What record NHS investment means for each of my priorities
Secretary of State for Health and Social Care Matt Hancock's speech at Policy Exchange.
Thank you for having me. It’s great to be back.
Back as Secretary of State for Health and Social Care. Back in a Conservative government with the biggest majority in 30 years so we can get things done and move this country forward.
And brilliant timing that Policy Exchange has brought out the People’s NHS, which is your research into the public’s top priorities and I’m delighted to say it was no surprise.
No surprise that commitment to ‘more stuff’ is at the top of the list – and fits with my experience over the last 18 months as Health Secretary and over the last 6 weeks, where I’ve visited more hospitals than I’ve had hot dinners.
It’s also great to be back here with you today and see so many familiar faces.
Over the past 6 weeks, I’ve been right across the country. From Durham to Devon. From Bishop Auckland to Bracknell. I went down to Cornwall and took a dip in the sea. I’ve been to the beautiful beaches of Banff and Buchan.
I’ve been to so many hospitals that I’ve racked up a small fortune in car parking charges. But we’re doing something about that.
125 constituency visits.
I’ve spoken to doctors, nurses, paramedics, porters, and patients the length and breadth of this nation.
I’ve learnt a lot. As well as being on broadcast and trying to win this general election and supporting the party, I’ve also been listening.
And it’s clear: what unites us, what we share is a deep and abiding love for the NHS. It’s as if those 3 letters are embedded into our collective DNA.
One of the things this election result proves is that the people of this country want us to get Brexit done and invest in our NHS.
What we need now is a vision: a long-term plan for health and social care – bold, confident and ambitious.
That message resonated so strongly with patients who I met and with the people who work in the NHS, who are desperate for the improvements in technology and to make sure that the pressures on the NHS are relieved.
When we look back in 2030 to this moment – this once in a generation opportunity – where a political commitment and the financial resources are in perfect alignment with the overwhelming public mandate, I want us to be able to say: “Yes. We got it right.”
We made the right decisions, took the necessary steps to build a stronger and more sustainable health and social care system.
Because I want us to seize this opportunity and over the next decade, by 2030, have an NHS where everyone is empowered and supported to stay healthy and out of hospital wherever possible.
Where people have more control over their personal healthcare, and technology enhances the ability of staff to care.
Where we build on the record levels of satisfaction in the NHS that we see right now, and the record levels of treatment in the NHS and build on our cutting-edge life sciences. Create a more integrated NHS with a culture that maximises the potential of every single member of its staff.
I want to stress this point. I’ve met so many members of staff in the NHS over last 6 weeks and there’s so much dedication and commitment, but there are also parts of the NHS where that full potential is not brought out of every single individual, and that is down to leadership and culture.
We need a leadership and culture across the whole NHS that matches the best parts of it now where every single person can achieve their best. I’ve seen that talking to people on wards, in primary care and talking to people at all levels – the capability must be unleashed with a more supportive working culture.
We also need to rise to increasing levels of demand and an ageing population are not things we fear, but things we are prepared for, and can make the most of because people living longer is a good thing we should celebrate.
That’s my vision for where we need to get to. And I know it’s a vision shared by people across the nation.
One of the things I heard, over and over again, is that the early priorities I set for the whole of the health and social care system – these priorities are the right priorities, and we need to double down and re-energise them.
And thanks to the emphatic support of the Prime Minister, and the Chancellor of the Exchequer, I can add one more. So my priorities, which will apply to each and every part of the health and care system, are:
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Prevention: because prevention is better than cure.
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People: because we need more people working smarter.
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Technology: because patients and clinicians demand better.
And today, I’m adding a fourth priority. Infrastructure: because buildings matter too.
And all of this capital investment is underpinned by our record financial commitment to the NHS Long Term Plan: £33.9 billion extra every year within the next 5 years.
And we will meet our first manifesto pledge by enshrining that into law.
My 4 priorities are backed by clear numerical commitments we made in the campaign, which I am determined to meet:
- 40 new hospitals over the next decade
- 50,000 more nurses
- 6,000 more GPs
- 6,000 more primary care professionals
- and 50 million more GP appointments
We will deliver on these and each and every commitment in our manifesto.
One of the reasons I’m here, less than a week from the election result, having worked through the weekend to get the early announcements out – is that we are absolutely determined to deliver on our commitments.
So let me just take a moment to spell out what this record investment means for each of my 4 priorities.
