13 April 2006
Reforms in the NHS will bring improvement as the service becomes more "patient-centred", Tony Blair said at a meeting of health bosses.
Parts of this transcript may have been edited
Read the transcript of PM’s opening remarks
Good morning everyone. Thanks very much indeed for coming into Downing Street this morning, and welcome to our friends and colleagues in the media here as well. I am just going to say a few words by way of opening, and then Ian is going to give us a presentation.
The great paradox whenever you talk about the National Health Service is that in all the survey work that we do, and other independent organisations indeed, you come up against this problem. If you ask people what their own personal experience has been of the National Health Service, it is usually very positive; if you ask people what the overall state of the Health Service is it would be very negative. And of course there will still be individual bad stories, and that is natural in an organisation that treats a million people every 36 hours, but nonetheless I think there is a reason why people’s actual experience of the NHS is overwhelmingly positive, and it is because there is immensely strong delivery taking place within the NHS, even as it goes through difficult and challenging times, the fact is waiting times are coming down, waiting lists are coming down.
If you look at cancer care it is probably the fastest improving in Europe, cardiac care has been transformed in the last few years. If you just take something like cataract operations, and I know this from talking to people in different parts of the country who used to wait a year, two years, in order to get that done, they now get it done with immense speed. Accident and Emergency departments, again one can only generalise, but in general are a very different place to visit than they were a few years ago.
So there is very, very strong delivery going on. And I think that is the context in which to put the issues to do with financial deficit, and issues to do with so-called staff reductions. Because the important thing about the deficits is that when we actually analyse the whole system, the majority of Trusts are in fact either in surplus or breaking even, over half the deficit is in 7% of the Trusts, and in many circumstances what is actually happening is not that something wholly new has arisen, but what is being exposed are problems that have built up over a considerable period of time and frankly it is time we dealt with them.
In relation to staff reductions, yes there will be difficult situations for some of the Trusts, as we know, although a lot of this is happening through not filling temporary posts and so on, and not hiring agency workers, but on any basis frankly the NHS is going to be employing round about 300,000 extra staff from where it was a decade ago. So even there, there is a context that I think has to be understood.
However, having said all of that, there is a big challenge for the National Health Service because despite the falling waiting times, and waiting lists, and improvements in cancer and cardiac care and accident and emergency and so on, despite all of that there is a real challenge for certain Trusts and for the system as a whole as we introduce what is effectively a re-engineering of the whole system of the National Health Service in order to put the patient at the centre of it, in order to introduce proper financial disciplines and accountability pretty much for the first time.
And my sense of this is, and obviously it is going to be very important to hear from you the individual experiences that you have got, is that the important thing at the moment is that we have confidence that out of the process of change will emerge a stronger, and better, and more sustainable National Health Service, that the improvements that we have seen up to now will be deepened and carried through, and that this is a time not to step back from the changes and reforms that we have made, but to push on with them because they do offer us in the end the best chance of getting the type of National Health Service we want to see, that is treating people free at the point of use, but treating them with quality, with high standards of service and with access to the National Health Service at times that people can relate to.
So we are going to hear now from Ian and to see the various issues that there are within the National Health Service, and then I know Patricia we are going to hear from some of our colleagues who are actually, as opposed to me talking about it, actually doing it, which is always a more worthwhile experience to reflect upon. And I would just like to say through Ian to all of you, to give you our thanks for the enormous hard work that the NHS professionals and the staff are putting in at the moment, and by that I don’t just mean the clinicians and the nurses, but all of the people, those in management who are engaging in this process of change.
In the year 2000 we published a 10 year plan and I think it is worth just going back and reflecting that this service was never going to be turned around and changed fundamentally within the space of a few years, but there has been massive change, that change has been to the benefit of patients and if we, as I say, have confidence then I am quite sure that the rest of the process of change will be successfully introduced. And even though it will take a lot of sorting out in the meantime, it is sorting out that is worth doing.
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