Hunt Jeremy red tieJeremy Hunt MP is Secretary of State for Health. Follow Jeremy on Twitter.

Anyone who
has been to an A&E department in recent weeks will know that they are under
pressure. A million more people a year are going through the doors compared
with Labour’s last year in office.

Some of the root causes stem from decisions
we inherited, like the changes to the GP contract in 2004 which led to a decline
in the quality and availability of out of hours care. Falling ill at evenings
or weekends shouldn’t necessarily mean a trip to A&E, but in too many cases
it does, reflecting many people’s lack of confidence in their local out of
hours services.

But it is not just about the number of patients
going to A&E – the cases are often more complex too. This is particularly
true for frail older patients with long term conditions like dementia. A fall
at home might lead to a hospital admission. But because of the barriers between
hospitals and social care, arranging the discharge of an elderly patient can be
a bureaucratic nightmare, causing distress for the patient and adding to the
pressures in hospitals.

We have taken a big step forward by giving
more power to doctors and nurses through the new Clinical Commissioning Groups.
The managers who used to hold the purse strings rarely came into contact with
patients. But clinicians do – they know what needs to change and now they have
the money and authority to do it.
But this is not just about systems and
structures, it is also about attitudes towards the frail elderly and how they
are treated in hospital. The Francis Report into the Mid Staffs scandal
highlighted how important it is that the nurses on the wards and in our communities,
the people who care for patients day in day out, have the right values and
behaviours as well as the right training and qualifications.

Modern nursing is a highly skilled
profession.  It is right that nurses are
trained to degree level. But healthcare is not just about competence, it is
about compassion too.  Nursing is a difficult job and I am full of
admiration for nurses and the work they do often under intense pressure across
the NHS.

But with evidence that more than a
quarter of nursing students drop out of some courses before qualifying, it must
be right that we do all we can to recruit the right people into nursing, and
make sure they gain experience of the fundamentals of compassionate care at the
start of their training.

That’s why we are making changes to
nurse training, including the requirement that student nurses spend up to a
year working on the frontline as a prerequisite for receiving degree funding. It’s true that some, including the leadership
of the RCN, don’t like the idea.  And
Labour won't support it because they are in hock to the unions and unable to
speak up for patients.  But I have found
strong support among the many nurses I have spoken with recently.

Despite 13 years in power, Labour ducked the
long term challenge of improving care for our ageing population. Instead they
created a targets at any cost culture in the NHS which led to appalling cases
like Mid Staffs. It has fallen to this Government to do things differently.