John Hutton – 2005 Speech at NHSFT Forum

Below is the text of the speech made by John Hutton, the then Minister of State for Health on 11 January 2005.

Good afternoon.

I’m delighted to take advantage this opportunity to say a few words to you today because it is very important we have an open and effective dialogue over the future of NHS Foundation Trusts. But first I’d like to say 1 or 2 words about what it is we’re trying to do – because NHS Foundation Trusts are very much a means to an end.

Establishing NHS Foundation Trusts was all about re-invigorating the delivery of NHS services by introducing new freedoms and new rewards for good performance. As far as the Department and Government are concerned we remain absolutely committed to these objectives and they will continue to guide our thinking about the next steps in the process of establishing new waves of NHS Foundation Trusts.

For the vast majority of the people who live in our country, the NHS remains central to our national identity and national sense of purpose. It stands for a set of values and principles our society continues to hold dear. Our task in Government is, and remains, to ensure the NHS delivers its services in a way that will allow support for these core values to be maintained and strengthened. That is what NHS Foundation Trusts are all about. They are designed to sustain not to supplant these essential principles of equity and universality.

If we are going to succeed in doing this we cannot afford to stand still, because the challenges the NHS faces today are different from those of fifty, twenty or even ten years ago. Our national expectations, both as consumers and taxpayers are higher today then they’ve ever been before. Rightly so. We know how important good health is to the quality of our lives and those of our families. We expect a more personal service. We want our healthcare to be provided at a time and place that suits us best. And we want more choice over what sort of service we can use.

That sort of healthcare service has of course always been available to those who could afford it. For most of our fellow citizens however, it has sadly always been out of reach because this wasn’t the service that the NHS provided. This is what has to change. Making this change is I think the biggest challenge facing the NHS today. People want the NHS to succeed in rising to this challenge, because we know it is the fairest and most efficient way to organise and deliver the highest quality healthcare to the largest number of people.

NHS principles stand head and shoulders above private insurance or voucher based alternatives in terms of equity of access. Every piece of research, both national and international, confirms this. The task facing all of us today is how to convert the principle of equity of access that rightly underpin the NHS into a modern delivery mechanism that guarantees patients the kind of service they have come to associate exclusively with the private sector. To succeed in this historic challenge we need two things. Investment and reform.

We need significant and sustained investment so that we can make good decades of under funding which has left the NHS short of the necessary capacity and the infrastructure to meet the needs of the people we seek to serve.

The extra investment is already making a very big difference to the NHS. Waiting times are falling quickly in every part of the country. The quality of the care we provide is improving too. Fewer people with cancer and heart disease are dying from their illnesses. New treatments and drugs are being made available more quickly. More doctors and nurses than ever before are helping us to realise these improvements in the standards of care that we provide. We cannot claim that every single problem facing the NHS has been solved in the last seven years. That’s palpably not the case. But we are now heading firmly in the right direction.

But one thing is clear. Although essential, this investment on its own would never have been enough to complete this process of transition from the old NHS to the new. That’s why the way we deliver our services needs to change as well.

We have set out the changes we believe are necessary in order to help the NHS become the service we all want it to be. Led by greater choice for NHS patients, resourced through payment by results and supported through the largest investment in new information technology underway in any healthcare system anywhere in the world, the NHS stands on the threshold of the most radical reforms since it was created over fifty years ago.

NHS Foundation Trusts and the work of MONITOR are at the forefront of this programme of change. That is why the Government remains absolutely committed to the principles that underpin NHS Foundation Trust status and to making these reforms a success.

To make these reforms work in the acute sector, we need greater operational and financial freedom for providers, less bureaucracy and red tape, stronger local accountability, and greater rewards and incentives to raise the standards of patient care. In all of these key areas, NHS Foundation Trusts are quite literally leading the way. All of you can point to real improvements and benefits to your patients that Foundation status has helped deliver. All of you have helped the NHS rise to the challenges it faces today. Less than a year into these reforms, I believe the progress you have made has been truly impressive.

It is clearly right however that we should look carefully at how we take forward this policy over the next few years. Firstly, we have to learn from the experience of the first wave. In particular, we need to reflect carefully on the support the Department provides applicants for NHS Foundation Trust status to see what more we can do to help Trusts prepare for the new financial regime under which they will operate.

Secondly, we all need to consider very carefully the experience of the first wave of NHS Foundation Trusts in operating the new Payment by Results system in order to make sure the wider NHS can benefit from the new incentive and reward systems. I think this is particularly true in the area of emergency care and outpatient activity.

Thirdly, we need to be mindful of the need to keep bureaucracy and red-tape to an absolute minimum so that hospitals can focus on the job at hand – treating patients and raising standards of care. This must be a shared priority for all of us. I was particularly glad last week that we were able to announce that NHS Foundation Trusts no longer need to inform the Department of Health every time there is a false fire alarm. I’m sure there is more that we can do on this front.

Fourthly, we need to maintain a strong focus on making the new governance arrangements work as they were intended by strengthening the new links that exist between hospitals and their local communities. I think we’ve got to ensure that this new form of public ownership adds real value to the NHS – strengthening the concepts of local accountability and public engagement.

And finally we will need to consider the report of the Healthcare Commission into how the new freedoms for NHS Foundation Trusts are working in practice.

So there is a full agenda in front of us. For our part, we are fully committed to working with individual NHS Foundation Trusts, with the FT Network, with MONITOR and the wider NHS to make a success of these reforms and a success of NHS Foundation Trust status. That is why we remain open to new ideas and suggestions from all of you about how foundation status can lead to a more dynamic, flexible, entrepreneurial and higher quality NHS.

I want to finish with this observation. At the beginning of this reform process two years ago, what mattered most was what Ministers said about NHS Foundation Trusts. Now what matters most is what you do with the new freedoms that you have – how you use them to improve the quality and convenience of the care you provide to your patients.

Thank you.Good afternoon.