Latest news with #NHSreform
The Independent
a day ago
- Health
- The Independent
No need for ‘ventriloquists' to give NHS patients a voice
Patients do not need 'ventriloquists' from arm's length bodies to speak for them, and more weight should be given to the likes of MPs and councillors, according to the Health Secretary. Wes Streeting suggested the patient safety landscape is 'cluttered', with NHS leaders receiving 'competing and contradictory instructions' from different organisations. He also said the creation of 'totally undemocratic' organisations is 'self infantilising' on politicians. It comes as reports from over the weekend suggested hundreds of bodies that oversee and run parts of the health service will be axed under the upcoming 10-year health plan. This could include Healthwatch England, the National Guardian's Office and the Health Services Safety Investigations Body. In March, Prime Minister Sir Keir Starmer also unveiled plans to scrap NHS England in a bid to slash bureaucracy and duplication. When asked about the reports on Healthwatch England and other organisations at the Local Government Association's annual conference in Liverpool on Tuesday, Mr Streeting said: 'There are way too many checkers and not enough doers in the system. 'And I think there are lots of ways in which we have tried to create new bodies to fulfil the failure of other parts of the state to do their job effectively. 'I mean, the revolution we're leading in patient voice will mean we can get rid of some of the intermediaries, and we don't need ventriloquists to speak for patients, patients can speak for ourselves if we're given the opportunity to do it.' He also called for 'more weight' to be given to democratically elected representatives, adding that some organisations were created to 'do the jobs politicians should be doing'. 'We're councillors, leaders, cabinet members, mayors and Members of Parliament, and at the moment, I think lots of us would feel that as elected representatives, that we don't have enough sense of agency and partnership and democratic accountability that I think we are owed,' Mr Streeting said. 'I think this actually speaks to the corrosion of of our democracy and politics more generally; we keep on inventing a whole load of organisations to do the jobs that politicians should be doing, and thereby sending a message to the public, that voting doesn't change anything, that we don't trust politicians and government to lead things locally or nationally, so we create a totally undemocratic set of organisations to do things for us, because we almost don't trust ourselves. 'And not only, I think, is that self infantilising on the politicians, it's also wasting public money that is in scarce supply. So we're taking the axe to lots of those organisations.' Mr Streeting also vowed to 'take a much more data and evidence based approach to quality and safety and try and declutter the patient safety landscape'. He said: 'I understand how we got here. Many of my predecessors, with good intentions, encountered challenges around patient safety and quality. 'They could see the bodies that already existed weren't doing an effective enough job. 'Rather than grasp to nettle and sort those organisations out, they created new organisations. 'If they felt that regulations weren't working effectively, they introduced more regulations, and in doing so, gave false comforts themselves and false comfort to the country that by adding more organisations and more regulations, we will necessarily be safer. 'We have cluttered the patient safety landscape to such an extent that the poor people on the front line and NHS leaders are on the receiving end of a whole number of sometimes competing and contradictory instructions from a wide range of organisations all trying to do the same job.' Mr Streeting also vowed to start working with local government on NHS winter planning 'much earlier' this year. He said: 'I am under no illusion about how serious the pressures are, and you'll be pleased to know that we are going much faster this year on winter planning, and we'll be engaging with you much earlier in the year on preparations for winter.'
The Guardian
3 days ago
- Health
- The Guardian
Downing St has a radical change in mind for the NHS: shifting its focus from treatment to prevention
In Lancaster the community nurse Lizzie Holmes knocks on doors to persuade people who are unwell but reluctant to accept NHS help. In Blackpool, 'community connectors' help low-income families get their children into healthy habits early in life. Both do necessary, vital, proactive work known as health prevention – stopping illness occurring in the first place and spotting it early when it does. The idea is that this will create a virtuous circle of a healthier population and thus less need for NHS care. But while the initiatives described in a Guardian investigation are imaginative and effective, they are also atypical of the way the NHS works. Over recent decades governments of different political colours have talked about turning the NHS from a service primarily focused on treating illness to one that does far more to prevent disease in the first place. A raft of expert reports over those years have urged ministers to make exactly that transformational change. It has never happened. However, on Thursday Keir Starmer, the prime minister, and Wes Streeting, the health secretary, will pledge to ensure that it finally does. It will be one of the 'three big shifts' in the way the NHS operates, which Labour has promised to implement since taking power almost a year ago, that will be set out in their 10-year health plan. There is a widespread consensus that those shifts – from analogue to digital, treatment to prevention and hospital to community – are essential if the health service is to escape its longstanding crisis and be able to deal with the rising tide of illness caused by the ageing population and lifestyle-related diseases such as obesity. The great paradox of health prevention is that although a mountain of evidence has long shown it works, very little of it actually occurs. A recent paper by the King's Fund thinktank outlined four key benefits of doing it. First, it is effective; public health improves. For example, tobacco control policies have led to less lung and heart disease. Second, 'preventing people getting sick, or preventing sickness getting worse, can reduce demand on services that are increasingly under pressure'. Third, prevention can bring wider economic benefits, by making people better able to work – a priority for a government grappling with an unprecedented 2.8 million people being too sick to do so. And, lastly, that the approach makes the health system more cost-effective in the long term. But, the thinktank added, health prevention is not just the NHS's responsibility. Government as a whole has a key role to play. For example, it could insist on reformulation of food to make it healthier or regulating to ensure better quality housing. Local councils can help too, for instance by tackling air pollution through congestion charges and low emission zones. The colossal overall annual costs of obesity (£98bn UK-wide), smoking (£43.7bn in England alone) and alcohol harm (£27.4bn in England alone) suggest that firm action by the UK government, such as the indoor smoking ban in 2007 and the sugar tax in 2018, could reap dividends. For example, being overweight is linked to 13 types of cancer and drinking alcohol to seven. However, the 10-year plan is unlikely to contain any radical new moves on public health. Instead it will give the NHS the heavy lifting to do. It will be told to move beyond the sickness service it has been since it was created almost 77 years ago and urgently reinvent itself as one that is prevention-focused, that measures success by patients kept out of hospital, not treated in them. That will require more screening, more vaccinations, more health checks, more self-care and more conversations with patients about leading healthier lives. It will also require initiatives like those in Lancashire to be adopted everywhere and for a revolution in the NHS's thinking, culture and modus operandi. The service's future, and the nation's health, mean this time it has to happen.
