GovWire

Speech: The challenge today: NHS 75 and post pandemic

Department Of Health

July 14
08:56 2023

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We gather here just a week before we will mark the 75th anniversary of the founding of the NHS.

There is much to celebrate: the NHS is treating more patients than ever before and using cutting-edge medicine day in and day out.

But we also must acknowledge that services face sustained pressure.

Much of this stems from the pandemic.

You only need look at the graphs showing the numbers of patients waiting more than a year for surgery before the pandemic to see its impact.

The virus left behind long waiting times for patients who had their care delayed or cancelled.

And it placed a huge burden on our NHS and social care staff, who responded with dedication and commitment.

But faced with these bigger challenges, we now need to be more open to the bigger opportunities for change COVID-19 has shown is possible.

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The Prime Minister has rightly made cutting waiting lists one of his 5 priorities.

Our 3 recovery plans reflect this absolute focus on delivery and chart a clear course to do exactly that across:

  • electives
  • urgent and emergency care
  • primary care

Ive been clear with the NHS that this is where I want its focus to be. And in return there will be fewer targets and less micromanagement from the centre.

Last weeks NHS mandate illustrated this point. A short and clear document that is half the size of previous years.

Cutting waiting lists is not just important for patients. Its also important for the economy. People leaving employment due to poor health is increasingly a headwind for wider economic performance.

But there are signs of progress.

Weve virtually eliminated 2-year waiting lists for elective operations like knee replacements, and reduced waits of 18 months by over 90%, showing that the NHS in England is on the path to recovery [political content removed].

Were using technology to end the 8am rush for GP appointments.

Were delivering 5,000 new permanent beds to get more patients into hospital, faster.

And in the coming days the NHS will be publishing the much-anticipated Long Term Workforce Plan.

This, for the first time in history, will set out our plans to recruit, retain and reform our workforce for the next 15 years so that it can better meet the needs of patients.

Im driving the NHS to put patients first.Because too often our health system doesnt.

Thats why we need to double down on giving patients more control over their care through initiatives like patient choice, and the work were doing to update the NHS App so people can access their medical records, manage prescriptions and sign up for clinical research.

The same principles should apply to public health and prevention - supporting people to make healthier choices throughout their lives.

Because it is in their interests to do so.

We need to give people the knowledge to understand their own health and the freedom to decide whats best for them, the freedom to live their lives as they see fit.

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Outlook ahead

Demand for healthcare continues to rise.

The pressure on public finances is growing. Our population is ageing. And medical advances mean that more can be done.

When the NHS was founded in 1948, it had less than 145,000 staff and an annual settlement of 11.4 billion in current prices.

Today it employs 1.4 million people and has a budget approaching the GDP of Greece.

This means it delivers much broader, more comprehensive care than 75 years ago.

Indeed on a typical weekday, around 70,000 people attend A&E. Over 370,000 people attend an outpatient appointment. And more than a million people use general practice.

Yet demand is rising further still. From my experience working in the Treasury and elsewhere in government, I know that there are consequences if we were to allow the NHS budget to grow without control.

Two examples illustrate the size of the challenge ahead which makes action on prevention so pivotal.

One in 4 adults across England live with 2 or more health conditions.

And people over 70 are 5 times more likely to visit a GP than young people - and the number of 70 year olds is rising rapidly.

Most agree that prevention is the only way to bend this demand curve. But what I believe is that the only way we can do this is by giving people the tools to take more responsibility for their own health.

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Children warrant tighter controls

That sense of pragmatism means that I accept that on occasion government will need to intervene.

I am pleased there is a political consensus to reduce smoking, and steps taken over the last 13 years [such as on plain packaging] have made material progress.

And when it comes to our children there is a case for even tighter controls.

Take vaping. As Professor Chris Whitty, our Chief Medical Officer says: If you smoke, vaping is much safer; if you dont smoke, dont vape, and marketing to children is utterly unacceptable.

This is a pragmatic approach that this government is taking forward.

Smoking has long been recognised as the biggest cause of cancer.

And its right to encourage smokers to switch to vaping.

But its wrong that disposable vapes were being marketed to children when it is illegal to sell vapes to children.

As a dad of 2 young children, I know how frustrating it is when parents see products which are marketed specifically to attract children.

Thats why we recently cracked down on underage sales with our illicit vapes enforcement squad and why we ran a call for evidence on youth vaping.

We are looking closely at the evidence on the unknown long-term effects - and will be announcing further steps soon.

My choice

This is how I am approaching public health in my role as Health Secretary.

A deeply pragmatic approach that empowers adults and better protects children.

It is an approach that I know the Centre for Policy Studies has already championed, including through their paper on Powerful patients and paperless systems with my colleague Alan Mak.

And it is the reason I have asked Rob [Colvile] for his input to the work that Professor John Deanfield is leading on a more personalised approach to prevention.

The opportunity

I want to give people the tools and knowledge to navigate the system quickly and effectively, being realistic about what works for busy people with busy lives.

We all know that family members sometimes put off going to their GP until symptoms have advanced - often for understandable reasons.

Balancing work and family life can be tough - and often your own health is sidelined.

Thats why we are making it much easier for patients to get the care they need at a time and place that suits them.

Starting new oral contraception with a trip to your local pharmacist, instead of needing to visit the GP.

Allowing patients to directly refer themselves to physiotherapy or podiatry for certain conditions rather than having to complete an obstacle course of appointments before being referred.

Giving patients access to their test results on the NHS App, rather than having to make another GP appointment.

And using the time freed up for GPs so they can deliver the high-quality care which we know they want to.

Simple, common-sense reforms that allow patients to tackle illness earlier.

This is exactly the mindset we need to approach prevention.

People in politics often talk about cutting red tape. In pharmacy thats exactly what we are doing.

At the moment the rules say you cannot collect your medicine if the pharmacist isnt there.

Even if they have bagged it up ready.

We are changing that.

The rules say they must deliver the exact quantities of medicines prescribed - so pharmacists waste time opening boxes and snipping up pill packs.

We are removing that burden.

The rules make pharmacists waste time supervising basic tasks and ban modern ways of doing things like hub and spoke models.

Well change that.

There are lots of limits on what pharmacy technicians can do.

We are changing the rules to free up pharmacist time for patients - speeding up access to care and cutting waiting times.

Making it happen

Vaccination

The lesson from COVID-19 is that vaccination is one of the best value interventions we have to protect the public.

We are already seeing how innovation from our life science partners are applying this to prevention more widely.

Think about how the HPV vaccine is reducing incidence of cervical cancer.

Or hepatitis B for cancers of the liver.

And earlier this week the JCVI issued an update on the potential for new vaccines in RSV, a nasty respiratory co

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