Health secretary Wes Streeting has promised a sweeping performance review of the NHS with a league table for trusts that he says will help patients to choose where they want their treatment.
He also defended the choices made in last month’s Budget, pledged to be a patients’ champion and warned of the consequences of the NHS failing to adapt to new approaches.
“The NHS is already living on borrowed time, and if a Labour government can’t improve the NHS then it simply can’t survive,” Streeting (pictured) said in his address to the NHS Providers conference in Liverpool this morning.
He said: “I’m here to be the patients’ champion – they will be at the heart of the 10-year plan.
“Patients should be able to choose where we’re treated and when.”
Streeting said: “A culture that puts sparing political blushes or protecting the reputation of the NHS above protecting the interests of patients is one that stifle inconvenient truths being spoken to power. Ultimately puts patient safety at risk.”
“Honesty is the best policy,” Streeting said, adding: “The NHS is in critical condition but its vital signs are strong.”
Think tanks
He criticised negative comments from think tanks about the Budget not giving the NHS enough money.
“Well one of the luxuries of leading a think tank is that you don’t have to engage with the choices and trade-offs that government does.”
He said: “The choices and trade-offs aren’t just about spending money, but raising it. The tax burden in this country is at record levels.”
“We stand by our decision to prioritise the health service. Healthy businesses depend on a healthy workforce and a strong economy depends on a strong NHS.”
He said the average tax payer welcomes the investment in the NHS, but worries that it won’t be spent wisely.
Greater reform
That meant greater reform was needed to do the heavy lifting.
He said three big shifts would underpin the upcoming 10-year plan for health: “From hospital to community, from analog to digital and from sickness to prevention.”
“I want to lead an NHS where power is moved from the centre to the local, and from the local to the citizen,” Streeting said.
On the issue of intergrated care boards (ICBs) Streeting said: “I want to see local commissioning back and I want to see ICBs leading it. ICB chiefs – I’m talking directly to you – you will lead the transformation of care.”
He said he wanted ICBs to focus on: “One big thing, the development of a new neighbourhood health service.”
“Fragmentation needs to give way to integration and that is the job of the integrated care boards.”
He said “Critically those ICBs that perform best, particularly in developing neighbourhood health services should also enjoy greater freedom and flexibility.”
“We will no longer treat all providers and ICBs as if they are all performing equally, when you and I know its a mixed ability class.”
“There will be no more awards for failure.”
The Department for Health and Social Care announced that persistently failing managers will be replaced and turnaround teams of expert leaders will be deployed to help providers which are running big deficits or poor services for patients.
High-performing providers will be given greater freedom over funding and flexibility, with it noting that there is little incentive across the system to run budget surpluses as providers cannot benefit from it.
Managers needed with the right skills
“One person behind the desk in Whitehall cannot deliver the mammoth task ahead of us – taking the NHS from the worst crisis in its history and making it fit for the future will require first class leadership at every level of the system.”
He said despite the fact that it could be a popular decision, he would not be reducing the number of manager jobs.
“The problem is not too many mangers – but too few with the right skills and capabilities.”
He said: “The NHS is one of the biggest organisations in the world. We should be competing with global businesses and public services to attract top talent.”
The DHSC has already announced that senior NHS managers who fail to improve patient care could be denied pay rises but Streeting was prepared to pay for the best and use incentives to attract and keep talented people in the NHS.
The NHS Oversight Framework, which sets out how trusts and integrated care boards are best monitored, will be updated by the next financial year to ensure performance is properly scrutinised.
Deep dives into poorly performing trusts will be carried out by the government and NHS England to identify the most pressing issues and how they can be resolved.
Streeting concluded by saying: “If we can get this right we can look back on our time with pride and say we were the generation that took the NHS from the worst crisis in its history, got it back on its feet and made it fit for the future.”
