Speeches by Streeting.

“That is not very cheerful before Christmas! I will send your representations to the Chancellor ahead of the spending review, but I do not feel that pessimistic about the settlement we received, for a few reasons. First, some of the reform agenda is not high cost; it is about spending money we already have more effectiv…”

“On elective recovery and the waiting list, for example, across the NHS we see teams using different ways of organising their clinics to deliver more productivity and more patient throughput within the resources we currently have in the NHS. That is the approach I want to see right across the NHS. As I have said before,…”

“And some of that is low to no cost. And then the final thing—I appreciate we want to get into talking about future finances. I am determined, by the way, to start the process in the next financial year with the budget we have just been given. I am determined to start delivering now the shift out of hospital into commun…”

“I will happily take more questioning on that. But the final thing I want to say is that, as well as thinking about how we spend the new money we are being given by the Chancellor, we spend a huge amount of money on our health and care services today. I am not convinced—neither are the frontline staff and patients—that …”

“I think it is primarily the fault of our predecessors. One of the things about the Darzi investigation is that it spelt out very clearly the consequences, for example, of Andrew Lansley’s disastrous top-down reorganisation. The churn of Secretaries of State in recent years has not helped.”

“So you would like to spend more on social care. Which taxes are you raising to provide more money for social care?”

“That is a very good question. I would say a couple of things about that. First, I think culture is set from the top. One of the reasons I came in and on day one said, “The NHS is broken”—it is not beaten, but it is broken—was to acknowledge from the start a culture in which we can be honest about NHS failings. A politi…”

“But the point is, to go to the solution, that is why I wanted to establish a culture up front where we are honest about challenges within the system. If you are honest about the problems, you can start dealing with them. And that cascades right down to line manager-level conversations on the frontline. The second thing…”

“What I want to see over the course of the 10-year plan implementation is earned autonomy for our best performers, where we are not looking over their shoulders so much and dictating—”

“I think we can let go of some of the control, yes. I am up for a debate throughout the NHS about which targets are useful and which ones are not, because if you are measuring everything you are actually measuring nothing. So, I am up for that debate. There will be more freedom in terms of how to spend their budgets and…”

“That is where planning guidance is very important in the NHS, and we will publish the Government’s mandate to the NHS shortly and the planning guidance in the new year. I am committed to the mental health investment standard. I think it is really important. It is one of the better decisions that my predecessors made an…”

“That is great; I am really pleased about that.”

“This is one of the things that I have a sharp eye on, and there is definitely inconsistency across the country in coverage and impact. Going back to one of my earlier points, if we can take the best and leading practice and make sure that it is consistently delivered across the country, that will be better use of taxpa…”

“To reassure people specifically on mental health, because I know there is lots of interest in it, bear in mind that in the first five months we have introduced the Mental Health Bill in Parliament, and not as a draft Bill or pre-legislative scrutiny; we have actually introduced the Bill. This will be the first time the…”

“This is definitely by way of reassurance: what you will not get from the 10-year plan is just a set of vision and values statements. We have done quite a lot of that, actually, and we have come into government with a clear sense of direction. We identified the three big shifts. Those three shifts—hospital to community,…”

“We are consulting on that at the moment. It is a genuine consultation. I do not want to pre-empt a live consultation and disrespect people who are giving up their time to input, but it will be about delivery, not simply about objectives and targets. It will be about the how, not just the what. So how do we shift from—”

“Yes, and, crucially, how do we shift from hospital to community, how do we shift from analogue to digital, how do we shift from sickness to prevention, and what are the priorities we are choosing as a Government to deliver those shifts?”

“Oh, we’ve got to make progress on all three shifts, otherwise we’re stuffed.”

“Choosing between children.”

“Oh, you knew where I was going with that!”