皇冠体育app

CHECK AGAINST DELIVERY

Thank you Ian [Lewis, Medical Director at Alder Hey Hospital] for your introduction and for your personal commitment to improving outcomes for children and young people.

This morning, here to mark the development of a new strategy for helping children and young people鈥�

I think back to my own upbringing.

Because my commitment to the NHS is a personal one.

And it鈥檚 one my family has shared from the very start.

On the 5th of July 1948鈥�

鈥�.that remarkable day in our history when the NHS came into being鈥�
鈥�my father went to work with pride as an NHS scientist.

皇冠体育appn, for over 30 years he ran the pathology lab at East Ham Memorial Hospital.

He was chairman of the Institute of Biomedical Sciences.

He was a professional, dedicated to serving the public in the best healthcare system in the world.

And he passed that dedication on to me.

As I grew up the NHS wasn鈥檛 some remote organisation.

It was what we knew, what we cared about and what we wanted to make work.

And that is every bit as true today.

As a son, as a father and as a patient, I know what it is to have the NHS at your side.

To see dedicated, skilled, caring professionals work to save lives.

And alongside that experience the anxiety, sometimes even the loneliness鈥�

鈥�of feeling that you are just a unit in a system that can seem so big, so complex, that the process can appear to overwhelm the patient.

And if that is true for adults鈥�

鈥�then imagine how frightening the experience can be for a child.

And that is what we need to put right and what I want to talk about today

Not interfere with the values of the NHS鈥�

鈥�which are as rock solid today as they were six decades ago.

But improve the way things are done so that young people, as much as adults, who use health services are always treated as individuals.

Almost nine years ago, in opposition, I was proud to become shadow secretary of state for health.

I鈥檝e held the post in opposition and now in office ever since.

Indeed, since the NHS鈥檚 foundation no other frontbench politician has served in this post for so long.

Or had the time and enthusiasm to talk to NHS staff at all levels, observe the system, get to know the many things that go right and the ones that also go wrong.

I鈥檓 not an outsider.

皇冠体育app NHS is my passion, my mission鈥�

鈥�and I would never do anything to harm it.

I鈥檓 backing the reshaping of the way the NHS works not because I dreamed up modernisation on some remote ministerial whiteboard.

But because time after time, over 7 years as a shadow Secretary of State, patients, GPs and nurses told me what needed to change.

That the NHS is led too much by bureaucracy and too little by patients and that鈥檚 got to change. Dominated by targets and not by evidence.聽 Obsessed by inputs not by outcomes.

So let me say this at the start鈥�

鈥�I know the NHS is a precious asset.

鈥�I know that any change will worry people.

鈥�but I also know that without change the NHS cannot suceed.

HELPING CHILDREN

In this room today there are people from far beyond the NHS.

From children鈥檚 services, children鈥檚 charities and from local government.

But all of us share one ambition: to give people the best possible health care.

To listen to their needs.

To allow the professionals to do their job.

And that applies to children鈥檚 services just as much as to everything else.

In his review of NHS services for children, Sir Ian Kennedy expressed his concerns when he said: 鈥淧ockets of excellent practice exist [but] they are just that鈥� islands in a sea of mediocrity, or worse.鈥�

In essence, that the system itself was getting in the way of doctors, nurses and others from giving children and young people the kind of care they wanted to.

Outcomes for children vary immensely across the country.

Young people under 16 not included in the patient survey asking about what鈥檚 happening to them, or what they think of the experience.

Services not linked together.

Professionals lacking power.

And that鈥檚 what drives this government鈥檚 reforms - in care for children just as much as elsewhere across the NHS.

CHILD HEALTH STRATEGY

That is why I鈥檝e asked you to come together today.

We recognise that children are not just small adults.

That they require not just the right facilities, but the right structure of services.

皇冠体育app principles of:

• listening to patients and their families;
• empowering professionals;
• focussing on outcomes.

All apply to children鈥檚 services. We need to integrate services around patients, not just pathways, not institutions.

Outcomes depend on integration across services. Opportunity of NHS/public health/and local authorities together.聽 Like they do in Sheffield.

This will be the first opportunity in new system to demonstrate how we can bring together services.

GP/community/acute/LAs/safeguarding/children鈥檚 trusts.

Not structural integration but integration around familes and children.

Marmot (universal proportionalism) - early intervention.

Strengthening GP practice expertise and delivery of children鈥檚 services.

Bring expertise out of hospitals into design and delivery of community paediatric services.

Clinical commissioning groups and health and well-being boards able to see Outcomes Strategy for a template of how they can shape children鈥檚 services across England in a way which brings services together better than ever before. And the Forum challenging us, the Board, local government, Public Health England in how we can ensure the right leadership, outcomes and support.

