10 min read

Editor's blog Tuesday 5 October 2010: Health Secretary Andrew Lansley's Conservative Party conference speech, translated

Andrew Lansley's speech to the Conservative Party Conference.

Analysis and translation appear in bold italics.


"At each of the last six conferences, I addressed you as Shadow Health Secretary. What a pleasure it is to address you today as Health Secretary.

You think you're surprised? I can't believe it either!

"And it's my privilege too, to introduce to you the Government's new health team. Simon Burns, Anne Milton, Freddie Howe.

None of whom understand my Great Plan. But I am The Liberator. I can liberate them from their ignorance.

"And also our valued Liberal Democrat colleague, Paul Burstow, who has assured me that the Department of Health would be safe in his hands while we were away.

Paul who?

"Together, we are pressing forward the health and social care reforms our country needs, with real purpose and pace. We won't make Labour's mistakes.

Of governing for 13 years

"It took Labour three years, after 1997, just to publish a plan about what they wanted to do in the NHS.

I have forgotten that they pledged to stick to Conservative spending plans for the first two financial years of their administration

"Even then, there was no coherence; no consistency.

All you need is Equity And Excellence.

"There was no unity of purpose: a divided government, which picked up the baton of reform, but dropped it as soon as it got hot.

NICE, foundation trusts, payment by results, patient-reported outcome measures, 4-hour waits in A&E, 18-week waits for electives, 2-week waits for cancer, extended access in primary care, dropping rates for MRSA and C Diff, World-Class Commissioning - yes, they never stuck with anything. NHS managers couldn't move for the dropped batons.

"We want people to be clear that this is a government that's serious about real reform: we have already published comprehensive plans setting out our ambitious vision to improve the NHS - none of Labour's delays and procrastination;

OK, so The Plan is not being rapturously received as yet ...

"We intend to drive forward reform of our public services as a united government - together, in the national interest

David and George said remember TINI, always say TINI

"I think many of you already know how passionate we are here to improve public services. I come from a public service family. My father worked in the NHS. My eldest brother, was a teacher. My other brother, a police officer. And me, first a civil servant, more recently in Parliament- I've spent two thirds of my working life in public service. I care about public services - and that is why I know they need to change. To be genuinely responsive to the people they serve - not the politicians and civil servants in Whitehall.

"The NHS is a great national institution. It embodies the values of a society in which we care about each other; not just about ourselves.

Please don't let anybody notice that that's socialism

"A society with the values of: Freedom, Fairness; and, Responsibility.

That's the obligatory Coalition Agreement bit in

"We know the extraordinary commitment of the staff who work in the NHS. We have all seen it. I have the privilege of seeing it every week.

"I saw a premature baby earlier this year, at Southampton General, in an incubator, being fed her mother's milk through a tube. She had a better chance of surviving, thanks to the expert professionals on hand.

"I met a teenage cancer patient in Leeds in May, receiving specialist care in a cancer ward that, with the help of a charity, had been designed with flair to make teenagers feel at home.

"And a man I met in Basingstoke in July who'd had a frightening and rare cancer. He told me his story. A decade ago, he would have died but the innovation and life-saving care he received now gave him hope for his future.

"Just a handful of examples from the millions of people whom the NHS takes care of every week.    

I meet real patients, you know. That practically makes me a doctor

"And do you know what? Not one of them insecure because they couldn't afford treatment.  

If I'm lucky, I may get away with this line. Fear non-universal coverage, people, even though the NHS was created as a response to such a situation

"And we as a party have always supported the NHS, free at the point of use, based on need, not ability to pay.

Ulp. Any historians in tonight? Will anyone remember we voted against its creation 51 times? No - that was a long time ago. Better hope there's not too much research into whether we opposed the New Labour bills proposing increasing the funding

"And we do so again today. Committed to the NHS. An historic commitment to increase NHS resources in real terms each year, despite the dreadful debts we inherited. We will not make the sick pay for Labour's debt crisis.

Need to mention "Labour's debt crisis" again

"But because we have made our commitment to the NHS, that doesn't mean we sit back and put more of taxpayer's money into an unreformed system. Labour's debt crisis means we must look carefully at all our public services. To ensure they are delivering value for money; to give the public what they expect from the services they pay for; and to equip Britain for the challenges we will face in the future.