First: infrastructure.
Over the last couple of decades, the approach to upgrading hospital infrastructure has been too piecemeal and unstrategic. I’ve seen some places where the infrastructure is fantastic, but in others it’s crying out for an upgrade.
Under the Health Infrastructure Plan, the NHS will come out of the 2020s completely physically transformed. 40 new hospitals over the next decade, but also addressing the short-term demands, fixing the backlog of maintenance and integrating care, both between primary and secondary, community and mental health, and the wider life sciences and research agenda.
The Health Infrastructure Plan will include the 20 hospital upgrades the PM announced on the steps of Downing Street, which are already underway.
We’re going to build a better NHS brick by brick: modern well-designed wards, with the right facilities to speed up recovery, ensure patients receive the right treatment, cut waiting times, improve patient safety, and make life easier for staff.
But it’s not just about the bricks and mortar. It’s about integrating care better. It’s going to be the biggest hospital building programme in a generation.
And we’re going to radically simplify the approvals process to make the whole approach for the use of capital investment more strategic across integrated care systems – not piecemeal trust by trust.
But it isn’t just about investing in new buildings, but embracing a new mindset.
So my second priority is prevention. Putting prevention at the heart of everything we do. Prevention of ill health.
It can’t be right that as we enter the 2020s a man born in Buckingham can expect 68 years of good health, but a man born in Blackpool can only expect 53. That’s a health-span gap of 15 years. And it starts even before a child is born.
So we’re massively investing in maternity care and in primary care because primary care is the frontline of prevention.
We will deliver an extra 50 million appointments a year in general practice within the next 5 years – by expanding the workforce, harnessing the power of technology, and giving GPs the support they need.
And we will also “unleash the potential” of our pharmacies because there really is so much more they are capable of doing.
Over the next 5 years, they will become the first port of call for patients with minor illnesses. More than 10,000 pharmacies are ready to receive referrals from other parts of the health service – and that number will grow.
The prevention agenda is incredibly important because prevention is better than cure.
We also know the challenges the NHS faces: demand is rising faster than at any point in history.
Baby-boomers are reaching the age where they need more and more healthcare.
So, as well as investing in infrastructure, we need to make the 2020s a decade of prevention of ill health:
Support everyone to take more care of their own health. I don’t believe in the worried well – I want healthy people to be concerned about their own health so they stay healthy.
Vaccinate against preventable diseases.
Redouble our efforts to be smoke-free, redouble our efforts on obesity, and embed a more proactive, predictive and personalised approach across the NHS.
And we must hardwire good health into housing, transport, education, welfare and the economy because we all know preventing ill health – mental and physical – is about more than just healthcare. I pay tribute to the work of Public Health England, and we are going to do much more.
My third priority is people.
On my 125 visits, I met the most amazing people and was inspired once again by their service and dedication. We need the right numbers of people, and we also need the right culture.
I know there is an urgent need for more nurses in our health service.
Every hospital I go to, I ask staff, top to bottom: “If there’s one thing you could change what would it be?” and the “number of nurses” is, without fail, the number one thing.
So I welcome yesterday’s news that we now have record numbers of registered nurses, midwives and nursing associates. The Nursing and Midwifery Council said the all-time high figure has been achieved by more people – more new nurses – joining the register and fewer people leaving.
I will deliver on the commitment that, in 5 years time, we will have 50,000 more nurses in the NHS.
More nurses coming through the traditional route. More nursing apprenticeships, which I introduced as skills minister and means a lot to me. More international nurses.
And of course more retention because you increase the number of nurses by persuading fewer to leave.
And I can formally announce today, we are starting immediately with delivering on our commitment of 50,000 more nurses.
First, we are launching an expanded nursing recruitment advertising campaign.
As my grandmother taught me, nursing is one of the most fulfilling careers you can have. These days it’s a high-tech, highly rewarding job, one of the most respected, valued and caring professions you can do.
I’d like to thank the Chief Nurse, Dr Ruth May, for the work she’s done to attract the brightest and the best into nursing, but I know that advertising alone is not enough.
So to attract more nurses into the profession, and to reward students who choose nursing as a career, today I can announce a £2 billion package of financial support for trainee nurses.
We’re going to give student nurses a free, non-repayable training grant worth up to £8,000 a year, on top of the existing funding available, almost doubling the financial support on offer.