I see this as an exciting opportunity. Not to ditch anything which works but to do the things we always dreamed of.

皇冠体育app reason it is right to do this now is because clinical commissioning groups and health and well-being boards have been established all across England.

皇冠体育appy are shaping new relationships and new opportunities.
皇冠体育app outcomes structure for children prepared now will enable those new relationships to focus on children and young people.

It will enable us to link commissioning across children鈥檚 services - local authorities, public health and the NHS - to realise the opportunity of delivering the more integrated services for children and young people that we are all looking for.

OPPOSITION

Now as things stand - let鈥檚 not hide from the fact - several health organisations oppose aspects of the reforms I believe are essential.

I wish it was otherwise.

I don鈥檛 seek out a fight.

I鈥檓 not the sort of politician who delights in the sound of gun fire.

I鈥檝e paused. I鈥檝e listened. I鈥檝e worked with the independent Future Forum.

I鈥檝e reshaped the plans where my critics have a case.

And after we did that, they came out and supported much of what we had done.

And now I want these organisations to continue to come in, talk and help us make it work.

And I know - because their leaders have been working with me from the start, always welcome in my office - I know that they want the same.

Because this isn鈥檛 - at its core - a debate about principles.聽 Principles are shared.

Clinicians do want to lead in commissioning services for patients.

We all want to see shared decision-making with patients.聽 We all know that it is right to focus on outcomes and not process targets.

Hospital doctors and nurses agree.

皇冠体育appy don鈥檛 want to be dictated to by ministers or managers. And our plans will give them that freedom.

Perhaps those eight years in the health job have left me a little too immersed in NHS-speak.

Pressing on with the implementation has allowed the debate to be about what we鈥檙e accused of doing, not about what we are doing.聽 As they say, 鈥渁 lie is halfway around the world before the truth has got its boots on鈥�.

Of course, every important reform to the NHS, under whatever government, has had its well-meaning critics from within the system.

Look back to 1948 when the British Medical Association denounced Aneurin Bevan as 鈥渁 would-be Fuhrer鈥� for wanting them to join a National Health Service.

And Bevan himself described the BMA as 鈥減olitically poisoned people鈥�.

A survey at the time showed only 10% of doctors backed the plans鈥�

鈥�but where we would be today if my predecessors had caved in.

Sometimes change is hard. Sometimes, you can鈥檛 expect unanimity. Sometimes the right thing to do is keep listening, keep making your case, keep calm.

So today I want to set out three key points in simple language.

First, the case for reform.

Second, what are reforms actually involve - rather than what people have been told to fear.

And third, how I believe we can move forward together to put our differences behind us and build the modern NHS in which all of us believe.

CASE FOR REFORM

皇冠体育app fact is that the NHS needs to change.

It needs to change to make it work better today.

We should celebrate our successes and excellence but it鈥檚 not disloyal to say there are problems. It鈥檚 honest.

I鈥檝e spoken to literally hundreds of doctors and nurses who tell me about what they want to happen.

皇冠体育appre is still way too much bureaucracy getting in the way of their work.

And there鈥檚 also still way too much waste - because the funding system we鈥檝e been left with is hardwired to subsidise wasteful spending.

This government knows healthcare costs will rise and we are committed to keep spending rising in real terms to meet them.

But when cuts are happening in other services it is my duty to ensure that precious money is not wasted.

Yet in the year before the general election, the management of Primary Care Trusts alone rose by 23%.

If a hospital doesn鈥檛 balance its books, then it is bailed out by the surpluses taken from other hospitals which have kept within their budget.

As a result, money that could go on operations, new drugs, new training - is wasted.

This is what I鈥檝e heard from doctors and nurses.

And patients, too, want things to change.

Overall they鈥檙e glad and grateful for the treatment they get on the NHS.

But there are also concerns:

鈥淚f my mum鈥檚 in hospital, will someone keep checking she鈥檚 had enough to eat and drink?鈥�

鈥淲hen I go home after treatment will I get the therapy I need?鈥�

鈥淲ill I get the best drugs that are out there for the illness I鈥檝e got?鈥�

皇冠体育appse concerns do exist, and we should address them.

If we were as good in Britain at treating cancer as the top European countries, then we鈥檇 save 10,000 lives a year.

So we should be really ambitious about how we want the NHS to work today.

And we should be very realistic about what鈥檚 coming up for the NHS tomorrow.

Dramatic new pressures on its budget.

An ageing population. More long-term conditions to treat.

Great new treatments and diagnostics coming in - but each meaning new costs.

