Secretary of State for Health and Social Care, Wes Streeting
And thanks to all of you for joining in on a Sunday morning.
I’ve spent a lot of time talking to your leaders over the past year across the various BMA committees, but this is the first chance I’ve had to speak directly to all of you as reps and members.
And despite all of the media headlines and despite the things that we have substantially disagreed on, I actually think that we could all agree there’s an awful lot we do agree on, both in terms of the challenges in the NHS today, where we want it to be and the prize that awaits us if we work together to reach that destination as partners.
I know there are questions.
I’ll leave plenty of time for that, but let me just set out for a moment where I think we are collectively as a government and as a medical profession.
I’m not sure how many of you have had the chance to see it, but I’ve seen Nye at the National Theatre a couple of times before the general election.
And, I was struck watching that play by the caricature of the BMA, for those of you who haven’t seen it.
Whenever the BMA appear, the doctor’s huge faces are projected onto a screen behind the stage, standing Big Brother style, looking down, intimidating in their surgical masks and gear, staring down at my Labour predecessor, Nye Bevan.
And as Bevan makes his requests and suggests, compromises, these implacable foes deny each one again and again.
Now fast forward to this Labour health secretary.
And it doesn’t feel like that’s our relationship most of the time.
Even though we don’t always see eye to eye, I feel very strongly that our relationship needs to be collaborative and cooperative.
Right from the start, I’ve shown the lengths I’m willing to go to build a constructive partnership with doctors.
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On my first day in office, I called what was then your junior doctors committee to start the ball rolling on pay and conditions.
In my first week, I had a face to face meeting with Rob and Vivek, the co-chairs at the time, and by week four, we’d struck a deal that saw an end to the pay dispute that had been rumbling on for two years.
As a result of that deal, and accepting the pay review bodies recommendations for above inflation pay rises two years in a row, both in F1 and F2, pay is now over £6,000 a year more than when we came in.
It’s worth noting, too, that for a new full time specialty doctor, it’s over £5500 more, and for a new full time consultant, around £10,000 more.
It’s not just the size of the pay rises, but the willingness to roll up our sleeves to rebuild the relationship between doctors and their government.
That should be grounds for optimism, not just to avoid industrial action, but because we’ve known for years that the treatment of NHS staff, resident doctors particularly was unacceptable.
I agree with your complaints about bottlenecks, rotations and the lack of respect.
Some doctors and frankly other NHS staff have shown by their employers.
These are unjust.
They’re bad for the NHS because they risk driving doctors away and that’s why I want to solve them.
Then there was the issue of GP unemployment.
One of my first decisions as health secretary was to reform the rules around ARRS, and found an additional £82 million.
That was the first step to recruiting an extra 2000 GPS, a win for practices, patients and newly graduated doctors
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I’m not blowing my own trumpet.
I’m not saying that everything’s been fixed in a year, and I’m certainly not promising that everything will be fixed by this time next year.
I am just reminding you of how serious I am about rebuilding a relationship that is broken under my predecessors.
My door’s always open, I’m always at the other end of the phone and I’m always willing to get around the table.
And there are not many people outside my department who I’ve spent more time with over the last year than representatives of the BMA.
If I’m honest, though, I’m still waiting for the BMA to take the olive branch.
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It is the job of trade unions to push employers and governments to go further, and I respect that.
It is also my responsibility to think about how we deliver right across the NHS, for all staff and for our patients.
And sometimes that does mean saying no.
Sometimes it means saying not now, and sometimes it means saying, let’s work together to make sure we can get this done.
Fundamentally, I think we all want the same thing, which is an NHS fit for the future, where staff are treated with respect and patients treated on time.
And after more than a decade of decline, things are gradually moving in the right direction.
Let’s look at just what we’ve achieved in over a year.
5 million extra appointments, more than double what we promised to tackle the elective backlog.
Waiting lists cut by 220,000 and down in April, traditionally the busiest time of year for electives.
It’s the first time that’s happened in 17 years.
Patient satisfaction with GP access is on the up.
That is credit to you because nothing positive for people using the NHS ever happens without people who work in the NHS.
