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Editorial Wednesday 20 June 2012: An exclusive preview of Andrew Lansley's NHS Confederation speech

As we did last year, Health Policy Insight has an exclusive leak of Andrew Lansley’s authentic speech to the NHS Confederation conference.

Under embargo to 1.15 pm Wednesday 20 June 2012

Secretary Of State – speech to the NHS Confederation conference, Manchester

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Thanks Mike, and thanks to all the team. I want to say how much I personally appreciate all of the wasteful bureaucracy that the Confederation’s members are no longer doing.

A lot has happened since I spoke to you last year.


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Much of it, interestingly, has been almost totally unimportant. Such as lots of bureaucrats losing their jobs. I notice that the audience is a bit smaller this year, but that will be because of the important principle of the NHS reforms ‘no decision about me without me’ - and clearly many of these bureaucrats didn’t want to make a decision, so we are having this conference without them.

And that’s really what the Health And Social Care Act is all about.

On the one hand, you have patient choice, which is very important.

And on the other hand, you have no bureaucrats, and therefore no decisions by bureaucrats who aren’t there. It stands to reason.

And as we face years of financial stringency with The Nicholson Challenge, we need more of no decisions being made by bureaucrats.

Because bureaucracy is bad. And doctors are good.

Industrial action
But they’re not good not when they go on strike.

Oh no. Good doctors who go on strike become bad doctors.

In fact, doctors should never go on strike about their pay and conditions. Because this is our NHS. Indeed, it’s my Health And Social Care Act, and so in many ways, I’m sure you’d agree that it’s my NHS.

And by taking this industrial action over trivia like retirement age, doctors are taking a decision about my NHS without me.

And that’s just not on.

And I think the public will be outraged by the greed of doctors. Did you know that every doctor retires on a pension worth three billion pounds a year, with a lump sum of sixty-seven million pounds?

It’s pretty shocking, isn’t it? It may not be true, but it’s a fact.

And really, what could possibly go wrong with getting doctors to work longer while cutting their benefits and stopping pay rises?

It’s just common sense.

Anyway, doctors shouldn’t strike. They’re not matches!  (pause for laughter)

Simon Burns gave me that joke. And I’d just like to pay tribute to Simon, and to Anne Milton for their hard work. I know there’s someone else I should thank, but I can’t remember who.

Principles: that’s not just a cheap high street clothes shop. Principles are what the Health Act is all about: principles like the end to top-down orders.

This is why we have liberated CCG pathfinders to mandatorily commission NHS 111 and three other services.

We will have no more of Labour’s stifling, top-down approaches to the NHS.

Let’s face it, the NHS is not lean enough to take its top off yet.

We really believe in the importance of clinical commissioning groups being new, distinct and sovereign organisations. This is a core principle of the reforms.

And if you’re still sceptical about the reforms, then just look at all the important differences between PCTs and CCGs.

PCTs were geographically-based statutory organisations with boards meeting in public; all called by a standardised format of ‘NHS local geographical name’; and which went through a bureaucratic and centralised process to assure the competence and quality of their commissioning.

CCGs are, of course, completely different.

We believe in CCG autonomy and sovereignty so strongly that we tried, very hard, to have a national communications service for CCGs.

Now I have heard rumours that some of you are a bit concerned about Sir David Nicholson’s grip.

I’m not sure the word ‘grip’ is very helpful. It implies a sort of top-down control that, as I’ve already mentioned, is very much a thing of the past.

So I’ve talked to Sir David, and we’ve agreed that from now onward, ‘grip’ will no longer be used to refer to what is, after all, no more than line management.

The new acceptable phrase to be used for referring to Sir David’s management style will be ‘firm cuddle’.

I’m sure you’ll agree that once we put ‘The Nicholson Firm Cuddle’ alongside ‘The Nicholson Challenge’, we move significantly closer to a solution.

The future
Now the future is jolly important. And I do have some news about the future.

We don’t want things getting too cosy or complacent in the NHS. And so today I am announcing a new restructuring, and I’d like to thank Sir David Nicholson for his input into this.

All CCG pathfinders will be merging with local providers, to create supervised social-healthcare remits (SSRs). This should ensure that the care is wrapped around the patient. Now clearly, we will need some co-ordination across the system, and Sir David suggested that we should have a name that implies uniting, and what better title could there be than the Union of Supervised Social-Healthcare Remits?

Naturally, Sir David Nicholson will be the leader of the USSR.

I also have an announcement about my future. When David Cameron told the Conservative Party and the electorate that he planned to leave me as Health Secretary for the whole of the Parliament, I took that as a great vote of confidence.

But of course, the USSR will need another leadership figure. We wouldn’t want things getting top-down again; we know what trouble that causes. And so Sir David and I have agreed that I will be the Tsar of the USSR.

This has of course left a vacancy as Health Secretary, but I think you will agree that an outstanding candidate has already presented himself through his sterling performances in the passing of the Bill and in Commons debates.

The time has come: will you please welcome Simon Burns, Secretary Of State For Health.