If the 'sentance-as-list' thing worked for Tony Blair, it can work for me

"Labour claimed to modernise the NHS.

Delivered adequate funding, increased staff, slashed waiting times. Ahem.

"They said they'd get rid of mixed-sex accommodation. But they didn't. This year alone, tens of thousands of patients denied this basic dignity.

"They said everyone should get NHS dentistry. But a million lost it and millions now don't even try for an NHS dentist.

I am ignoring recent DH statistics

"They said they'd rebuild the NHS.  But they left us to pick up the bill. £50 billion of outstanding PFI pyaments.  A £4 billion backlog of maintenance.

And guess what we're going to do, when it comes to funding any new infrastructure?

"What a legacy.

"If we change nothing, nothing will change.

Straight from the Faber Book Of Gnomic And Meaningless Phrases - love it!

"But change is needed.

If "change" worked for Barack Obama, it can work for me

"When not one area of this country achieves cancer survival rates equal to the best in Europe, change is needed.

"When the number of managers was rising at six times the rate of nurses, when administration costs increased under the last year of Labour by £346 million, and when consultancy costs increased by 80% in just the last two years, then change is needed.

"When health inequalities have widened - and men in different parts of Birmingham have a ten-year gap in life expectancy.

Although it depends how you define managers ... and the NHS and healthcare are not the dominant determinants of life expectancy. Anyway ... shall I say "change" some more?

"The question isn't whether we change. It's what kind of change we need. Why we are making the reforms.

"Four years ago, at our conference, David Cameron spelt out his priority in three letters: N.H.S.

Tsch. Do you see what you get with Labour governments? Even our Prime Minister can't spell. His priority is h-i-s-p-r-i-o-r-i-t-y; not N-H-S.

"And that is the Coalition Government's priority today: to transform the NHS into one of the great health systems of the world. True to its values, but fit for the future.

"A modern NHS.

Nice line, that. Nicked it from Patricia's Fabian lecture

"A truly patient-centred service, focussed on delivering results for patients and the best outcomes, using the best practice and best technology.

Best technology sounds a bit pricey, but bear with me.

"That is why we are proposing ambitious reforms:

"To give doctors and nurses, rather than administrators, the power and responsibility to improve the quality of service they provide, and the budgets they use in providing it;

So if the grateless bastards could say something nice about The Plan, that would be good. The NHS will run fine without administration

"To make sure services fail patients have nowhere to hide; and

Nowhere to hide? I sound like George Bush talking about Bin Laden.

"To ensure the NHS delivers the quality of care that we expect from the resources we are committing to it. And together, drawing on the consultation we are running, we won't delay or dither in taking action.

So anyone who wants to see this piloted and evaluated before we gamble £80 billion a year can sod off, OK?

"Our reforms will mean:

"giving family doctors control over the budgets which are used to care for the patients they see - because family doctors see patients every day, they know where services are failing, and they will fight for the best care possible for their patients.  

I have confused commissioning with prescribing and referring. I also think GPs know where really bad secondary services are., as in Mid-Staffs, maternity services at St Marys and Northwick Park ... oh, hang on ...

"rewarding those hospitals and services which care for patients the best , and we are giving them the freedoms to expand and grow - and deliver better services to even more patients

Neatly ignoring what we will do about failing providers

"And, giving patients choice - and not just choice of a hospital. We are giving patients the right to choose their doctor, and their treatment, anywhere which meets the standards of the NHS and costs the same as NHS prices or less. That means any social enterprise, charitable organisation, public or independent provider - the right to choose where to be treated at any provider in what will become the largest social enterprise in the world.

"But choice without information is no choice at all - That is why we will unleash an information revolution throughout the health and social care services. Because, armed with the right information, patients themselves will drive up standards in the NHS - as they vote with their feet for the services which are succeeding.

I am ignoring the challenge that although people report valuing choice, they mostly don't use it or even remember being offered it

"Because I simply don't believe that if there was more information about the quality of care, the scandalous failings that took place in Maidstone and Tunbridge Wells and then at Mid Staffordshire,  could have gone unchallenged for so long.

I have still not got the point that if politicians even read their local papers, these would both have been spotted long before. Private Eye does much the same thing too.

