Conference Speech 2009 on the future of the NHS

Norman Lamb, 20/09/2009

Category: Liberal Democrat Conference (General Speeches), Health Service

Every day in our hospitals moments pass that change the course of people“s lives.
Many of us have experienced the joy of welcoming new life into the world.
Others have spent long nights sitting by a loved one“s bed.

When our own son was rushed to A and E after being hit by a car we witnessed firsthand the care and dedication of doctors and nurses.

This is when we discover just how lucky we are to have the NHS.

A service that makes no distinctions between rich and poor.

A service which treats all people equally - and is free when we need it.

The National Health Service represents values which bind us together as a nation.

If you ever are in doubt of the value of the NHS then cast a glance across the Atlantic.

In the United States, if you are out of luck, the illness you“re suffering from is excluded from your insurance “ or you may have no insurance at all.

Just imagine the anxiety and distress for so many families when a loved one falls ill.

This summer we have witnessed the most distorted, dishonest debate on healthcare reform in the US.

Sarah Palin outrageously claimed that the NHS has death panels to decide who lives and who dies.

Sarah, even with lipstick, a lie is still a lie.

This in a country with one of the worst infant mortality rates in the developed world.

And yet who was there providing succour and support to those defending the indefensible? Leading Conservative, Daniel Hannan.

He says the NHS is a “60 year mistake“.

And when Mr Hannan said this, did David Cameron move swiftly to squash him?

Err“?no. Instead he waited three weeks “ three weeks for these words to stain the public record. And then he promoted him.

And now we know from polling that 2/3rd“s of Tory MPs do not believe that a health service, funded from general taxation and free at the point of delivery will survive.

So the mask has slipped “ Daniel Hannan reflects mainstream conservative opinion.

The terrible mistake is not the NHS - the terrible mistake would be if we ever handed responsibility for the NHS back to the Tories.

But the NHS is in danger.

We“re now facing the biggest financial challenge in its history.

Whoever wins the next election, the pressures will be the same.

The crisis in public finances dictates that savings must be found.

And this is not the time for false promises.

Health care must be a high priority because health costs will continue to rise “ particularly with an ageing population.

But there cannot be any no-go areas.

After all, every pound wasted is a pound not going into patient care.

I want to make savings to re-invest in the NHS.

And, if we“re honest, not everything in the NHS is as good as it should be.

Cancer and stroke survival rates still lag behind many other countries.

Mental health services are simply not good enough.

The Patients Association complains of numerous examples of neglect, particularly of older people.

And shocking failures in the standards of care, such as at Mid-Staffordshire hospital, continue to happen.

No one can deny that the Labour Party“s intentions have been right.

But the road to hell is paved with a bungled Private finance initiative

Labour invested an enormous amount of our money to make up for the years of Tory neglect.

But too much has been squandered.

Instead of letting local managers innovate and develop their services to meet local needs - they have imposed a crushing straightjacket from above.

Instead of empowering NHS staff to make decisions based on years of experience - they have second guessed their judgment from the comfort of Whitehall.

And instead of trusting doctors and nurses to know what“s best for their patients - they judge them on their ability to meet Labour“s targets.

Labour“s approach to health is “nanny knows best“.

They“ve created 698 standards to measure hospitals, with over 60 different bodies inspecting them, often repeating the same questions time and time again and applying different standards.

There are a plethora of organisations with some role in patient safety “

the Care Quality Commission,

the National Patient Safety Agency,

Monitor,

the Health Protection Agency,

and the Health and Safety Executive “ to name a few.

But which one actually takes responsibility when something goes wrong? Who is accountable?

Endless legislation with layers of regulation and more to come “ but has it made any difference?

This is Labour madness.

It requires a hidden army of clerks in every hospital to feed the beast.

All designed to show that on paper the hospital is safe.

But as we know from recent scandals “ such as the deaths at Mid-Staffordshire hospital or the horrifying case of Baby P - this often bears little relationship to reality.

This is what happens with a tick-box culture.

You get paper safety not real patient safety.

Did you know there are now more administrators, managers and clerks in the NHS than there are hospital beds to put them in?

We“ve ended up with a heavily regulated, suffocating bureaucracy which blocks innovation, destroys the morale of staff and undermines patient care.

Reform is not a luxury, it“s a necessity

Labour“s failed

The Tories cannot be trusted

So it falls to the Liberal Democrats to point the way forward to a people-centred NHS, fit for the 21st century.

There are 3 key challenges ahead:

Dismantling Labour“s bureaucratic monster to free up resources for patient care.

Liberating the remarkable NHS staff to give their very best

Getting the money working in the health service to keep us all healthy and avoid crisis admissions to hospital.

Labour“s leviathan has grown so large that health Quangos alone now cost nearly £1.2 billion a year, employing 25,000 people and with 24 quango chiefs each being paid more than the Prime Minister - the time has come to sort this out.

The Liberal Democrat vision for the NHS is for those in charge of your local services to be accountable to you “ not to government ministers.

