Jeremy Hunt MP is the Secretary of State for Health
The foundation of the NHS in 1948 was the first time that healthcare free at the point of use was made available anywhere in the world. It gave us all certainty about getting care when we need it. Patients consistently say that timely access to treatment is one of the most important things they want from our NHS.
So keeping waiting times low is a key objective for this government. Labour too made welcome progress in bringing down the number of people waiting too long for operations.
But we must recognise that the best healthcare systems do more than hit targets – for waiting times or otherwise. They prioritise patient safety and compassionate care. In short, the best healthcare systems treat patients as people, not statistics. Today, I’m announcing new changes to help fulfil that ambition for the NHS.
In 2004, Labour introduced a target that said patients should not wait more than 18 weeks after referral by a doctor to get their treatment or operation. Now, every month, more than a million patients start specialist treatment. We no longer read about the scandal of people routinely dying on waiting lists because access to the life-saving treatment they need comes too late.
We’ve ring-fenced the NHS budget, but pouring extra cash into the system to meet this rising demand hasn’t been an option during this Parliament – because we are taking tough decisions to deal with Labour’s deficit. So how are we delivering 850,000 extra operations every year? By driving efficiencies, cutting bureaucracy and removing 19,000 managerial posts. We’ve saved nearly £20 billion already, all of which is ploughed directly back into the frontline.
Labour bitterly opposed that decision to cut bureaucracy and waste. And here’s another difference between this government and Labour. We understand that targets can’t be the be-all and end-all. Where they are, patient care suffers.
Under overwhelming political pressure to hit the 18 week target, from 2007 hospitals had an incentive to treat patients who had not yet missed the target over those who had – because that helped their performance statistics. So managers understandably gamed Labour’s system, meeting the target but leaving patients to suffer the consequences.
This government is changing that invidious culture. We’ve stripped out targets that don’t work, and are ensuring others are implemented more humanely and sensibly.
When we came to office in 2010, there were 18,500 people who had been waiting over a year for treatment. None of those people count towards the 18 week standard, but we have nonetheless reduced the number to just over 550.
But even this is too many. Today I am announcing a new ambition for the NHS: I want the number of people waiting more than a year for their operation to be as close to zero as possible. Unless there are good clinical reasons, or a patient makes a personal decision to delay, no-one should have to wait more than a year for treatment.
I also want the NHS to put particular focus on anyone who has been waiting more than 18 weeks, and have commissioned 100,000 additional treatments over the summer.
This focus on long waiters may mean we undershoot the 18 week target for a period, although we will return to meeting it before the end of the year. But this Government is determined to do the right thing by patients – and we aren’t prepared to meet a target by neglecting those who have been waiting the longest.
Targets matter, but they should never be the only thing that matters.
Robert Francis hit the nail on the head in his report on Mid Staffs when he said “targets were often given priority without considering the impact on the quality of care”. Still, Labour haven’t apologised for these policy failures that led to cruelty becoming somehow normal in parts of the NHS.
Even before Mid Staffs, the Healthcare Commission attributed one of the causes of over 30 C-diff deaths at Buckinghamshire NHS Trust as an over-focusing by the Trust on meeting government targets.
Which is why last year we introduced a new inspection regime for hospitals that looks at performance more broadly than just targets – with the expert inspectors that Labour inexplicably abolished.
Across the NHS we now have more than 6,300 additional nurses in our wards than in 2010. Not because of a mandatory staffing target – but because the NHS is responding to the lessons of the Francis Report into Mid Staffs.
There and elsewhere, the desire to hit Labour’s targets at the expense of good care was an appalling betrayal of patients by the last government.
None of this is ever mentioned by the Shadow Health Secretary, Andy Burnham. His last speech was about privatisation – an exercise in political posturing, because use of the private sector actually increased more under Labour than under the Coalition. And sadly, it’s yet another example of how Labour put politics before patients. In the ambition to end the scandal of patients being forced to wait for care, I am clear that this government will always put patients first.