NHS
Dr David Bull NHS Speech Transcript:
Well hello, good afternoon ladies and gentlemen. I’m sure you can do better; good afternoon ladies and gentlemen really good to see you. Let me tell you the train was fantastic on the way from London I was delighted. Many of you were watching the show this morning saying how is David going to get here well I made it so, I am delighted by that. Also I am already in trouble. A number of gentlemen have come up to me and said you are spending more time in my bedroom with my wife than I am!
Let’s move on to some really serious issues. I want to talk about a subject really close to my heart and that of course is the NHS and I want to talk about my prescription for the nation. How do we reform the NHS and I want to start by posing a question to you. What do you think actually defines an advanced Society? Well, I think the mark of an advanced Society is when people live with organization and comfort where they have high levels of health, of science, of Industry, with culture and government.
Now fundamental to this quest is to ensure that we have a robust world-class healthcare system that doesn’t discriminate. It doesn’t discriminate on the basis of class, of race, of gender ,sexuality or income, and that is why the Inception of the NHS in 1948 under Bevan was really so trailblazing. It was so ground-breaking and that is why the NHS remains a core British value. I can tell you this, it elucidates very strong emotions indeed. It is part of our national DNA. Now to understand where we are and what reforms need to be affected I think we actually have to travel back to the very start to the conception and the founding principles of the NHS.
Prior to the formation of the NHS there had been some form of state funded provision in England for some 400 years now initially the poor, the infirm and the elderly receive care from religious orders particularly the monasteries. After they were abolished the poor law came in. 1601 brought with it alms houses, later on the workhouses provided shelter for the poor, for the orphans and for the elderly.
Where it gets really interesting is by the late part of the 19th century differing models of healthcare began to emerge in this country including hospitals for mental illness, for infectious diseases. There were also voluntary hospitals run by Boards of Governors alongside this primary and Community Care then began to emerge separately from those hospitals but right at the beginning there was no cohesive structure and the whole thing was incredibly disjointed.
The first step in creating a Nationalized Health Service was in 1938 prior to the war. What happened then was the Emergency Medical Services Act was passed that required hospitals to register and for the very first time these were run centrally. Now the culmination of all of this was the Beverage report and that was in 1942 that led to the Inception of the NHS and let’s just be really clear here what the NHS is and what it was set up to do.
It was an integrated state funded service to guarantee and I quote basic levels of personal and social security it had a defining characteristic; it had to be free at the point of need and for the very first time the government assumed responsibility for the provision of a comprehensive service for the whole population. What is very striking, there was a leaflet sent to every single home in this country and the government promised that the new NHS will provide you with all medical, dental and nursing care. Everyone whether you’re rich whether you’re poor, you can use it or you can use any part of it.
So let’s now look at the differences between then and now. Clearly there are massive differences between then and now let me illustrate that. In 1948 there were just 43 million people in this country there are now 67 million people in this country. People now live on average at least 10 years longer than they did in 1948. In 1948 there were nearly half a million hospital beds, half a million hospital beds for that population of 43 million.
Today how many hospital beds are there? Not half a million 300,000 no 200,000 no there are only 67,000 hospital beds in this country, even though the population has gone up by 25 million people.
In 1948 the total budget for the entirety of the NHS was £248 million, today the total budget is £170 billion we now spend 11.7% of our GDP on Health in the UK per year, so it is not about money and all of these bleeding heart politicians will tell you the solution is more money. The solution is not more money, so let’s just look at the state of the NHS. What does the NHS actually look like in 2024? So despite having record levels of funding the Health Service and I think this is fair to say is in terminal decline.
Let’s start with doctors, there are only 123,000 doctors in this country we are short of 12,000 doctors we only have 27,000 full-time GPs, 25% of those GPs will leave in the next few years. In six years’ time we are going to lose another 8,800 GPs. On top of that 1,200 GP practices have now closed at the same time as all of this of course the NHS in its infinite wisdom has still managed to spend £40 million on diversity related roles. But the real test for me actually is not that, it’s waiting lists. Something dear to your hearts.