We will wield an axe to the quango state.

In a decentralised NHS there are 5 steps to be taken.

We will not allow more than one organisation to ask the same question to a hospital or any other health trust.

We will cut the amount spent on quangos by a fifth - scrapping many of them completely.

We will cap high-earners pay in Health Quango“s so that no one is paid more than the Prime Minister.

We will cut the bureaucracy of the Department of Health by half.

We will scrap Strategic Health Authorities which have no place in a decentralised NHS.

This would result in huge savings, over £1/2 billion a year, not only in central costs but in every hospital.

This is what we mean by a people-centred NHS, fit for the 21st century.

Our approach is a fundamental challenge to the Labour mantra that you can improve the quality of care by imposing rules from Whitehall.

The secret is in liberating those who work in the organisation giving them a say in the way their service is run and a stake in its success.

Rather than dictating to experienced NHS staff about how to improve our hospitals “ let“s start listening to what they have to say.

I have met many extraordinary people working in our hospitals - really dedicated staff.

Too often they tell me of their frustrations: that no-one listens to them, that the care they can offer is compromised by targets imposed from on high.

The Liberal Democrats will give power back to the nurses who run our wards.

This means giving the ward sister control over their budgets and responsibility for the staff who work there.

So that when they“re understaffed, they“re able to call in extra help.

So that the ward sister can take whatever steps are necessary to ensure that patients are properly fed and end the utter disgrace of patients leaving hospital malnourished.

And so that when the cleanliness of wards isn“t up to scratch, they“re responsible for sorting it out and they have the power to act - the ward sister must have the final say.

The Liberal Democrat message is get rid of nanny and put sister in charge.

But this is not enough “ we must go much further if we want to get the very best from this remarkable workforce.

We must empower staff at every level “ not just doctors and nurses “ but the whole team - from the cleaner right up to the chief executive.

We should look at what works in other sectors and learn from their success “ the John Lewis Partnership model is just such a case.

In this highly successful business every staff member is a partner, has a say in important decisions and benefits from the success.

The Liberal Democrats would turn every NHS hospital into an employee owned trust - so that people working in the NHS have a stake in it as well.

This makes a reality of Jo Grimond“s great vision of employee involvement.

All the evidence shows that this approach will improve quality and save money.

We know this can work. Just look at the success of Central Surrey Health, where nurses and therapists took over community services from the PCT.

Now every member of staff has a share. Services have improved and waiting lists are down. The culture has changed. They are in charge.

This is what we mean by a people-centred NHS, fit for the 21st century.

If we“re going to weather the current financial storm then we must make the NHS work better with the resources it has.

Rather than simply giving hospitals money for doing more and more operations we should reward those that help keep people healthy, bridging the divide between primary and secondary care.

By reforming the payment system we can help hospitals to be more efficient.

Hospitals would receive payments for operations at a rate based on the best run hospitals rather than the average.

This reform alone would save over £2 billion a year to invest in frontline services.

These are the tough decisions that the tough times require.

This is what we mean by a people-centred NHS, fit for the 21st century.

By reducing needless waste we can stave off budget shortfalls and reinvest in areas where the NHS must improve.

Such as in mental health “ for too long, just not given sufficient priority.

The Liberal Democrats are the only party committed to ensuring equal treatment for those currently waiting months on end for therapy.

Another area where there is real need for reform is dentistry.

The Liberal Democrats will ensure there is an NHS dentist available to everyone who needs one.

By making sure that dentists who are trained by the NHS - work in the NHS for a minimum of five years.

By reforming dentists“ contracts so they“re paid to take on more NHS patients, not just getting money for the number of treatments they provide.

And we“ll prioritise areas where dental services are worst, by providing increased payments to dentists who operate in the areas of greatest need.

Finally, Labour promised at the last election that every woman would be supported by the same midwife throughout her pregnancy and be entitled to choose where she gave birth.

But “ if you“ll excuse the pun - they simply haven“t delivered.

While births continue to rise at a rapid rate, the number of midwives has stalled.

In North Norfolk a pregnant woman was turned away from her local hospital because there weren“t enough beds and staff to deliver her baby.

Many women are not being given a choice about where they give birth or the support they need at home.

Instead of spending £150m on the health and pregnancy grant giveaway we“ll recruit 3000 more mid-wives and health visitors - so that every mother has the advice and support she needs and is given a choice about where she gives birth.

This is what we mean by a people-centred NHS, fit for the 21st century.

So, the choice is clear.

Vote Labour and you will continue with an NHS strangled by bureaucracy.

Vote Tory and the very existence of the NHS is at risk.

Or vote Liberal Democrat for a party which is ambitious, straight talking and
prepared to take the tough decisions to safeguard the very future of our NHS.

Over sixty years ago, at a time of crisis. Sir William Beveridge, that great Liberal, came up with a vision for a health service to meet everyone“s need.

Conference, the time has come once again for the Liberal Democrats to reaffirm Beveridge's great vision - a people centred health service for all fit for the 21st century.