PM David Cameron's speech at Guys Hospital on NHS reform

Ten weeks ago we pressed pause on our NHS reforms.

We wanted to speak to professionals, patients and everyone who cares about the NHS, and make sure our proposals were absolutely right.

Now there were those who said this was a humiliating U-turn, that we were back-tracking and ditching all our plans.

And there were those who said the opposite, that actually we weren’t going to change anything – that this was all a big PR stunt.

Today we show that both are wrong.

The fundamentals of our plans: more control to patients, more power to doctors and nurses, less bureaucracy in the NHS, they are as strong today as they’ve ever been.

But the shape of our plans, the detail of how we’re going to make all this work, that really has changed – as a direct result of this consultation.

We listened to what professionals and patients told us.

You wanted us to make clear that competition isn’t there for its own sake, but to make life better for patients – done.

You wanted us to get specialists – not just GPs – on commissioning groups – done.

You wanted us to join up the different parts of the NHS, to put integration right at the heart of our reforms – done.

We have listened, we have learned, and we are improving our plans for the NHS.

We come here today with a substantive package of changes, and for that I want to thank Steve Field, the Future Forum and everyone who took part.

In a moment Nick and Andrew are going to say something about those changes, but first I want to remind people why we’re doing this.

Because behind all the talk about processes and policies there are people saying: ‘what’s the point of these plans?’ ‘What do they actually mean for me?’

Today I want to answer that.

I want to set out the five big things these reforms mean for you.

Free Health Service
One, they mean the NHS you know and love is safeguarded and secured for the years ahead.

We all know about the pressures on our health service.

A population ageing so fast that the number of people over 85 is set to double over the next two decades.

New drugs and treatments that are so expensive they add hundreds of millions to the bill each year.

This is a monumental challenge for the NHS.

Fail to reform now and we could see a bigger and bigger black hole opening up in the budget.

Fail to confront this and the founding principle of the NHS – health care available to everyone who needs it, free at the point of use – would be in danger.

I refuse to let that happen.

Because of what we’re doing today, the NHS will continue to thrive tomorrow; it will continue to be free at the point of use, based on need and not ability to pay; and our children and grandchildren will be able to rely on it – just as we have done.

Choice
The second thing these reforms mean for you is greater choice - the choice to get treated where you want, the way you want.

So if you’re being treated for cancer and you want to have your drug treatment at home at a time that suits you – you should have that choice.

If your child needs a wheelchair and you want to choose the supplier – you should that choice.

If you’ve got problems with your heart and need regular tests – you should be able to decide when and where.

This is your National Health Service, and we are going to put you in the driving seat.

Access to the best
Three, they mean you’re going to have access to the best.

Because as well as giving you more choice, we’re giving you more information.
Information on how hospitals are performing, on survival rates from operations, on patient satisfaction: all there online for you to see.

In this non-bureaucratic, patient-driven, clinician-led, open and transparent system, you’re going to be able to seek out the best treatments there are.

Of course what’s important to people isn’t just how and where they get treated but when they get treated.

That’s why waiting times are online too.

We are keeping the 18-week limit – and we will keep on measuring how long people have to wait in A&E.

Be in no doubt that this government is pledged, determined, committed to keeping waiting times low.

Breaking down barriers
Four, these reforms will mean a smoother, more seamless journey through the health service.

If there’s one big frustration a lot of people have, it’s that the NHS can seem a bit disjointed.

You see different doctors at different appointments, all to talk about the same thing.

Or your mother gets stuck in hospital when she wants to come home, because social services and the NHS aren’t properly joined up.

Our plans are about breaking down these barriers, with specialists from across the NHS talking to each other to get the best for you.

And we’ll be exploring ways to bring the different pots of money together across health and social care.

This might sound dry – but it’s going to make a real difference to people’s lives.

Long-term conditions
And five, these reforms will mean a big improvement in the way people with long-term conditions are treated.

Today one in three people has a condition like asthma, arthritis or diabetes.

They account for 70 per cent of spending on health.

They are the biggest users of the NHS, but frankly, the NHS hasn’t caught up.

People routinely end up in hospital when their condition could have been managed at home.

Patients have to check in with specialists when they’d quite happily monitor themselves.

These reforms change all that.

Putting spending power into the hands of doctors and nurses is going to make a radical difference to millions of lives.

Why? Because together with your GP you’ll be able to design a package of care that fits into your life.

So say you’ve got diabetes.

With our changes, as part of your care planning you can talk to your GP about access to education and support so you can manage your own blood sugar levels; something we know works, and which will help you reduce your chances of winding up in hospital to be stabilised when it gets too late.

That’s good for you – giving you more independence and more control.

And it’s good for our NHS – as we start to manage these long-term conditions much more effectively and efficiently.

Conclusion
So this is what we’re doing this for.

Putting power in patients’ hands.

Making sure everyone has access to the best.

Making the whole system more seamless.

Treating long-term conditions the right way, not the old way.

Above all – safeguarding our NHS and everything it stands for.

Ten weeks ago, we paused our legislation.

Today, we show how we are improving it.

Ten weeks ago, some of the people who worked in our NHS were sceptical of our changes.

Today, we are taking people with us.

It’s in this spirit of unity that we want to continue.

We’re going to carry on listening and we’re going to carry on working together – for the good of our NHS.