Thank you Deborah [Rozansky, Pincipal, Organisational Development, Office of Public Management].

I’m sure everyone in this room felt the same joy and pride in what our Olympic athletes accomplished in Beijing last month.

There is something special about watching people at the very pinnacle of their sport compete at an Olympic Games. Even more so when those winning are so often from your own country.

But things weren’t always so rosy. In Atlanta in ‘96, we brought back just one gold medal. Our worst performance ever. Now we’re celebrating our finest medal haul for a century. From national shame to global acclaim, all within the last 12 years.

And though I would not want to be accused of over-claiming, thinking about this incredible turn around, I can’t help seeing some parallels with the NHS.

Just as lottery funding breathed new life into UK sport, so sustained investment and reform have transformed the NHS – helping us to build fantastic new hospitals and slash waiting lists.

Just as our athletes now have the financial security they need to focus on their pursuit of excellence, so we have given the NHS financial stability and our doctors and nurses a fairer deal so they can focus on the outstanding work that they do.

And just as competition between athletes has propelled them to glory, so competition between providers is helping to transform the quality of patient care.

Ara Darzi’s Next Stage Review of the NHS, published earlier in this non-summer, presents a vision of the NHS that consistently delivers the highest quality of care to all its patients. Enabling staff to offer treatments that are personal, effective and safe.

It is not a vision dreamt up in Whitehall. But the result of a year’s work listening to staff and patients across the country.
The next 5 years are going to see that vision implimented. Not top-down change directed from centre. But change led from the ground up. Change in which the independent sector will play an important part.

The Value of the NHS to British Business

The NHS is vital to the competitiveness of Britain, bringing huge benefits to British business.

Across the Atlantic, one of the biggest election issues for business is the cost of health care. Starbucks spends more on healthcare than it does on coffee. General Motors more than it does on steel for its cars.

These costs hurt the profits of large companies, but they can be ruinous for small businesses.

The NHS helps to free our firms to focus on doing business, not on doing health care.

People are the most important asset of any company, and businesses are dependent on the health of their workforce. Take as just one example, the total cost to the UK economy of depression, anxiety and stress. It’s estimated to cause companies to lose as much as £17 billion a year through time off sick, unemployment and lower output. With billions more in carers and public service costs.

The NHS is business’s best weapon in tackling this. We’ve recently invested an extra £173 million to improve access to psychological therapy, with the aim to treat almost a million more patients over the next 3 years.

Pilot schemes in Newham and Doncaster have already seen a 10% increase in those working rather than being signed off sick.

Next year, we will pilot a Fit for Work Service. A scheme that will test early intervention of work-related support for people on long-term sick leave.

Whether it’s a bad back, depression or for any other reason, PCTs and other local partners will give people the personalised support they need to get back to the office, the factory or the farm as quickly as possible, before the potentially devastating effects associated with long-term absence can set in.

Every year, British businesses lose more working-hours to people needing to take time off of work to see their GP, than they do to strike action.

Over the next year, more than 150 new GP health centres will open. Open 7 days a week, from 8 in the morning to 8 at night. Making it possible to see a doctor close to where you work or live at a time that suits you.

3,700 practices, almost 45% of GPs across England now offer extended hours, enabling more and more people to see their GP in the evening or at weekends.

Those using these new more convenient opening times are not those disparagingly referred to by David Cameron as “yuppies popping in for their jabs before flying to Thailand.”, nor those the BMA leadership describes as the “worried well,” but they are hard working people who pay for the health service and welcome the fact that they don’t have to take time off work any more – in some cases losing wages as a result – just to see a doctor.

The NHS and the direction we are taking it are incredibly important to the success of business in this country.

Not just for the direct benefits they receive from it. Not just for the potential opportunities for the independent sector that it presents. But for its core NHS values.

The US spends twice our proportion of GDP on health, but has worse health outcomes and 60 million people not covered at all.

And the OECD recently described the NHS as the fastest improving health care system in the developed world.

