NHS Confederation: Media centre

Press release: We must bring doctors and nurses on board or NHS reform will fail

15 Jun 2005

Doctors and nurses are not fully engaged with the Government's reform agenda, threatening its success, Dame Gill Morgan, Chief Executive of the NHS Confederation will say today.

In a wide ranging speech to the NHS Confederation Annual Conference in Birmingham, Gill Morgan will call on the Government and managers to join the gulf between policy makers and front line staff.

'Engagement and understanding is the foundation of the partnership between patients and the service and between managers and employees' Gill Morgan will say.

'It is key to delivering a service which is not only rapidly accessible but treats patients with dignity.

'We must re-engage everyone - the clinicians who deliver care, the cleaners who have such a crucial role, and the junior managers who see themselves vilified at every turn by a political and media elite who should know better.

'This does not require another project called 'clinical engagement' but the development of a simple but shared vision of what the 21st century health service should be.'

The speech coincides with the publication today of a poll of NHS Chief Executives in which 58 per cent said that clinicians are not engaged with the government's reform agenda.

The speech will also focus on 5 key areas identified by confederation members as crucial concerns. These are:

Affordability: We have won the debate on whether the NHS is getting better. Now we need to show the public and the media that we are as productive as we can be and using public money wisely. After years of underinvestment, with an ageing population, and rising number of people with long term conditions, we have a huge agenda to deliver. We must prove that we are lean and mean or we will lose the argument for more funding after 2008.
Incentives: Incentives and delivery mechanisms are not fully aligned with policy objectives. Sometimes they have perverse effects, stopping us from improving. The starting point has got to be the patient and incentives and structures are merely tools to help us deliver.
A coherent vision: The raft of NHS reforms must be joined up to create a simple and coherent story which explains where the service is going. There are many unanswered questions such as how much spare capacity will we need to support contestability and how will this work in a cash controlled system? Will we really be allowed to shut a hospital delivering emergency care that goes bankrupt because of the loss of orthopaedic and ophthalmology services.
Regulation: A streamlined regulation regime is essential to ensure that the NHS doesn't spend all its time filling in similar forms for a raft of regulators. The price of more freedom for local trusts will be more public accountability. The NHS should embrace the use of external reporting and statistical analysis which can help us ask the right questions about the service we deliver for patients.
A separate fund for health improvement would ensure that the Government's long term targets on health inequality can be met. Patricia Hewitt is asking the right questions on the smoking ban and the Confederation will work with her to ensure the legislation is workable and effective.

Gill Morgan will conclude that with such a massive reform agenda, the NHS needs time to implement policies.
'Unleash us and support us; give us time to think, adequate resources and well crafted tools. Trust us and we can deliver.'

Ends

Notes for editors

1. The NHS Confederation represents more than 92% of the organisations that make up the NHS throughout the UK. Its members include the majority of NHS trusts, foundation trusts, ambulance trusts, mental health 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.
2. The NHS Confederation poll is based on an email questionnaire sent out to a representative sample of 113 NHS chief executives in England across a range of NHS trusts, mental health trusts, ambulance trusts, primary care trusts, strategic health authorities and foundation trusts - 80 chief executives responded to this poll.