Speech to Conservative Party Conference 2004
"You know, last year, something very important happened. A new beginning.
No - I know what you're thinking - but not that. Something even more important, at least to me and my wife Sally. Our daughter, Martha, was born.
She was born at the 'Rosie' Maternity hospital in Cambridge. Today they celebrate 21 years of the Rosie. Happy Birthday! Rosie - although I suspect they're too busy to be watching. Four and a half thousand babies a year is a lot of new beginnings. If anyone ever says the NHS doesn't deliver, tell them that.
The National Health Service was there for us then. It is there for us in the moments of hope, and of despair. Of happiness and sadness. When we are at our most vulnerable.
That is why nothing matters more than the future of the National Health Service. We need to know it will be there for us. Those who work in the NHS need to know we are there for them. They have every right to expect it.
How many of us have to make life and death decisions when we're dog-tired? How many of us have to be able to account for every decision because, if something goes wrong, someone could die? How many of us have a chance to give someone back their health and their hope?
That's why doctors and nurses, other health professionals, are not just part of a hierarchy; like teachers, police or the armed services, they are part of the fabric of our quality of life. For them, and for the contribution they make, we know their value, we don't just count the cost.
GP practices see a million patients a day. 200 thousand visit hospital services. Twenty thousand operations a day. Two million prescriptions. And all this for less than the price of a packet of cigarettes - just under £4 a day for each of us.
Labour say we don't understand or appreciate the NHS - they treat it like it's their property. A typical Labour combination of arrogance and misrepresentation.
As Conservatives we rely on the NHS, we work in the NHS and, yes, we care about the NHS.
And it is because we care about the NHS that we know the NHS deserves better. People used to say the NHS was the envy of the world. Why don't they say it today?
Not because we don't have some of the finest doctors and nurses - we do. Our system of GPs is a cornerstone of quality health care. If one has serious, acute illness or injury, NHS care is often as good as anywhere in the world.
So what is the difference?
The difference is that in other developed countries there are more doctors and nurses. Patients don't expect to wait months for operations. They can often choose their doctor and their hospital. They aren't exposed to such a risk of MRSA infection. They expect clean and safe hospitals. They aren't admitted to mixed sex wards. They have more control over their healthcare.
The differences between our healthcare and those of other countries are still too great. And the difference is because under Labour, although we've got first-class people they are working in a second-rate system. The NHS deserves better. The NHS needs reform.
Reforms which mean the extra money for the NHS isn't wasted. So that funds get to the front-line. That the service isn't submerged in bureaucracy. That we recruit doctors and nurses three times faster than managers, not the other way round. Where hospitals don't have 41 different inspectors or 250 different targets.
An NHS where it would not be possible for managers to overrule infection control teams who say a ward should be closed to be cleaned.
An NHS which delivers care to clinical standards, not to government's political targets and is measured by the quality of service, not by absurd and misleading star ratings.
An NHS where it would not be possible for an MRI scanner -which the Lottery paid for - to stand idle while the Health Department puts a mobile MRI in the car park once a week.
A reformed NHS is one in which GPs once again have the ability to secure for their patients the healthcare they need. We did this for GP fundholders in the past. We must do it for every GP in the future.
And on Dentistry. In a reformed NHS, instead of Mr Blair's failed promise five years ago to give everyone the chance to see an NHS dentist, we will give patients the means and dentists the incentive to put NHS dentistry back on the high-street.
A reformed NHS is one which is accountable to patients not to bureaucrats. Where patients have more control over their health and more choice. Where patients have the Right to Choose.
The Right to choose is central to reform.
Choice is a powerful means to an end - to deliver the services patients need. And to create choice, information is essential. Getting more information about waiting times, infection rates on wards, clinical outcomes, the number of cancelled operations, whether there are mixed sex wards or single rooms, access and transport and patient's experiences at the hospital. Such information makes choice real.
If, at the end of the day, we choose our local hospital, fine, that is our choice. But if you want to be treated in weeks rather than months, or one hospital has high infection rates on the ward, then you should be able to choose another hospital.
Labour would restrict choice to the options decided by the bureaucracy. That is no choice.
Ours is a practical choice. Armed with information, patients will be able to book treatments through their GP, at the hospital of their choice. As an NHS patient, their treatment will be free. The hospital may be a foundation hospital or a private one, but NHS care will be free, to NHS standards.
