This week I gave a speech to the NHS Providers Conference in Liverpool. NHS Providers represents NHS hospital, mental health, community and ambulance services so it was fantastic to be able to discuss the future of our health service with those tasked with running it. You can read my full speech here:
Thank you so much for inviting me to be with you today.
In the wake of the latest NHS Providers survey warning that fewer than half of trusts now expect to meet key end of year elective recovery and cancer targets, Saffron warned that “alarm bells should be ringing across Whitehall”.
I fear it will be your telephones that will be ringing with Steve Barclay at the other end of the line, demanding to know what you’re doing about it.
I must admit, I found accounts of the Secretary of State’s phone calls over the summer baffling and infuriating.
Baffling, because it doesn’t strike me as a particularly constructive way to work with your partners.
Infuriating, because I think it’s a bit rich for the government to lecture others on the responsibility of leadership given the chaos we’ve seen in recent months and the fact that so many of the problems confronting the NHS have been either created in, or exacerbated by, government.
No wonder the theme of your conference is resilience.
So perhaps the most important message for me to leave you with today is that a Labour government will want to work with you, in partnership, because I genuinely think it is the only way we will be able to grip the biggest crisis in the history of the NHS at the same time as taking the right long-term decisions to make the NHS fit for the future.
I love the NHS. Like the overwhelming majority of people in our country, I am proud of the fact that it is publicly funded and free at the point of need. When I went through my own experience with kidney cancer last year, the one thing I didn’t have to worry about was the bill.
It is because I love the NHS, and want to defend that equitable principle at the heart of our health service, that I have been so brutally honest about its current condition and the existential threat it faces unless we change how our health and social care system works.
Even before the Conservatives crashed the economy and created a black hole in the public finances, it was clear that there is no future for the NHS that involves pouring ever larger amounts of money into 20th century care.
We’re spending far too much on late diagnosis and more expensive treatment, because we don’t focus enough on prevention, early intervention, and social care.
The case for change is unarguable.
Firstly, the consequence of the economic disaster that unfolded after the mini-budget is that fiscal policy will be tighter. In a time of constrained resources more of the heavy lifting will need to be done by reform.
Secondly, to be sustainable, any system or organisation needs to keep pace with the times. The challenge of demography and the opportunities of life sciences and technology mean that we must evolve.
Thirdly, people working in the system today need hope of a better future and belief that there’s a plan to get there.
As the Party that aspires to govern after the next general election, we feel a particular weight of responsibility to provide that hope and belief in a better future.
When the President of the Royal College of Emergency Medicine warns hospitals are becoming “lobster traps,” it needs to be a wake-up call met with action.
Thousands of patients every day are stuck in hospital when they don’t need to be there, some for months at a time. It is miserable for them, reduces capacity in the NHS, and is more expensive for the taxpayer.
It’s no use blaming ambulance services for the queues outside the front of hospitals.
The Conservatives’ mismanagement of the NHS and their failure to fix social care over the past 12 years has left the system gridlocked as it approaches winter.
The chaos in the Conservative Party has prevented them delivering on their promises to the NHS. Not a penny of the funding earmarked to increase capacity in social care this winter has left Whitehall. Every day of delay means less time for health and care services to prepare. Steve Barclay needs to pull his finger out, get that funding out the door before it is too late, and ensure patients aren’t stuck in hospital any longer.
The best NHS leaders aren’t waiting for the government to act. Trailblazing trust leaders are voluntarily giving up funding to invest in local social care beds. They recognise that it’s better value for money and means better care for patients. That’s my challenge to you, and my test for the new Integrated Care Systems.
As well as short-term action, we need long-term reform. A shift in the focus of healthcare, out of the hospital and into the community. That will be at the heart of the 10-year plan for change and modernisation the next Labour Government will undertake.
It’s not only because of problems in social care that we see patients in hospital who needn’t be there.
Patients who can’t get a GP appointment are ending up in A&E;
Others are reaching crisis point because they are made to wait years for mental health support.
Fortunately, what is best for the patient can also be good for the taxpayer.
I know there are lots of you here today who provide services in the community. Recently I spent time shadowing a district nurse in Romford in Essex with the Queen’s Nursing Institute. I watched her at work, caring for a lung cancer patient in the comfort of his own home, freeing up a hospital bed for someone else; providing palliative care to another man dying at home, surrounded by his family.
This should be the future for care. Care in the community.
District nursing will be at the heart of Labour’s plan for modern community care, so we will double the number of district nurses qualifying every year.
For all children, but especially kids from working class backgrounds like mine, our life chances and even life expectancy can be determined from the moment we’re born.
Health visitors have such an important role to play in early childhood development, but the Conservatives have cut them by a third. Every child matters, so we will train an additional 5,000 health visitors to tackle the shortage and give every child the best start in life.
The Covid pandemic has left a lasting legacy on the mental health of our nation. I doubt that we yet understand the impact lockdowns have had, particularly on young people.
So Labour will hire 8,500 new mental health professionals
Providing support in every school
Guaranteeing treatment sooner
And taking pressure off hospital wards.
Medical science and technology offer a world of possibility to transform patient care.
