There are moments in our national story when our choices define who we are. In 1948, Clement Attlee’s government made a choice founded on fairness: that everyone in our country deserves to receive the care they need, not the care they can afford.
That the National Health Service was created amid the rubble and ruin of the aftermath of war makes that choice all the more remarkable. It enshrined in law and in the service itself our collective conviction that healthcare is not a privilege to be bought and sold, but a right to be cherished and protected. Now it falls to our generation to make the same choice.
There have always been those who have whispered that the NHS is a burden, too expensive, inferior to the market. Today, those voices grow louder, determined to use the crisis in the NHS as an opportunity to dismantle it. This government rejects the pessimistic view that universal healthcare could be afforded in the 20th century but not in the 21st. So does the public. But unless the NHS changes, the argument that it is unsustainable will grow more compelling. It really is change or bust. We choose change.
Today, the prime minister will launch our 10-year plan for health, to radically reimagine healthcare. More care will be available on your doorstep and from your own home, with thousands more GPs. Services and resources will be moved out of hospitals and into the community. New neighbourhood health centres[?] will house doctors, nurses, physios, therapists, tests, scans and urgent care under one roof, built around patients’ convenience.
AI technology will liberate frontline staff from the drudgery of admin, giving them time to care. Saving just 90 seconds of data entry and note-taking per appointment would be the equivalent of hiring an extra 2,000 GPs. For patients, tech will make booking appointments and managing your care as easy as doing your shopping online.
By treating and caring for patients closer to home, we will reach patients earlier, to catch illness before it worsens, and prevent it in the first place. Our plan brings together a coalition of the willing on public health, working with supermarkets to make the healthy choice the easy choice and pharmaceutical companies to secure obesity jabs for NHS patients.
The plan is backed by an extra £29bn investment to fund the reforms, better services and new technology.
I am sometimes told that NHS staff are resistant to change. In my experience, they’re crying out for it. They have suffered the moral injury of turning up to work, slogging their guts out, only to leave at the end of the day feeling exhausted and demoralised by the conditions that patients are being treated in because of circumstances beyond their control.
I spoke to a nurse in a community clinic who told me she spends more time filling out forms than seeing patients. That’s not why she joined the NHS. We need to free up our staff to do what they do best – care. They’re the ones driving innovation on the frontline, and their fingerprints are all over this plan.
To succeed, we need to defeat the cynicism that says that “nothing ever changes”. We know the change in our plan is possible because it is already happening. We have toured the country and scouted the world for the best examples of innovation and reform. If Australia can effectively serve communities living in the remote outback, we can meet the needs of people living in rural and coastal England. If community health teams can go door to door to prevent ill health in Brazil, we can do the same in Bradford. We know we can build the “neighbourhood health service”, because teams in Cornwall, Camden and Northumberland are already showing us how.
Since July, we’ve already begun to turn the tide. We promised to deliver 2m extra elective appointments in our first year – we’ve delivered 4m and counting. Through our plan for change, we’ve taken almost a quarter of a million cases off the waiting list.
The science is on our side. The revolution in genomics, AI, machine learning and big data offers a golden opportunity to deliver better care for all patients and better value for taxpayers. We will take it, marrying the ingenuity of our country’s leading scientists with the care and compassion of the health service.
Above all else, we will give power to the patient. In an age of next-day deliveries, an NHS that forces you to wait on the phone at 8am to book an appointment feels ridiculously outdated. Patients don’t just want a service from the NHS, we want a say. We don’t want the same as everyone else; we want care that meets our individual needs. Equality does not mean uniformity, it means that every person receives the right care for them.
This plan will give people real choices, faster responses and a say in how their care is delivered and where. It will fulfil Nye Bevan’s commitment in 1948 that the NHS would put a “megaphone in the mouth” of every patient, and make sure that the advantages enjoyed by the privileged few were available to all.
We know the British people are counting on us to make sure that the NHS not only survives, but thrives. We are determined not to let them down.
That’s the plan – now it falls to us and the 1.5 million people working in the NHS to deliver it. It won’t be easy, but nothing could be more worthwhile. If we succeed, we will be able to say with pride, echoed through the remaining decades of this century, that we were the generation that built an NHS fit for the future and a fairer Britain, where everyone lives well for longer.
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