If patients want extra services and to go private, but take the burden off the health service, then we will support that choice too, with half the NHS cost. That's a saving for the NHS and a fair deal for patients who would otherwise pay twice for their healthcare. It's a practical approach which will deliver further reductions in waiting lists for everyone.
In a reformed NHS, Patient choice will stimulate investment and new capacity. It will determine the shape of the extra capacity which the health service needs to provide. Choice encourages patients to take responsibility for their care and improves the outcome of treatments. It promotes innovation. It forces hospitals to provide the infection-free wards which patients demand. It pushes down waiting times.
And, If patients are among the 17 million in this country who live with a long-term illness, patient choice gives them information and control, with their GP, over their healthcare. The Right to Choose gives the most to those who today have least. For those with long-term diseases, those with mental illness, those in poverty, it is they who will have the entitlements to care, and the ability to influence the services they receive, which too often now are determined by a bureaucracy over which they have - quite literally - no control.
In tomorrow's NHS, we will give a new focus to improving the Health of the Nation. We need a new focus on improving our public health. A focus which the Labour Party has lost. Public health has become fragmented. Confused and mixed messages from Labour Ministers have resulted in a crisis.
The evidence is shocking.
• new HIV diagnoses and sexually transmitted infections have doubled;
• rising numbers of TB cases - in parts of London, at virtually third world levels.
• MMR vaccination levels down to 80%;
• high levels of smoking among teenagers, especially girls; and let me tell John Reid if he thinks smoking is "one of life's small pleasures" for a single mum on a council estate, he is both wrong and patronising.
The tragic evidence goes on …
• young people in their 20s with cirrhosis of the liver because of binge-drinking;
• high levels of drug abuse, while the Government sends out mixed messages on cannabis; and
• Rising levels of obesity, with risk of future diabetes, stroke and heart disease but no coherent or consistent effort by the Government to encourage sport and exercise in schools, to improve food labelling, to enable the food and drink industry and retailers to promote healthier foods.
In tomorrow's NHS, I will be the Secretary of State for Public Health. Public health will be my personal priority. An independent Public Health Commission will gather the evidence and make recommendations. Local public health teams will ensure co-ordinated, consistent efforts, across private and public sectors to tackle the problems of poor sexual health, alcohol and drug abuse, smoking, poor housing and poverty. I will back that up with national campaigns and influence over national policies.
The next Conservative government will be accountable for the Health of the Nation, but we will stop trying to run the day-to-day health service from desks in Whitehall.
The NHS will be accountable to patients and to the public for the services they provide. I will be accountable to you for delivering the resources and the reform our NHS needs so badly. To achieve this will mean a 'timetable for action' on health from day one of the next Conservative government.
On the first day, we will abolish central targets imposed on hospitals so doctors, nurses and managers will be able to run hospitals in the interests of patients.
In the first week, we will prepare for the Right to Choose, including providing access to information on performance and infection rates in hospitals.
In the first month, we will introduce legislation to free the NHS from Whitehall controls, to provide mental health services with the framework they need, and to establish our Health of the Nation strategy.
So, what will be the character of tomorrow's NHS under the Conservatives?
Focused on improving the Health of the Nation. Delivering care which responds directly to patients' needs and choices. Where clinical standards and the evidence of effectiveness determine care, not political targets: where patient's interests come first. A service in which there is leadership and management, not bureaucracy, blame and buck-passing.
A GP told me recently about the vision of healthcare promoted by the Institute for Health Improvement in Boston. Of course, the NHS has always had a vision. A vision of equal access, of healthcare for all. A service based on need not ability to pay. That vision will endure but it will not suffice.
There is no room in tomorrow's NHS for an equality of misery. We must look to an NHS which pursues the highest standards.
Standards which mean:
no needless pain;
no needless harm;
no needless death;
no needless waiting;
Dignity and choice for patients; and
Respect and reward for healthcare professionals.
I can see an NHS in which first-class doctors and nurses are empowered to deliver first class care. Where compassion, choice and competition combine to deliver excellence.
A vision for quality.
A vision for tomorrow's NHS.
A vision of an NHS which we will be proud once again to call the envy of the world."