NHS Confederation: Media centre

Press release: Clinton's former Health Secretary warns NHS against making same mistakes as US

16 Jun 2005

Donna Shalala, President of the University of Miami and former Secretary of State for Health under President Clinton, warned the NHS not to make the same mistakes as the US.

Speaking at the NHS Confederation Annual Conference, Professor Shalala urged the NHS to increasingly put patients in the driving seat to help them look after themselves more effectively, and to provide seamless care.

She warned the health service not 'to get hung up on organisational mergers as a way of achieving clinical integration.' This had not worked in the US, she said. Neither managers nor doctors had been taught to design and organise an integrated care system.

Healthcare commissioning needed to be proactive and not reactive, she urged. Otherwise: 'you run the risk that services are shaped not by needs or patient preferences, but by providers themselves.'

Most of healthcare provision was bout looking after people with long term conditions, and an increasingly elderly population, she said.

'The challenge of ageing is not just in the numbers, but how to support patients with chronic conditions, and how to keep them active, healthy, and thinking positive,' she said.

'The average person with diabetes may see a health professional for 3 hours a year. That means for the other 8,757 hours a year, they are their own health professional.

'We know that patients often experience health care as a series of disconnected and fragmented and reactive episodes. What they need is ongoing, integrated, anticipatory and ongoing support,' she said.

She also urged the health service to focus on the retention of its staff, particularly nurses. 'Retention is far cheaper than recruitment. In the United States if we simply retained every nurse we have trained, we would have no nursing shortage,' she said.

Not feeling part of the team, rather than pay, is what drives most nurses out of their jobs, she said.

ENDS

Notes for editors

1. The NHS Confederation represents more than 90% of the organisations that make up the NHS throughout the UK. Its members include the majority of NHS trusts, foundation trusts, primary care trusts and health authorities in England; trusts and local health boards in Wales; NHS boards and special boards in Scotland; and health and social service trusts and boards in Northern Ireland.