Several critical points were made by NHS England’s chief executive and medical director to MPs today - including Sir Bruce Keogh distancing himself from the junior doctors contract row.

Sir Bruce put clear blue water between himself and the approach taken by health secretary Jeremy Hunt during the contract row.

  • Sir Bruce indicated he disagreed with the way the government had linked the contract row to improvement of weekend service standards - an agenda he has been pressing for for years. He said: “Things became very complicated when contract negotiations were linked to weekend mortality.” This increased discontent among junior doctors, he said. He also said “both sides” had misused mortality figures.
  • Sir Bruce listed concerns about training and working conditions, which he said affected junior doctor morale and satisfaction. He said: ”Many of the issues raised… are just about decency, and how a decent organisation treats its staff.”

Simon Stevens answered a broad range of questions covering the implications of Brexit, NHS finance, STPs and drugs access.

  • Mr Stevens reiterated his plea for more funding in the shape of a capital infrastructure fund. Mr Stevens said: “My personal point of view is that it will be the ideal moment to consider an upgrade in NHS infrastructure.”
  • NHS England with other national bodies will “informally rank” all sustainability and transformation plans (STPs). Mr Stevens told the committee that October would now mark the deadline for finishing plans, and the beginning of implementation. He said that while some areas have a “well-articulated view of how to implement it and are waiting to fire the starting gun in October” others will “have a further path to tread”. He maintained that “the majority of the country will have well designed plans that we will be able to back come October”.
  • The NHS England chief executive said it was “too early to say” what impact Brexit would have on the NHS, but said “there was no reason” the government should not be able to give reassurance that the NH will be able to retain EU staff. He also said there was a “strong case to continue to be members” of the European Medicines Agency.
  • On mental health, Mr Stevens said it would “not be mission accomplished by 2020” and that while the national implementation plan released today would see concrete improvements in the care provided, there will still be two children out of every three not receiving timely treatment.
  • Mr Stevens thinks affordability should be considered in deciding whether “budget-busting” drugs are approved for use on the NHS – but doesn’t think this responsibility has to necessarily lie with National Institute for Health and Care Excellence. As the budget holder he would like to see NHS England play a bigger role in working with pharmaceutical companies.
  • He recognises there are varying views on the impact of cutting bursaries for nurses and allied health professionals. Stevens said: “I think we will get a clearer picture in the next 12 months.” He continued: “It could be a positive development but will have to be tracked very carefully.” And Mr Stevens accepted there was “legitimate concern” that bursary removal could deter mature students.

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