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Political power needed to drive NHS service redesign

22 June 2012

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Political interference is needed to fundamentally change the way we provide healthcare, the Chief Executive of the NHS David Nicholson has said.

Speaking at the NHS Confederation’s annual conference in Manchester earlier this week (21 June), Nicholson said he was incredulous when he first heard Health Secretary Andrew Lansley’s plans for the NHS.

“When the coalition came into government and Andrew Lansley set out the kind of things he was thinking of doing and my immediate response was ‘you can’t possibly be wanting to do that’,” he said.

Nicholson said he went through stages of being angry and depressed with the government and its reforms but finally came to a point of acceptance.

He praised former Health Minister and now Chair of the Health Select Committee Stephen Dorrell for quoting Enoch Powell’s ground-breaking Watertower speech at the conference and said now is the time for another like it.

“In lots of ways, [the watertower speech] is the sort of speech we need our politicians to be making at the moment,” said Nicholson.

“It is in a sense being honest with the public about the nature and scale of change that is required in order to live in a world where we get great outcomes for our patients, universally available but in the resources we have.”

He told a packed conference hall that the “challenging” financial position of the NHS gives the “burning platform” to move away from the default care position of hospital beds.

However, Lansley, who also spoke at the event, distanced the role of politicians from leading service change in the NHS.

He said the leaderships of the NHS should come from within the service itself and not be “imposed from outside”.

“The relationship of politicians to the NHS should be one of support not interference,” he said.

“When it comes to service change politicians shouldn’t be the ones to tell the NHS or the public what the best shape of their local services should be anymore than there should be a top down managerial instruction to the NHS about how they should work.”