How Choice improves Quality

Over the last year, we have introduced two major changes. World Class Commissioning to help PCTs choose the best provider of services. And new arrangements to allow patients to choose when and where they receive treatment.

I would like to thank the CBI for welcoming both changes, and reaffirming your own commitment to a tax funded Health Service. In your recent report, ‘A healthy choice: Building a stronger NHS’.

Countries around the world are increasingly recognising that our tax-funded system is not only fairer, but more also cost effective. In Germany, where they have a system of insurance similar to that proposed by the group Reform earlier in the week, the long-term trend is towards greater public financing because of the costs and inefficiencies inherent in an insurance based system.

The simple ability for people to make choices propelled the British economy from the sick man of Europe in the 1970s to one of the most open, dynamic and innovative economies in the world, notwithstanding the tough times we are going through now.

People can choose who provides their mobile phone, their bank account, in fact almost every material aspect of their lives. This means that providers must constantly strive to give their customers higher quality and better value for money or risk losing them.

The NHS has to respond to this, giving people the better quality of service they rightly demand.

This means more than receiving the best clinical care. It means you can see your GP when you want. That you are treated with dignity and respect. That you get the treatment you need and the aftercare you deserve.

For the first time patients are starting to decide for themselves the most appropriate and convenient care. Perhaps they want to be seen somewhere that is close to their family rather than their home? Perhaps how long they have to wait for treatment is the most important thing to them? Or the cleanliness rating or the overall reputation of a hospital?

All of this and more is freely available on the NHS Choices website. No other healthcare system in Europe now offerers the level of choice to the public that the NHS does. Patients can see how hospitals are rated and even read what peole have to say about the care they have received.

We had a big publicity drive earlier in the summer opn the back of the introduction of free choice. We are currently consulting about making a patient’s choice of elective care a legal right through the NHS Constitution. We are also planning new measures to ensure GPs and local primary care trusts – through the annual prospectuses they deliver to every household and through other means do more to make sure people know they have a choice.

Commissioning

But if choice presents new opportunities, it presents challenges too.

First and foremost, it requires a fundamental change in how services are commissioned and managed.

The NHS is just too big for us to improve the day-to-day experience of every patient from the centre. No Government minister or Whitehall mandarin, however skilled, can centrally manage 1.3 million employees, a £100 billion budget and the health care of every person in the country.

And this would hold true too for a central, independent NHS Board proposed by some. Quite apart from the fact that it would break the link of democratic accountability between Ministers and Parliament.

When the original NHS Bill was passing through the House of Commons in 1948, Nye Bevan spoke of the “absolute necessity” of the NHS being “subject to local influence as well as to cental influence.”
So we are pushing the power to choose to the local level, to the Primary Care Trust, where the needs of the individual and of the community are properly understood.

This is a big step for PCTs. Some will adapt faster than others, but we are doing everything we can to ease the transition. To help them see competition and cooperation as a route to high quality services and value for money. Not to privatisation by the back door or any nonsense about the closure of GP practice.

The World Class Commissioning programme will help give those PCTs the skills they need to exercise their new power. And the independent sector will help provide some of the choice and competition.
The Independent Sector

From PFI built hospitals and ISTCs, to providing clinical services to Primary Care Trusts and spear-heading ‘Free Choice’ for patients; the independent sector has already played a key role in NHS reforms. This Government is not, as David Cameron alleged his recent speech on health, “blinded by the private sector.” We believe that a mixed economy in health, true to the principles of the NHS has helped increase capacity and to cut waiting lists. It has helped drive up standards and provide better value.

As well as welcoming competition in the health service in England we are engaged in a fascinating competition in health policy among the three main parts of the United Kingdom. The development of different approaches in Wales and Scotland the dogmatic ruling out of using the independent sector there should enable us once and for all to show the benefits of the English approach.

I get fed up being told by some of the media that England suffers from health apartheid – an inappropriate word in the health context in any event – because millionaires in Wales get their prescriptions free or Scotland plans to allow anyone who wants to to park in busy hospital car parks for free.

