Speeches by Streeting.

“Ultimately, in terms of performance improvement, it is a range of levers and a range of consequences.”

“The first thing to say is we will trial this approach initially, because it has never been done before, and with something like this, we would not want to just roll it out across the NHS without making sure there are not unintended consequences. The purpose behind it is to give the patient real bite in the system. At t…”

“The money is not pulled away completely; it will go into a patient improvement fund, and everyone from ICBs to NHS regions has oversight of services and financial performance, as well as quality and safety. There are checks and balances in place. What this will enable us to do, if it works as I intend, is to allow pati…”

“In terms of the development of neighbourhood health and care plans, I want to see people work together to develop them and sign them off together in a spirit of partnership. I think it is fair to say, having sat in different parts of this system over the years, that the NHS always feels like the big beast at the table.…”

“Yes.”

“Yes.”

“We have committed during this Parliament to 40 to 50 neighbourhood health centres that we think we can roll out during that period. If we are able to leverage in more external investment, obviously our capability and capacity to do more will be better.”

“And poor contract management, so we need to make sure we learn those lessons and get this absolutely right.”

“There are two different things. There is neighbourhood health, in terms of leadership of the needs of the local population, and then there are neighbourhood health centres. In terms of neighbourhood health models, of course, any new provider organisation would obviously be commissioned and established with a level of m…”

“Yes, always led by the NHS.”

“In terms of neighbourhood health services, we would anticipate that these would be mainly NHS organisations, but you could imagine, with some of the things that we want to achieve, that we will be working with companies like Boots and Specsavers to deliver a greater range of services as well.”

“The real thing we are driving at is to make sure that the level of resource going into general practice is able to meet the needs of the local population. You have got to take into account a whole range of demographic pressures and societal conditions on the health need and demand.”

“We are going to consult on Carr-Hill. It is a reasonable thing for people to ask us to look at, and we will take it into consideration.”

“Yes. When you illustrate the cost to the economy as a whole, that can be really helpful in terms of elevating something as a priority and demonstrating the impact that it would have if we solved x problem on the cost to the economy, but I think even more powerfully, in an NHS context, we can demonstrate the actual cash…”

“I would just add, briefly, that this is where we need to reform our approach to diversity, equality and inclusion. There is a school of thought that says that anything that is spent on DEI is dead-weight cost and wasteful—that we should get it out of the NHS. Actually, as we can see through the black maternal mortality…”

“Yes. Unfortunately, this is a huge issue in the NHS at every level. If you look at the experiences of black and Asian staff—if you look at the experiences of black and Asian patients, even adjusting for class inequalities and social determinants, we are seeing unequal outcomes for patients. We are seeing bullying of st…”

“If the diary allows.”

“I don’t agree we have kicked the can down. Since coming into government—we have only been in a year—we have increased the spending power in social care significantly. We have delivered the biggest expansion of carer’s allowance since the 1970s, and a big increase in the disabled facilities grant. We have legislated for…”

“I don’t quite accept that characterisation. Social care features in so far as it impacts on the NHS. We envisage social care being part of the neighbourhood health ecosystem. Much of the care delivered in people’s homes will involve partnership with social care. In fact, we want to upskill the social care workforce to …”

“I’m not pretending for a moment it’s a panacea, but those are meaningful, demonstrable steps in the right direction, and there is more to come.”