a week so that people feel they have an alternative to turning up at hospital.

Secondly, we are overhauling our approach to failure. After the scandal of Mid Staffs, Morecambe Bay and countless other hospitals where patients suffered because high death rates went unchecked for years under the last Labour Government, we have learnt that we need to call a spade a spade, and tackle failure quickly and decisively wherever it exists. So we have introduced straightforward, Ofsted-style ratings for all NHS organisations through a tough new inspection regime. As a result, 27 hospitals – around 20 per cent of all trusts – have been put into special measures. Between them they have hired over 5000 extra doctors and nurses, and an independent study suggests that up to 450 lives could have been saved to date as a result of this process – with 11 already exiting special measures and dramatic improvements across the board.  We have also introduced a whole raft of new transparency data, such as nurse to patient ratios on every ward, patient feedback on their NHS experience, and surgeons’ success rates.

Thirdly, we are introducing a new measure of avoidable mortality in every hospital across England.  This will be a world first, and see hospitals publish transparently for the first time the number of deaths that could have been avoided in their organisation every year – crucially with a plan to improve. We are also setting up a powerful new Healthcare Accident Investigation Branch, similar to the highly successful Airline Accident Investigation Branch, which will conduct rapid, no-blame investigations into preventable tragedies like stillbirths or baby deaths, and make sure we learn all the lessons so that we can really say ‘never again’. Taken together, these innovations should transform the NHS’ approach to avoidable deaths, and save many lives.

Finally, we are transforming the fundamental power balance within our health service so that patients are always in the driving seat of everything we do.  Within the next five years your electronic health records will be available wherever you turn up in the NHS: whether it’s a busy GP surgery near your place of work, the NHS111 service, or an emergency hospital visit when you’re far away from home. Soon, you will only have to tell your story once, and your allergies, personal history, and list of medications will – with your permission – be available to anyone who treats you.  You will be able to access your records, share them, and mark preferences on them. We are also investing £4.2 billion in new technology to help patients benefit from the digital revolution that has transformed so many other walks of life. There are  thousands of apps available and under development which will transform our approach to our own health: monitoring our heart rate, blood pressure and other vital signs, and helping us to predict and prevent rather than simply treat illness.

We want the NHS to be the safest, highest quality healthcare system in the world. With record funding in the spending review we can now deliver that – but with money there needs to be reform, however difficult the choices sometimes are.