What about the fact that in England you get your operation much more quickly, you don’t have to wait for more than 4 hours in A and E any more and it’s easier to see a GP when you want. These things matter more to the public, we’re delivering them in England and we’ve doing so while spending less per head on health than in Scotland and Wales. So, we are already seeing the benefits of a mixed economy in England and I expect those to become even clearer as time goes on.

From the very beginning, Bevan understood that how services are delivered, and who delivers them, is never as important as the quality of the healthcare provided and that it is free at the point of need. The founding values of the NHS remain paramount and ever lasting even as the methods for delivering them evolve.

Excellent local commissioning from the independent sector is already bringing real benefit to patients.

B Braun Avitum, a German company, now provides the Renal Dialysis Service in Kidderminster. This means that Worcestershire patients can receive their dialysis locally rather than having to travel all the way to Birmingham for treatment.

InHealth now provide the breast screening in my own constituency, Exeter. From having a mammogram to hearing the result should take no longer than 2 weeks. But 2 years ago, the North & East Devon Breast Screening Service was failing, with almost no women getting their results in time. Today, that figure is well over 90%. That means women getting the treatment they need as quickly as they need it. A difference that is saving lives.
Fair competition

Of course, choice must work for providers too.

Public sector partners, social enterprises and private companies will all compete to supply PCTs in a free, fair and transparent way. Having an agreed NHS price means that competition focuses on innovation and the quality of provision; not on cobbling together the bare bones for the lowest price.

As part of our commitment to fair competition, the new ‘Choose and Book’ system no longer differentiates between independent sector and NHS providers. It simply sorts by who’s closest.

Through Free Choice, the nine and a half million NHS patients who need elective surgery each year can choose when and where they receive their treatment. As Free Choice expands to include patients with long-term conditions, maternity services and primary care this will grow to 15 million patients each year.

Many of these patients are already choosing the independent sector. In July alone, patients chose to have treatment worth over £34 million through the Independent Sector Extended Choice Network or ISTCs.

Accountability

Competition must be, and be seen to be, open and transparent. Fair commissioning requires strong accountability and control, to make sure the interests of all providers are represented, and any disputes swiftly and fairly settled.

At the end of last year we published the Principles and Rules for Cooperation and Competition – in effect the first ever competition policy for the NHS.
At a regional level, the Strategic Health Authority will translate this national policy into regional strategy, providing effective oversight of PCTs and NHS Trusts. Their job is too hold people to account and to intervene where necessary.

But where disputes cannot be resolved locally, they will be referred to the NHS’s own version of the Competition Commission. The Panel on Cooperation and Competition will provide independent, expert advice on issues arising from this new competition policy, as well as recommendations on specific disputes.

Such an important organisation needs a strong leader at the helm to steer it through some inevitably choppy waters. It is with great pleasure that I can today announce that Lord Patrick Carter will be its Chair.

Patrick brings with him a wealth of experience delivering services to the NHS from within the independent sector. Notably he built Westminster Health Care Services from nothing into one of the UK’s leading independent health care providers, employing 12,000 people.

He has a long history of bringing his skills and experience to bare on the challenge of improving public services.

And as Chair of Sport England for 4 years, and as a board member of the London 2012 Olympic bid, he has also played a considerable part in our Olympics success.

I know Patrick will make an excellent Chair, and I am sure you will all join me in welcoming him to the post.

Conclusion

This conference asks whether the NHS will be healthier at 65.

By that time, London 2012 will have come and gone – hopefully with even more gold medals for British athletes and a Games that will live long in the memory.

By staying true to its values, the National Health Service can mirror that success.

A more personal Health Service, with the needs of individual patients at the heart of everything it does. A more local Health Service, led by the patient, the Primary Care Trust and the clinician. A more innovative Health Service, where competition and cooperation between providers and patient choice continually drive up quality.

A Health Service that helps make our people and our workforce healthier, boosting our economy. An NHS that goes from strength to strength with the support and involvement of the independent sector.

That prize, for me, as a Minister of Health in the year of the NHS’s 60th birthday, will be a more exciting prospect that any amount of Olympic Gold.

Thank you.