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Andrew Lansley: Our NHS - our number one priority

Do you know when is the hardest time to speak to a Conservative conference?

Right after William Hague.

He’s not just a fabulous speaker. He’s a fantastic colleague in the Shadow Cabinet.

And, electorate willing, we know he will make a great Foreign Secretary.

Before I start, let me introduce our team and guests here this afternoon:

First, from my own team. Two of our extremely hard-working health team.

Anne Milton, who leads on nursing, maternity and long-term conditions.

Mike Penning, who leads on emergency services, dentistry and ambulance services.

Also, may I introduce our guests:

Professor David Kerr Professor of Cancer Medicine at Oxford, President of the European Society of Medical Oncology. Author of the 20-year plan for the NHS in Scotland. And former health adviser to Tony Blair.

Sam Everington, GP, who set up an award winning surgery in the East End of London as part of a social enterprise. Sam – I believe you too, were a Government adviser, specialising in primary care access?

And two of our prospective parliamentary candidates.

Amber Rudd, PPC for Hastings and Rye.

And Dr. Daniel Poulter, PPC for Central Suffolk and Ipswich North.

We will hear from them all a bit later on.

Every week, I meet NHS staff and patients.

On Thursday of this week, I saw some sharply contrasting aspects of today’s NHS.

In the morning, I was at Alder Hey in Liverpool. I saw surgery with inter-operative MRI scanning, so that surgeons can get imaging, in the middle of an operation, to ensure that they have cut out a tumour – all of it – and nothing else.

It was equipment, the only system of its kind in Europe, very generously funded by the Barclay Foundation.

Dedicated, expert, committed staff, there and on the wards in Alder Hey.

I also went to some of those wards.

One was opened by Florence Nightingale.

The children and their parents and staff were cheek by jowl.

Z-beds for parents to sleep in, with just curtains to pull round. About two feet from the next bed.

But the parents told me the quality of treatment and the care from the staff was fantastic.

Later that day, I was in Stafford.

Meeting again the relatives of those who died, who saw the neglect and shameful lack of care of some staff at Stafford General in the past.

These things tell us of a painful contrast. On the positive side: that the NHS can and does deliver excellent care every day.

They often do it in spite of the conditions and in spite of Government bureaucracy and targets.

But then on the negative, where leadership is lacking, the vast NHS bureaucracy doesn’t provide protection. It distorts priorities and damages patients. It suppresses complaints. It protects itself not patients.

The tick-box targets led to patients being treated like numbers, not individuals. The bureaucracy rewarded processes and ignored patients.

How can it be that we have tripled health spending and still have children at one of the world’s leading children’s hospitals in Victorian accommodation?

How could a hospital be given gold stars while they cut staffing below danger levels and let patients go without food and drink?

Leadership is the key, not targets.

Leadership which says the patient comes first.

That it’s the outcome that matters.

Leadership at the top and empowered leadership at every level within the NHS.

That respects the professionalism of staff and will back them up, to deliver results for patients.

Leaders not box-tickers.

So, yes – it is time for change.

And change starts for us with our number one priority: our NHS.

When you ask people what issue matters most to them, it’s most often health – of their family, and the health services we all depend on.

It’s the security of knowing, if a problem arises, the NHS will be there 24/7.

That the care we receive will be free at the point of use, based on need and not on ability to pay.

As the Party of the NHS, we promise we will be true to those values.

And we will back it by two strong commitments.

First, our commitment to increase health spending in real terms, year by year through the next Parliament. To protect the NHS.

We have a growing population.

We have a rising birth rate.

We have an ageing population.

Escalating threats to our public health.

Worsening health inequalities.

Medical advances bringing new opportunities but at new costs.

And our health standards and outcomes need to improve.

All this demands that protect the NHS budget.

That is our pledge.

We will not cut the NHS.

Yet this also means we need to make another commitment.

To focus every effort, every person, every penny and every pound, on delivering the best healthcare anywhere in the world. So that the quality of care and the treatment you receive through the NHS is never second-best.

To ensure that people have access to the best care, when they need it, when they need it.

And we have the plan for reform that the NHS needs to make the these changes.

Outcomes not targets

At the heart of our plan is one goal.

To improve the results for patients.

Does the level of spending match the results we’re getting?

I’m afraid the answer now is ‘no’.

Drugs, routinely available in European countries, not available here.

Deaths from breast cancer, in the worst quartile of European countries.

Obesity rates higher than most European countries.

Chances of dying from lung disease – two-thirds higher than in most European countries.

You know, there’s one simple explanation for this: Labour has made the NHS listen to politicians, not the patients.

Targets which dictate processes but distort priorities.

Endless, pointless, bureaucracy, costing the NHS billions extra every year.

One third increase in admin staff in the last five years, while the number of district nurses and health visitors has been cut.

We can’t go on like this.

The NHS needs a fresh approach to meet the demands of the 21st Century.

Every resource, every incentive, needs to be redirected towards results for patients – replacing the top-down relationship between politicians and professionals, with a direct relationship between patients and professionals.

Only if the NHS focuses its attention on results, will we achieve our ambitious aims:

Five year survival rates for cancer in excess of EU averages by 2015.

Premature mortality from lung disease below EU averages by 2020.

Year on year improvements in wellbeing for those living with long term conditions, retaining mobility, supporting independence, relieving pain.

Year on year improvement in patients’ satisfaction with their access to, and experience of, healthcare.