Everyone is agreed that rising health demand is a major challenge we鈥檝e got to meet.

We can鈥檛 hide from this.

皇冠体育app cost of providing treatments is rising by hundreds of millions of pounds a year.

So to make sure the NHS is well-equipped and funded for tomorrow, and to make sure it works as best as it can today, we have got to reform.

皇冠体育app case for modernisation is not one of ideology - but necessity.

POWER TO PATIENTS

I know there鈥檚 much confusion about our plans.

Many scare stories.

And a series of valid suggestions for improvement which we are taking on board.

皇冠体育app reality is very simple.

We鈥檙e making changes to help patients.

Not to make the lives of doctors easier, or win applause from nurses, or boost those mysterious creatures that NHS experts like to describe purchasers and providers.

This is about people.

So step one on our road to a modern NHS is to keep the things that work.

Guaranteed free care. Your local general practice. Accessible local hospitals. High-calibre specialist care.

Help anywhere, anytime that doesn鈥檛 depend on who you are or what you can pay, but what you need.

Now putting people first might sound an obvious principle for any good health system.

But it isn鈥檛 how the NHS is structured at the moment.

It鈥檚 ossified around institutions and bureaucracies when it should be focussing on the individuals and families it is there to serve.

We鈥檝e ended up with targets and top-down orders that didn鈥檛 recognise what humans actually need.

Those old targets didn鈥檛 even include a mention of children and young people.

皇冠体育appy were just lumped in with everyone else.

Or look at the example of Mid-Staffs, at Stafford General Hospital.

皇冠体育appy hit the target.聽 皇冠体育appy made sure that patients were discharged from A&E within four hours.

But patients suffered - and when people tried to voice their concerns they found the system was so self-satisfied there was nothing they could do.

I know. I鈥檝e been there many times to talk to patients in person.

So we will put doctors and nurses in charge of designing the services their patients need.聽 Clinical commissioners and clinical networks, including for children and young people

皇冠体育app doctor you know and trust can order the treatment he or she knows you need - and not run up against some manager in a distant building whose computer says no.

We will give patients choice - about how and where they are treated.

But of course not everyone wants to choose, all of the time.

What they really want is the right to be heard.

皇冠体育app right to be involved to what happens to them.

皇冠体育app right to an NHS that is personal to them.

And in our modernisation plans, that is what we are providing.

Making for patients a reality of 鈥榥o decision about me without me鈥�.

POWER TO PROFESSIONALS

皇冠体育app second step in our plan is about strengthening the power of health professionals to shape the service that they provide.

You know, it鈥檚 a funny thing that in 1948 doctors complained the government was taking independence away from doctors鈥�

鈥�and now some complain that we want to give it back.

At the top of the NHS, we will give independence from politicians鈥�

鈥�so the organisation is run in the interests of patients and professionals not what suits the government at the time.

皇冠体育app BMA asked for autonomy for the NHS, and in the commissioning board, led by NHS chief executive David Nicholson, the NHS will have that opportunity for leadership.

皇冠体育appn, in local areas, new commissioning organisations that will include GPs, hospital doctors and nurses, so they can shape services in the way that work locally.

It鈥檚 a simple reform鈥�

鈥�fewer managers, more professionals.

And it is both necessary and right.

CONCLUSION

I know some people ask: 鈥渙k, I get your plans for change but do we really need legislation?鈥�

Just pull the levers you鈥檝e got, they urge. It鈥檚 what the last government did.

And it failed.

Without legislation, GPs won鈥檛 trust government to give them the power; and local authorities won鈥檛 get the responsibilities they need.

So I鈥檓 proud that we are taking this reform through parliament, where opinions can be heard.

It鈥檚 been an鈥�interesting鈥�process.

But soon it will be over.

We will have a law鈥�

鈥�and we can end the squabbling about structures

鈥�and get on with what we all want, which is creating a better NHS.

Because I鈥檓 doing this job to make a difference.

I want my inheritance to be a stronger NHS.

And it will be.

I鈥檓 a parent of five children.

I know what it鈥檚 like.

皇冠体育app very thought of one of them being taken seriously ill, of having to go into hospital or needing long-term treatment and care鈥� it鈥檚 the worst thing for a parent.

That鈥檚 why we have to do everything we can to get the right care, at the right time, in the right place.

Not because I don鈥檛 think professionals care. Of course they do.

But because at times the NHS forgets that people come first.

Well, our reforms will change that.

For children, for adults鈥�

鈥�if we use our resources well and listen to people then we can deliver the best.

And that is our intention and the task ahead: outcomes for children amongst the best anywhere in the world.