David Cameron was in Manchester this afternoon to give his first big speech of the year, on the NHS. The NHS Confederation has already welcomed it. He then went on to welcome a LibDem defector as the first Conservative councillor in Manchester City Council since 1996.

Click here for a pdf of the full speech, or see further below for our compilation of the most interesting points.

Samuel was there and, after saying it was a very good speech, asked Cameron how the decentralisation agenda would square with some of the local Conservative campaigns against the closure of large hospitals. Cameron, who had explained in the speech how the NHS of old had come to be centred on a system of large hospitals, replied that decisions shouldn’t be handed down from on high. Power should be given to GPs who understand what makes the system tick, he said, but he didn’t agree with some Labourites that the days of the District General Hospital were numbered. He also said that as he had now had praise from ConservativeHome there was no need to carry on with the press conference. He did, however, continue with several more questions. We think he was probably just being polite by sticking around a little while longer.

Sefton Central candidate Debi Jones asked what a Conservative government would do to help hospices. Cameron said it was a great shame that many of them don’t get any state funding, and Andrew Lansley said that money would follow the patient if they were getting treatment that the NHS would provide. A minister responsible for the Methodist churches and social action projects in the notorious Wythenshawe council estate spoke about all the things they do for the community, but also about how hard it was ("we almost have to deny we are churches") to partner with government bodies like PCTs. Cameron noted that he knew Wythenshawe well from some famous photos that may or may not have included someone in a hooded top. He was very sympathetic, saying that faith-based action should not be discriminated against in any way, and got applause with the joke: "take me to a humanist soup kitchen".

The issue of mixed sex wards was also raised, referring to the recent case of patient-to-patient sexual abuse in Manchester. Andrew Lansley said he had done some FOIs a few months ago that revealed that 30% of beds were in mixed wards, including 11% of planned admissions. He also quoted Tony Blair in 1996 saying that "it can’t be beyond the wit of government to end mixed sex wards"! There were no press questions, perhaps they didn’t fancy the trek up north so soon after New Year’s Eve! Even so, Cameron said it was one of his New Year’s resolutions to be nice to them – "let’s see how long that lasts!".

We’ve made an at-a-glance version of the speech by splicing it up into all the key verbatim phrases, please click continue to read it…

  • 60 years ago, in 1948, one of the great British institutions came into being… The National Health Service… Andrew Lansley’s father was working in the pathology lab at Highland Hospital in North London… I’d like to take this opportunity to extend an invitation to a celebration this summer, for anyone who was working in the health service in 1948.
  • I believe that Conservatives should never attack an institution… which embodies, in its very bricks and mortar, in its people, in its services, something which is great about Britain…. That something is equity, the founding value of the NHS.
  • A system which strives for equal access to healthcare is not a dream of socialism. It is not a hideous Marxist intrusion into the pure beauty of the free market. It is an institution I acknowledge and respect as a Conservative
  • I’ve said before that in their drive to ‘modernise’ the NHS, Labour haven’t improved it, so much as ripped out its heart and installed a malfunctioning computer instead.
  • … they fall for the sales patter of the management consultants and the big IT firms… The NHS is suffering from the hopeless gullibility of Labour ministers.
  • George Osborne and I have committed ourselves to delivering rising resources for public services – using the proceeds of growth to fund investment. That means more money for the NHS.
  • At the moment the NHS has no charter, no articles of incorporation, no governing document at all… Andrew Lansley published a White Paper proposing an NHS Constitution… Yesterday Gordon Brown proposed the same idea.
  • In 1948… The greatest threats to health were still the big epidemics: diphtheria, whooping cough, measles… defeated by the science of immunology. And we’ve taken huge steps forward in other fields. Drugs in psychiatry. Anaesthesia and antibiotics in surgery. Steroids. Organ transplants. IVF.
  • … we are on the cusp of a further evolution…. genetics, nanotechnology and robotics. It’s as if, having scratched away using open-cast mining for thousands of generations, we’ve suddenly discovered the far richer seams that lie deep beneath the surface.
  • We are realising just how central personal behaviour is to our health and wellbeing… we face new public health threats which were totally unfamiliar to the days when the NHS was founded: obesity, for instance, or widespread drug abuse and addiction.
  • The body remains subject to the will of its inhabitant… We must not put our trust in science to do what we can only do for ourselves – stay in shape by taking exercise, avoiding toxins, eating and drinking in moderation. As patients we need to be active, not passive.
  • Gordon Brown’s blundering into this subject at the start of the year was so depressing. This is the worst sort of government-by-gimmick, policy-by-press-briefing, and initiative-by-insinuation that he promised to get away from… when it comes to short-term sound-bite and tricksy politics, Brown is worse than Blair.
  • … in the 21st century healthcare is for life, not just for emergencies… doctors are now a regular part of life: a constant presence, not a remote authority. They deliver, not occasional intrusive treatment, but lifelong care… Rather than the doctor being a benevolent dictator he’s more a specialist adviser…
  • Instead of the national mainframe, we are entering the age of the local network… The experiences of patients can be distributed horizontally, from patient to patient, through online networks, rather than vertically as before through doctors and hospitals… I’ve done it myself.  If your child is ill, as soon as you hear the name of their condition, you get home and Google it on the internet.
  • … the option of gaining or losing patients is the most effective spur to improvement on the part of doctors, hospitals and other care providers. So we will give people a choice of GP. We will allow patients to choose, in consultation with their GP, where they get their secondary care.
  • It should be a basic rule of social policy that you don’t pay for what you don’t want more of. Money should attend success, not failure. So, for instance, I don’t think hospitals should be paid – or paid in full – for a treatment which leaves the patient with a hospital-acquired infection like MRSA. This is a means of hard-wiring infection control into the system.
  • Rather than a top-down system of targets which encourages ‘throughput’ above all else, we propose a bottom-up system which prioritises quality as well as quantity. This will make managers concentrate on the effectiveness, not just the volume of treatment.
  • … we want to explore new measures of patient-reported outcomes, which enables money to follow excellence in terms of the actual experience of people who use the NHS. But let me emphasise that this must never be at the expense of the professional ethos, the Hippocratic vocation of doctors.
  • … over the last five years £2 billion has been spent on pursuing targets – money that was supposed to be used to improve patient outcomes. That’s why a Conservative Government will scrap all centrally-imposed process targets, and enable the NHS to focus instead on outcomes… we’ll stop the health department endlessly measuring processes, and concentrate on outcomes – the ‘what’ not the ‘how’.
  • … the Conservative Party has an historic opportunity: to replace Labour as the party of the NHS. That’s quite an aspiration – but I believe it is our duty to live up to it. To be the party of the NHS is an honour that must be earned.

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