Technology can diagnose patients more accurately than the human eye.
Virtual wards allow people to receive hospital care at home.
But the biggest prize of all is the advance in genomics and the data revolution that will allow us to transform our model care from one that diagnoses and treats illness to one that can predict and prevent it.
This will also be at the heart of Labour’s 10-year plan for change and modernisation.
Then there is the issue at the heart of the immediate crisis – it is a workforce crisis.
The Conservatives failure to train the staff the NHS needs has left doctors and nurses overstretched, overworked, and burnt out. The government have been relying on goodwill – with nurses doing £2,000 unpaid overtime a year to make up for the shortages.
I don’t think anyone here would blame nurses for voting to take industrial action. But I am worried about the impact it could have on patient care. The single best thing Steve Barclay could do to help the NHS through this winter is to get round the table with the unions, negotiate, and prevent these strikes going ahead. It was unbelievably negligent of Ministers to refuse to engage with the RCN until the votes had been cast.
It’s not just pay that has driven nurses to this point. When I visit hospitals, the first thing they tell me about is the shortages of staff. Nurses are going home at the end of the day exhausted, but also carrying the moral injury of knowing their patients haven’t received the care they deserve.
One nurse told me she knows the problem can’t be solved overnight, she went through the training process, it takes years. But she just needs to know that the cavalry is coming. That things will get better.
Well, the cavalry is coming with Labour.
We will deliver the biggest expansion of medical school places in history – doubling the number of places to give the NHS the doctors it needs to provide the care that patients deserve.
We will create an extra 10,000 nursing and midwifery clinical placements every year.
We will fund this by abolishing the non-dom status, which will bring in double the £1.6 billion our workforce investment will require.
It’s a serious plan that has attracted widespread support including from the Chancellor, Jeremy Hunt. Writing as Chair of the Health and Social Care Select Committee, Jeremy said Labour’s plan is “something I very much hope the government also adopts on the basis that smart governments always nick the best ideas of their opponents.”
On Thursday, Jeremy Hunt has the opportunity to put his words into practice, so I hope he puts his money where his mouth is and nicks Labour’s plan. He is genuinely welcome to it.
Alongside serious investment in recruitment will sit serious workforce planning. We’re committed to establishing an independent workforce body tasked with providing independent assessments of current and future workforce needs and advice on training and recruitment pathways.
And I hear the voices in the sector telling me that it’s not just about recruitment. We need to retain the good people we have. I’ve been putting pressure on the government to act, raising issues like the early retirements forced by doctors’ pensions and on the low pay in health and social care that sees staff poached by retailers, but I’m increasingly worried that we will inherit an even worse situation than we see today.
That’s why my immediate priority in government will on the ‘three Rs’ of the workforce challenge: recruitment, retention and returners – to build a new generation of staff, to keep the brilliant people we have, and to encourage people who’ve left the system to come back.
In return for more investment in staff, we’ll expect higher standards for patients.
Longer waiting times cannot become the new normal. They are miserable for patients. And they are holding back our economy.
Hundreds of thousands more people are off-work, long-term sick, than before the pandemic.
Long Covid is playing a part. So too are NHS waiting lists, according to the Bank of England’s Monetary Policy Report. Poor mental health is driving young people out of the labour market.
You cannot have a healthy economy unless you have a healthy society. That’s what the Conservatives don’t understand.
I’m not going to expect you to meet performance standards overnight, but nor am I going to pretend they don’t matter. An incoming Labour government will want to agree an ambitious, but credible, timetable to ensure that they’re met.
I’ve done a lot of mystery shopping on the NHS as a cancer patient in the last 18 months, and I don’t think the patient’s voice is heard loudly enough.
So as Labour’s Secretary of State for Health and Social Care, I’ll be the shop steward for patients.
That means better use of technology to give all patients the ability to book appointments online, the opportunity to self-refer to specialist services where appropriate, and a wider range of choice, so that we can choose to see someone in person, on the phone, or via video link.
I recognise that every patient is different. I value fast and convenient access. I don’t mind if I don’t see the same person every time and I’m happy to see them on a screen.
But that isn’t appropriate for everyone.
Continuity of care benefits patients and takes pressure off other parts of the health system.
But 2 in 3 patients rarely or never speak to their preferred doctor.
So I have committed to introduce new incentives for continuity of care to bring back the family doctor.
That’s the change I want to see. Resources where they are better spent. Pressures removed from hospital through better primary care, social care, public health, mental health and diagnostics.
And Keir Starmer recognises that so much of what determines good health and wellbeing and creates deep health inequalities is decided outside of the NHS and the Department of Health and Social Care. His leadership and deep personal commitment to the preventative approach demanded by leaders like Michael Marmot will be crucial to making this a cross-government priority.
And I want your help to make sure we get this right.
So let me just say in conclusion: thank you.
Thank you for the leadership you showed during the unprecedented challenge of the pandemic and for busting a gut day in, day out since.
And thank you for sticking with it, because I know that politics has made your job harder, not easier, and I have a responsibility to fix that.
The country needs you and we’ll need to work together to build an NHS and social care system that’s fit for the future and that’s why I’m delighted to be here today.