And in the same way, it’s true that without you, the ten year plan will fail and without that ten year plan, the NHS will die.
So let’s work together to bring that plan to life.
A plan it’s worth remembering that was co-designed with the BMA Brains Trust.
The ten year plan offers a vision of the modern health service.
You’re crying out for one where you’re liberated from the parts of the job you hate, the form- filling, the pen-pushing, the tedious training, and where you can focus on what you actually came into your profession to do, where you have the tools, equipment and autonomy to provide world class care, and we are proud to treat patients in world class facilities where you feel safe and valued, supported by the working practices, better conditions and genuine career paths, and modern back office functions that are standard in almost every other workplace.
An NHS where you come in for every shift with a sense of purpose and go home with a sense of achievement.
That’s what’s on offer if we work together to achieve it.
The alternative is strikes continue to hold back the NHS recovery.
The costs of industrial action slow down investment in new technology, equipment and additional speciality places.
The changes that we all agree need to be made are blocked.
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That’s the stake that I’m dealing in and don’t be under any illusions.
I think you know perhaps better than I do because you work in it.
The NHS is hanging by a thread.
So I urge the BMA not to pull on it.
I do know that you feel particularly unhappy right now.
I absolutely take what Tom was just sharing with us about morale.
I get it because I hear it firsthand when I speak to staff in a range of professions and parts of the workplace around the country.
When I said the NHS was broken, I didn’t just mean for patients.
And I’m clear that the future depends on building a health service that values you, invests in you, and supports you.
We can only do that as friends, not foes.
So obviously, like any good trade union, you’re advocating for more for your members.
And believe me, I’ve done the same in the past.
In fact, let’s just do a quick stock take of your demands. Resident doctors.
You’re asking for full pay restoration and an end to bottlenecks and graduate unemployment made up I think of 15 proposals at the last count.
GPs you set out six demands, with probably more to follow on issues ranging from funding envelopes for 26/27 to GMS contract renewal and investment to GP under and unemployment.
Consultants. You’re after full pay restoration, increased SBA time, implementing the BMA consultant charter and working fewer nights and weekends.
And finally, SAS again.
Full pay restoration is the theme emerging here.
More time for job planning and training.
Expansion of the specialist role.
Annual leave parity with consultants.
Now that’s not even an exhaustive list.
One of the benefits of a new government is that we are able to look at all of these issues with a fresh pair of eyes and not be on the defensive about what’s gone before.
But I don’t think there’s a single person listening to that list who thinks I could do all of the things you’re asking for today or tomorrow.
There are so many issues, and to say we are heavily constrained on the money front would be an understatement.
The economy and public finances are in a very different shape to when the last Labour government walked in in 1997.
We’ve had 3% real terms growth in the NHS.
Everyone on this call knows that while this is relatively good compared to the rest of the public sector, the word relative is doing a lot of heavy lifting in that sentence.
So I simply cannot fix everything for everyone, everywhere, all at once.
It does mean I have to make tough choices and trade offs.
And while I accept it’s not your job to indulge necessarily in the world of choices and trade offs, if we are partners in this, then I do need a greater understanding of the constraints that I’m working under and a willingness to engage with and help me make those choices and trade offs.
Bevan’s relationship with the BMA is not the relationship that you and I should have, or can have, if we’re going to fix the NHS.
That’s why I didn’t give the invitation to come and talk to you today a second thought, because I wanted to deliver this message.
The government has changed the attitude and approach the NHS and its staff has changed.
I need the approach of the BMA to change to rescuing the NHS, and the biggest crisis in its history is a team effort.
It really is and it will only happen if we’re on the same side working together.
I can’t do this alone.
I need partners, not adversaries.
I’m in this job to fight for patients every day, just like you and just like you.
I’m in this job to fight to save our NHS every day.
If we join forces, it’s a fight we can win.
If we’re pitted against each other, the whole country loses.
I know that’s not what you want.
It’s not what I want.
And I hope that we can work together over the coming years to make sure that we can genuinely save for generations to come.
That we were the generation that took the NHS in the worst crisis in its history, got it back on its feet and made it fit for the future.
So thank you very much, genuinely, for having me to speak to you this morning.
Thank you very much.
