Across departments, this Government continues to grasp and confront the long term challenges. Nowhere are these more acute than in healthcare, which has to face not just constrained finances but the massive challenge of an ageing society. Last week, I set out how rediscovering the traditional role of the family doctor would be critical if we are to look after our growing elderly population with dignity and respect.
Much of my recent focus has been on hospital care, addressing the terrible failures identified by the Francis report on Mid Staffs hospital, where Labour's targets-at-any-cost culture led to appalling neglect and cruelty towards vulnerable patients. The new Chief Inspector of Hospitals, starting later this year, will ensure through strict, independent and public Ofsted-style ratings that no hospital can be judged as excellent unless it offers the highest standards of compassionate care.
But improving primary and community care, from which so much else flows, is even more important. Only by restoring the role of the family doctor, clinically accountable for the vulnerable older people on their lists, will we ensure that people are looked after better in their homes rather than constantly having to be rushed to hospital when things go wrong. When that happens, we not only place them in a bewildering and confusing environment, we also place huge pressure on A & E departments.
As I know from the time I have spent in local practices up and down the country, proactive case management is a role many GPs already perform and all aspire to. Tragically, Labour's 2004 changes to the GP contract made it much harder, removing responsibility for out-of-hours care and replacing personal accountability for patients with a series of boxes to tick and process targets to meet. GPs are working just as hard, in fairness, but are often left unable to focus on what matters most – making sure all their most needy patients have proper, integrated care and support.
In future, I want all vulnerable older patients to have a named clinician accountable for all their care outside hospital in the same way that they have a named consultant responsible for them inside hospital. A frail elderly patient should have a GP who knows them, understands their needs, and is responsible for follow up and support after they leave hospital. GPs won't personally deliver every element of care, but they should surely be the person with whom the buck stops. And indeed that kind of trust and responsibility is precisely what motivated them to go into General Practice in the first place.
To be sure that GP surgeries are caring for patients in this way, we will be appointing a Chief Inspector of General Practice to help drive up standards through clear, open assessments of each GP practice. This will also involve working together to make sure that primary care, hospitals and care homes are all playing their part to provide a seamless, joined up and integrated service for people with complex needs.
With energy and focus, working alongside GPs and others in the field, this Government can lay the foundations for a revolution in primary care – grounded in the traditional values of the NHS, but embracing the transformative power of modern technology and responding to patient demands. Whether in education, welfare or health, we are showing the power of a reforming vision grounded in a belief in the importance of personal responsibility.