In 1948 there were 492,000 people on the waiting list, how many people do you think are on the waiting list now? 20 million people are waiting for treatment on waiting list in this country. That is nearly a third of the population and you don’t know that and the reason you don’t know that is because the official list is 7.71 million. So what happens is there is a hidden waiting list and they won’t tell you about that. So you’ve got your 7.7 million here but another 11.3 million people are waiting for onward care.
They’ve been seen but they haven’t actually been dealt with. They are then hidden. Now you and I know the waits are intolerable. 15 million appointments took place later than 28 days after being booked. Let’s turn to doctor strikes and if you watch my show on Talk TV you will know I have been fairly strong about the doctor’s strikes. I think the impact of the strikes has been nothing short of catastrophic.
The strikes have cost us the taxpayer £3 billion. As a result 100,000 cancer patients are now diagnosed late, 29,000 people waited more than three months. Three months for an MRI or for a CT scan. 1.2 now 1.4 million operations and appointments have been cancelled. 1.4 million cancer operations 7,000 delayed. For every 4 weeks that we have a delay, your risk of death goes up 10%.
Let me bring this back to a human level, last week a 67 yr old woman died, she was trying to get through to her GP surgery for 3 hours. After she called an ambulance the ambulance was not sent. When she phoned 999 they said what is wrong with you? She said I cannot breathe. The ambulance did not come. She couldn’t get through to the GP. She died 3 hours later, still clutching her phone trying to get medical help.
I find it really hard to read those kind of stories, but we need to stop fooling ourselves because we keep saying the NHS is providing world-class care, that its the envy of the world. Guess what? It isn’t by either metric. So look, we have to do something. We have to have a bold ambitious plan. What do we do? How do we turn this around and that’s where we come in because we have to have this bold ambitious plan for the NHS and I believe as Richard does Reform UK is the only political party to openly admit that the NHS is not fit for purpose.
You will hear the politicians, the Tories the Labour party, they believe the only way out of this mess is to throw more money at an unfit, unwieldy, bust system. It’s not the answer. We need to be bold, we need to be radical, we need to have ambitious targets but we have to ensure we remain true to the founding principles of the NHS.
I said them right at the beginning that care must be free at the point of delivery and this is the big news. We as a party have identified how to fund and to invest £17 billion more per year into the NHS. That is an extra 10% into UK Healthcare but it’s not via the wasteful and often incompetent NHS managerial system, our investment gets that money to frontline staff and to the Independent Health Care sector that consists of not for profit groups like BUPA and Nuffield Health also private operators.
I bet many of you didn’t know that BUPA and Nuffield Health were not for profit? So our investment and reforming plans will make Healthcare in the UK fit for the 21st century and will enhance Bevan’s original achievements whilst ensuring the provision of healthcare remains free at the point of delivery.
We have a really bold target and our aim is really simple and we’re not ashamed of it we believe and we aim to deliver zero waiting lists within 2 years. It’s a big bold ambition and we can do that with a very clear initial five point plan.
1 The first of those points we want to incentivize doctors and nurses I feel very strongly about this we want doctors and nurses to feel valued they’ve got to feel loved we want to incentivize them to remain in the NHS so under our policy all Frontline NHS and social Care staff will pay zero basic rate tax for three years.
What does that mean in real life well for a standard nurse on the front line this is basically a net pay increase of £1,300 that is a 13% pay uplift and that is if you use existing tax thresholds or based on our new tax thresholds which Richard I’m sure has spoken about this morning it’s £2,800 uplift based on those new tax thresholds this will immediately actually do a number of things it will retain existing staff which we are currently losing it will make them feel valued it will also make them feel wanted.
One other thing it will actually attract some train staff back onto the front line caring for patients. I think crucially what it does is it restores morale and that is something that is sadly lacking in our Workforce. It will also dramatically reduce the ridiculous extraordinary sums being spent on agency staff.
2 The second point of the plan we have to incentivize students. Reform UK has consistently been calling on the government to train more doctors. I don’t know if you know this, the very people who blocked the number of doctors being trained were the British Medical Association the ones who are responsible for these strikes. It was kept at 7,500 training places a year. We have been going on and on and on about this and the government has finally listened they have doubled that to 15,000 places every year and not before time. But it’s not enough, we need to go further we need to end training caps completely.
