Michael Gove is the health secretary’s role model as he bids to become the patient’s champion
I am anxious to feel more comfortable about Jeremy Hunt’s tenure, he’s the only health secretary we’ve got. So I was pleased to read his speech to the King’s Fund about improving the quality of care in the NHS – and not just because he quoted Einstein either. How often does that happen in a Cabinet speech?
‘How often is Einstein quoted in a Cabinet minister’s speech?’
The secretary of state’s warning against “the normalisation of cruelty” among staff in places like Mid Staffordshire Foundation Trust or the Winterbourne View care home didn’t garner as many headlines as it might, had Fleet Street not been absorbed with itself and Leveson (Hunt only lightly admonished) last week.
But poor nursing standards are a worthy target and one which the chief nursing officer, Jane Cummings, amplified with the unveiling of her Compassion in Practice initiative, co-authored with Department of Health director of nursing Viv Bennett on Tuesday. Care, compassion, competence, communication, courage and commitment, the new “Six Cs” - how slick is that?
The larger issue, inevitably raised by Labour MPs at health question time, was whether such talk is compatible with falling staff numbers. This is at a time when barely a day passes without some gloomy expert verdict on overcrowded beds, needless emergency admissions and delays in accident and emergency. Thank goodness junior minister Dr Dan Poulter is young enough (34) and enthusiastic enough to go around insisting all will be well, it really will.
Of course, Labour says it won’t be. That’s what oppositions are for. Worsley’s Barbara Keeley extracted the admission that there were 310,793 full-time equivalent qualified nurses in England in May 2010 - when the coalition took power - and 304,566 in August 2012. No wonder the Care Quality Commission found 10 per cent of NHS hospitals aren’t treating patients with dignity and respect, the MP told Mr Hunt: they’re understaffed.
Hunt was having none of it and on this occasion I think he’s more right than wrong. Plenty of hard-pressed hospitals deliver “excellent care”, he insisted. What’s more there has been an increase in midwives (4 per cent), docs (5 per cent) and health visitors by a startling 50 per cent - fruit of that early Cameron/Lansley pledge, I expect. Something he called the “nurse-to-bed ratio” (it sounds like a Carry On film of the 50s) is also up, ie they’ve cut the number of beds.
In his King’s Fund speech, the one in which he unveiled Ofsted-style hospital ratings instead of silly old stars, he cited dreadful cases of neglect on the ward, but wisely offset them with heart-warming stories of kindness. I too hear both kind of stories and probably so do you. It’s not all about money, it is as Jane Cummings is saying, also about values.
So what to do? Hunt rejects the “false dichotomy between good treatment and good care” and presses the old point that “good care directly supports good outcomes” - and thus saves money in the long run, on emergency admissions for example. Cheerful docs (like Dr Dan?) and nurses also get better results. His remedy: stronger corporate and managerial accountability (no box-ticking or buck passing); better training and more transparency.
‘If I had a pound for every health secretary who said “care as you would wish to be cared for” I could retire yesterday’
Einstein, great humanist that he was, spoke of shedding excessive individualism and “widening the circle of compassion,” Hunt recalled. Here’s where next year’s ambitious “family and friends test” will come in. Fine, if I had a pound for every health secretary who said “care as you would wish to be cared for” I could retire yesterday.
In his new goal of becoming “patient’s champion” fashionable Michael Gove is said to be Hunt’s role model. Hmm. You can’t help noticing these free market individualists drawn into interventions once they occupy the boss’s chair.