"It means we at last create an NHS where patients, not politicians, are put in the driving seat; a service which means, for patients, "no decision about me, without me".

Line borrowed from this New Labour initiative. Sssh!

"We have already started to publish weekly MRSA and C-difficile data. And that is why I can today announce that, from next year, we will extend surveillance of hospital-acquired infections even further because patients must expect to be kept safe from harm in hospital.

'Safe from harm in hospitals' is interesting. Healthcare errors are generally agreed to harm one patient in 10

"These are practical measures which we are already making a reality. They are the principles on which a modern NHS should be built. And by recasting the NHS on these principles, we can sweep away all that top-down bureaucracy that prevents doctors and nurses making the best decisions for their patients.

Top-Down Reorganisation In 'Sweeps Away Top-Down Bureaucracy' Shock!

"Out go all the unjustifiable government targets which made doctors and nurses - who just want to care for patients - dance to the Whitehall tune.

Are you waiting comfortably?

"Out go two whole tiers of state-led management and oversight, reducing management costs by £850m by 2013/14.

Spending £106 billion a year effectively on healthcare requires practically no management.

"And out go half of the health quangos.

The private sector is dying to do all that stuff, and there is no way it will cost more

"When I stood before you this time last year, I said that I would cut NHS management costs by a third. I meant it. So one of the first things I did as Health Secretary was to ask the NHS to cut management costs, not by a third, but by almost half. And I can guarantee you that every penny saved will be reinvested to improve patient care.

"It is not just about spending our money wisely, stripping out these layers of bureaucracy also sends a very important message to the NHS. To the receptionists, the porters, the healthcare assistants, doctors, nurses and yes, to the managers - for the NHS needs good managers.

A pity the managers we inherited were all shit. Still, a nice redisorganisation should get them all applying for their jobs back

"The message is:

"You no longer have to wait for a cascade of diktats to tumble down from on high, in order to do your job.

"You are liberated from the targets, from the distracting controls imposed by Whitehall.

"You are free to deliver the services that best respond to the needs of your patients.

I have just unleashed sterile supplies managers and healthcare assistants on the healthcare of the population. Fear me!

"What is our aspiration for these changes? Simple: to achieve health outcomes in results for patients - as good as any in the world. And to show people what this means, we announced this week the action we are taking to improve our cancer survival rates. We plan to:

"Introduce a brand new screening technology, saving up to 3,000 lives a year.

"Introduce a cancer drugs fund, benefitting 2,000 patients this year alone.

Did you get the message yet, NICE? It starts with us undermining you like this ...

"Deliver 1,200 new specialists in cancer services in our NHS by the year after next.

"It is an aspiration for a healthcare system which delivers truly preventative care - so we have a healthier population and can keep the costs down for the NHS.

"Real local leadership

And surreal national leadership

"In all this, we want local communities - not central government - to be taking the lead in improving health.

The Big Society update - Buckhorn Weston Parish Council abolishes air pollution and enforces minimum retail unit price for alcohol

"It is a plan for truly integrated health and social care services; one that the Liberal Democrats brought into our coalition to place local government at the heart of NHS decision-making.

Please don't remember that the Lib Dems actually said 'elect PCT boards'

"So we are ring-fencing the public health budget and devolving it to communities so they can take the best decisions locally. And today, I can announce action to help further communities better respond to local people's needs:

"We will, in this financial year, provide £70 million to local NHS and councils to help patients this year have the support they need after being discharged from hospital - enough funding to provide support to 35,000 people over the next seven months.

"This means better support for the most vulnerable, when they need it most.

I can feel repeated use of the word "choice" coming on

"So as a Party and as a Coalition Government, we have made our choice: to cut the deficit, not the NHS. We have made our choice: to reform so that we can meet our aspiration to deliver world-class healthcare for NHS patients.

"We have made our choice: to sustain the values of the NHS. An NHS, free at the point of use, based on need and not on ability to pay. That's equity.

"We have made our choice: for NHS, focussed on results for patients, as good as any in the world. That's excellence.

"Equity and excellence - values we believe in, and NHS services of which we can all be proud.
That, Conference is our goal. Together, Conference, is in everyone's interest, we will liberate the NHS".

Lib-er-ate! Lib-er-ate! LIB-ER-ATE!