The Daily Telegraph
Coffey cannot make mistake of trying to keep NHS ‘quiet’
The Health Secretary must set out vision of reforms to break cycle of decline and offer real hope for staff
MANY in the NHS heaved a sigh of relief when Liz Truss appointed her closest confidante, Thérèse Coffey, to be Health Secretary. She is a nononsense, details person with an impressive track record of delivery including responsibility for huge changes to the benefits system delivered seamlessly during the pandemic. The fact that she is also Deputy Prime Minister further underlines the priority with which the NHS is seen.
She may feel she has to choose between her natural instinct to be a reformer and the political imperative to “keep the NHS quiet” ahead of an election. I was under similar instructions as health secretary but ultimately found it was a false choice: no leadership can inspire confidence unless it is tackling long-term challenges with wisdom and courage – and nowhere needs that more right now than the NHS.
Battered after a pandemic, facing a brutal workforce crisis and with the biggest waiting lists in its history, morale is low. But it would be a miscalculation to say it cannot get even lower – not least with the prospect of a winter flu season around the corner.
I am fully expecting to see some sensible short-term measures to ease pressure this winter. Ms Coffey will have received advice as to how to free up some of the 13,500 beds taken up by people who should be looked after by the social care system.
She will no doubt want to expand capacity at 111 call centres and hopefully make changes to shortsighted rules that cause people to be kept outside hospitals in ambulances, lengthening waits for other people.
But the test of her announcement will be if it looks at long-term reforms that could break the cycle of long waits, burned-out staff and declining standards. Top of this is workforce reform to end the shortages we now see in nearly every speciality.
The Government has promised a long-term strategy to make sure we are training enough doctors – but we have been waiting for it for more than a year. The Government voted down an amendment to the Health and Care Act that would have made this happen.
The then health secretary would not even commit to publishing any numbers. But what is the point of a workforce plan if it cannot answer the simplest of questions: how many doctors, nurses and midwives will we need in 10, 15 and 20 years’ time and are we training enough to get them?
Of course we know the answer: despite the six new medical schools announced in 2016, we are not training enough. This year we even cut the number of medical school places.
In my recent book Zero, I lifted the lid on the haphazard way in which workforce numbers are negotiated. Any plan that does not reform it will fall at the first hurdle. There are also measures that could ease pressures right away by stemming the flow of people leaving the NHS. Thousands of doctors are advised to retire early to avoid punitive taxes. That needs to be changed and it is welcome that the Prime Minister has said she wants to.
There are other badly needed reforms: fixing social care, removing the national targets that turn patients into numbers and going back to people having their own GP.
Setting out a vision of such reforms will not prevent a tough winter – but will earn the loyalty and goodwill of front line staff. It will also show the country Conservative commitment to the NHS is about more than words – it is about taking difficult decisions to reform a much-loved institution so that it stands the test of time.