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Speech by Rt Hon Alan Johnson MP, Secretary of State for Health, 4 October 2007: NHS next stage review - interim report

Speech at Launch of the Report at the NHS Next Stage Review National Workshop for Chairs and Facilitators, Riverbank Park Plaza, London

I want to conclude this session by saying a word about health inequalities.

No single institution has done more to promote greater equality in this country than the NHS, making medical care available for all: the weak and vulnerable, as well as the wealthy and privileged.

But as you know only too well some health inequalities remain. A man living in Manchester is likely to die almost nine years earlier than a man living in Kensington and Chelsea. Infant mortality amongst low skilled workers is almost twice that amongst professionals. And, for every stop on the Jubilee line between Westminster and Canning Town, life expectancy goes down by one year.

The compelling analysis in Ara’s report shows that at least in part these health inequalities are due to disparities in healthcare provision.

Northumberland and Wandsworth have more than twice as many doctors per head as Barking and Dagenham. Oxfordshire and the New Forest perform almost twice as well on the GP Quality Outcomes Framework as Bradford and Bromwich.

The local GP practice is the principle gateway to the NHS: so, if the quantity, quality and accessibility of GP services are uneven, health inequalities will remain.

Ara sets out a long term vision for a fair and equitable NHS but it is clear that we can take steps towards realising that vision immediately. In addition to the 150 health centres that the PM has mentioned,   we will therefore invest further resources to open at least 100 new GP practices in the 25% of PCTs with the poorest primary care provision as defined by the number of clinicians, the quality of access and  health outcomes.

This will make up to 900 additional GPs, nurses and healthcare assistants available – an army of health professionals to lead a targeted assault upon health inequalities. These practices will be able to embrace the latest, most modern models of primary care; situated in convenient locations; open into the evenings and at weekends.

Crucially they will have a remit to prevent as well as treat disease.

Lifestyle choices - Smoking, diet and exercise – are responsible for as much as half of the gap in health inequalities. Investing in more targeted and preventative interventions, identifying and tackling illnesses earlier on, not only makes financial sense, there is a moral imperative as well.

To develop future strategy on primary care, a new advisory board will be appointed, comprising GPs, community nurses and other health and care professionals. A number of eminent GPs have agreed to play a role in this group, including Professor Mayur Lakhani, Dr Sam Everington, Dr Michael Dixon, and Sir John Oldham. 

So tackling health inequalities means concentrating on access and prevention as well as innovation and change.

Not change for the sake of change. That is why I have already said that there will be no more top down structural change and why Ara’s Report will ensure that any change to NHS services clears a high clinical bar and fully engages patients and the public.   

We are seeking to take the NHS from “good” to great – world class in all aspects instead of just some.

With investment in place, staff numbers expanded and waiting lists down we can move onto the next stage of the journey with you the clinicians very much in the driving seat.

I’d like to thank Ara for his work so far and thank you for the work still to come.