Every student nurse will receive at least £5,000 extra a year from next September, with more financial support for childcare costs, or in regions or disciplines, such as mental health, where the need for nurses is more acute.
At the same time, we will expand further the routes into nursing with more nursing associates and apprentices. I want to make it easy to climb the career ladder to become a fully registered nurse.
It’s not just about nurses – GPs are the bedrock and nurses are the lifeblood of the NHS, and we must invest in both to build a better NHS.
I can also announce we will fix the pensions system so senior doctors and nurses can take on extra shifts without the fear of an unexpected tax bill.
We’ve already agreed a short-term solution for this winter, but today I can announce we’re launching an urgent review of the annual allowance taper so we can fix it permanently and give clinicians the confidence to do their jobs in the knowledge they will be fairly rewarded.
My department and the Treasury will work with the royal colleges and the British Medical Association to create a system that works for everyone.
But numbers are not enough. We must also change the working culture in large parts of the NHS so it’s a place where everyone’s contribution is valued.
It’s essential we cut the number of staff leaving the NHS each year because they feel burnt-out or under-valued.
We do that by:
- creating a positive, inclusive and compassionate culture
- tackling bullying, harassment, and discrimination
- and placing as much importance on the physical and mental health and wellbeing of our staff as our patients
That’s how we create the right culture and recruit and retain more staff. Our People Plan, led by Baroness Dido Harding, will set out the transformation to the working culture I want to see right across the NHS.
My fourth priority is technology.
If you thought I was going to relent on tech then I’m afraid I’ve got some bad news for you.
The next 5 years are going to see continuous upgrades.
And I know from my 125 visits how much the frontline is demanding better tech. I’ve seen the amount of time it saves clinicians.
There’s a brilliant example in Warrington – they had just introduced the e-prescribing on medicine rounds in the hospital. The drugs trolley was connected to the system so they knew exactly what medicine to put into patients’ casing and then the taking of the medicine was confirmed in the system.
It’s simple technology and it’s saving clinicians half an hour per day.
So we’re going to double down on the tech agenda and bring the NHS into the 21st century.
We’re going to use digital technology to ease the burden on staff, give people the tools and information to manage their own healthcare, and make sure that patient data can be safely accessed wherever and whenever it’s needed across the system.
Better technology means a child getting immediate support through their smartphone while they wait for their first mental health appointment.
Better technology means your elderly relative can live independently for longer thanks to wearables.
Better tech means we can help our staff with tools like e-rostering, instead of trusts having to phone round and fork out on agency fees.
It’s quite simple: better tech means better health and social care.
That’s why I set up NHSX. Their task is to articulate the vision, define the strategy, decide on priorities and spending, and then oversee delivery.
NHS Digital also has a vital role to play: designing, building, deploying and operating digital products and services.
But we need to get the basics right. Just to give you one example:
At Alder Hey they’ve reduced the time spent logging into each individual computer system from 1 minute 45 seconds to just 10 seconds. There’s almost 5,000 logins a day so that’s over 130 clinical hours saved each day.
I want the whole of the NHS to be part of the programme that will take us into the 2020s, not just the leading trusts.
Until now, the focus has been on getting some hospitals up to scratch through the global digital exemplar programme. They’ve got to keep advancing, but now we’re going to help many more hospitals with a new digital aspirant programme.
And this model of excellence crucially will become part of the CQC’s inspection regime too so people know they will be assessed against good use of high-quality technology and incentivised to deliver.
We’re going to use technology on the frontline and also to advance the cutting-edge techniques and we’re going to make the UK the world leader in life sciences, with doubling research into dementia and making sure data can be used appropriately and properly to advance the needs of the medical research community – to find new treatments and save more lives.
Each of my 4 priorities apply across every part of the system: pharmacies, primary care, community care, mental health, hospitals, and social care too.
We must seize this once in a generation opportunity by being bold, confident, ambitious, and harnessing the energy and enthusiasm that has been unleashed in this country for change.
That thing which unites us: the NHS. We can remake it anew, ready to rise to the challenges of today and of tomorrow by investing in infrastructure, embracing and embedding prevention, nurturing and empowering our people, and the best health technology in the world.
These are my 4 priorities as Secretary of State for Health and Social Care, as part of this new One Nation Conservative government.
It’s an energising agenda and I look forward to working with you all.
I am energised, excited but also absolutely determined to meet the commitments we’ve made – and also to repay the trust put in us.
There’s a lot of work to do. So let’s get to it.