Increases in the number of mothers who have a well baby having had a positive birth experience

Increases in the number of people with mental illness returning to work.

Year on year improvements in public health outcomes especially in the most deprived areas.

Outcomes for patients, not grandstanding by politicians.

That’s why I’m delighted to announce today that one of the most respected and able medical leaders, has agreed to help us achieve these outcomes.

Professor David Kerr.

David’s expertise and knowledge will be crucial in helping us to create a NHS which has patients at its centre.

He was a key architect of the Blairite health reforms. Reforms which subsequent Labour Ministers have failed to respect or deliver.

That David is now working with us, shows that under David Cameron’s leadership we have truly become the party of the NHS.

The way ahead

I have set out what our ambitions are.

Delivering them will mean transforming the way things work in the NHS.

Choice and competition.

First, we will put patients in the driving seat.

Choice of treatment from any healthcare provider, including new independent and voluntary sector providers, that meets NHS standards, within NHS prices.

Access to clear information about hospitals and doctors, so that you will be able to see their quality and results, and make your decision based on their track record.

Greater control over your personal health records, putting you in charge of information that affects your health and wellbeing.

Treatment and advice from the NHS at any time. A guarantee that you can receive urgent care advice or treatment from the NHS 24/7.

A personal budget if you have a long-term condition, so you can be in control of how and when you receive the support that you need.

Empowering professionals.

Secondly, we will empower our professionals to lead from the frontline.

So will abolish the targets that undermine clinical expertise and bind professionals in red tape.

We will take responsibility for resources and decisions away from unaccountable health authorities and hand them over to family doctors, working together locally, accountable directly to their patients.

We will also enable NHS professionals to establish themselves as the owners of Foundation Trusts. Freeing them to use their frontline experience to structure services around what works best for patients.

Payment By Results

Third: we will ensure that NHS resources are not only increased, but increasingly get results.

Family doctors will use their budgets to pay for performance from the services available for their patients.

The payment will be based on value and the quality delivered to patients.

Value by moving to a system where no hospital can expect to be paid more to treat patients than it costs efficient hospitals.

Quality through the introduction of penalties for poor performance and rewards for better results for patients and better patient experience.

And we will link GP rewards also to the quality of services they deliver for their patients.

In public health, ring-fenced funds, will be paid to local organisations with extra rewards for areas that are successful in improving their communities’ health – for example reducing teenage pregnancy and health inequalities.

And in terms of access to drugs, we will reform the way drugs are priced so that drug companies will be paid according to the value that a drug offers to patients and to society, rather than the current system where NICE rules drugs out because the cost is too high – and the patients suffer.

Payment by results for drugs will mean that all new clinically effective treatments, will be available for doctors to prescribe to their patients.

The best outcomes for patients.

Further access to drugs, not

patients denied the drugs they need.

Better value for money, making frontline services stretch further.

These are changes worth fighting for.

Because it will be a fight.

The dividing line between Labour and Conservatives .

Gordon Brown lives by dividing lines. He only seeks consensus to protect himself from criticism. He has used the NHS as a political football, setting up artificial dividing lines.

Well, let me tell you that there are real dividing lines between us and Labour.

We will protect the NHS budget, Labour would not.

Labour’s aim is for people to wait four months for an appointment. We will aim to make waiting lists a thing of the past.

We will put patients at the heart of NHS priorities. Labour make tick box targets their priority.

We will cut bureaucracy by a third and keep cutting it. Labour doubled it.

We will listen and work with NHS professionals. Labour treat them like production line drones.

We will give older people the chance to protect their home; Labour’s death tax would deprive them of their homes and their savings.


There is a choice at this Election. Labour’s failed system or a chance for change.

Labour promised to be wise spenders. They turned out to be wasters.

They promised to cut bureaucracy in the NHS. It doubled.

They promised everyone would get an NHS dentist. A million lost it.

They promised no-one would have to sell their home to have to pay for care. But a thousand each week still do so.

They promised to protect local NHS hospitals. But now they say they want to close them.

They promised to end mixed sex wards.

But they failed.

They promised one-to-one care from midwives. They failed.

They promised qualified school nurses for every school. They failed.

They said they would save the NHS. But they have sacrificed it to political interference, endless upheaval, rampant bureaucracy and the scandal of patients left to die on wards while boxes are ticked and Ministers congratulate themselves on their targets.

It’s time for change.

The vision.

I have a vision of how our NHS can be.

Patients for whom no decision is made about them, without them.

Doctors and nurses who know they can deliver the care their patients need and are trusted as professionals.

Quality, rigorously measured, as the thread which ties together services.

Services designed around patients, not processes.

A recognition that every £ spent in pointless bureaucracy is a £ lost to patient care.

An NHS which sees research and innovation as central to being the best healthcare.

A service and a government which not only knows that prevention is better than cure, but is organised to achieve it.

An NHS which provides the care patients need, when they need it, where they need it.

And a service which not only is constantly improving but is striving - and succeeding - to deliver healthcare as good as anywhere in the world.

An NHS which is true to its principles of equity. Which achieves efficiency, and which most of all, delivers excellence.

An NHS of which we can all be proud.

So I say: to all those who work in the NHS.

To all those who depend on the NHS.

To all those who care about the NHS.

Don’t just hope for change.

Be the change.

And as David Cameron will say tomorrow: ‘vote for change’.

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