One other thing, we need to increase accessibility for those wishing to study medicine especially from lower socioeconomic groups. I think that that group of people actually understand real hardship, they understand what it’s like to work to get to where you are they understand what it’s like to be poor in Britain. Shockingly 25% of newly qualified doctors leave the service after one year 25% and they leave for lots of reasons, but they leave with massive student debt. Massive student debt 50, 60, 70, 80, £100,000 of debt so here’s what we will do.
3 Reform will write off all the student debt for all doctors, all nurses, all medical staff pro rata per year over 10 years if you stay in the NHS for 10 years after you qualify. We will write off your entire student debt under these plans. Also remember and this is crucial under our student loan plans there is no interest either to pay on that student debt.
Now we need to tackle the Consultants. We have to incentivize Consultants to stay in the system the current pension rules are insane. They are actively encouraging senior Consultants to leave the service at the moment. They have a lifetime pension cap if you exceed that lifetime pension cap then you pay tax so as a result when they reach that level many of my friends have done it, they retire, it is not worth them continuing in the NHS. As a result 70% of consultant surgeons now do fewer hours as a result so we will be bold, we will remove that lifetime pension cap.
4 Our fourth policy we want to incentivize providers. There isn’t enough capacity in the system. You and I know that all too well, we need to dramatically ramp up the amount of capacity in the system and in the short term what does that mean? Well, over the next couple of years there has to be a huge endeavour by the NHS to buy millions of extra appointments and operations from the Independent sector. As I said right at the beginning, this sector is made up of charitable providers, also private providers, as a result of this they will rapidly step up to the plate, increase capacity and what they’ll do is they will work longer days, they will Implement weekend working and because there is more money in the system that will mean we can actually blossom and grow the capacity in the system.
5 Now to achieve this we also need logistical assistance from specialist in procurement to manage and reduce waiting lists and here’s the key reason this works. The money always follows the patient. I outlined this last year so the pledge to patients is simple;
If you can’t see a GP in 3 days you are then entitled to use a private GP and it will be paid for by the NHS.
If you cannot see a specialist within 3 weeks you will see a private specialist again that money that appointment will be paid for by the NHS.
If you can’t have your operation within 3 months again you can go privately and the NHS will settle your bill.
It’s a radical plan, it’s a radical medical plan but it will do two things; firstly it ensures that we slash waiting lists and we improve care for patients; secondly it will also cause private healthcare to mushroom and market forces will mean that the private providers will be incentivized to provide quality care at a competitive price.
Once waiting lists are then brought under control we will keep capacity in the system using a voucher system to maintain capacity and performance.
The final part to this is I really want patients to be incentivized. If you as a family want to be proactive and protect yourself and your family by taking out private health care you should not be penalized which is what is currently happening. Not only should you not be penalized actually you should be applauded because you are relieving pressure on the NHS and that is why Reform UK will give tax relief of 20% on all private healthcare and all insurance.
It’s simple isn’t it the more the pressure eases on the NHS via this incentive the faster the better care that everyone receives and competition is key. It drives up standards and it drives down costs. I was talking to someone earlier talking about the difference between throughput in an NHS hospital and in a private hospital they are poles apart. You are seen faster and quicker, it is much more efficient in a private Hospital why? Because time is money.
In the NHS they do things at a much slower rate, now alongside this initial five point plan there are other pressing issues to address such as cutting waste, bureaucracy, getting rid of a whole load of managers.
I’ll tell you something else we as a party came up with ‘Pharmacy First’ that has now been stolen by the Tories. We lead and they follow us. I want to be really clear here this is not about destroying the NHS, this is about improving and future proofing the NHS while staying true to Bevan’s original ground-breaking idea.
That is and I will reiterate it; care continues to remain free at the point of need. This is about finally providing world-class healthcare where zero waiting lists are the norm and not the exception. Our healthcare plan quite simply protects the NHS by taking huge pressure off it permanently.
Thank you very much