David Cameron denies he believes NHS is 'second rate'

David Cameron denies he believes NHS is 'second rate'

David Cameron has clarified that he does not think parts of the NHS were “second rate,” instead claiming he meant that we should not settle for “second best” in their treatment.

Mr Cameron was defending the plans for reform of the National health Service and the speed with which the shake-up is being introduced.  Photo: AP

By Andrew Porter, Political Editor 1:00PM GMT 17 Jan 2011

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The Prime Minister had been accused by Labour of insulting “millions of NHS staff” with his comments.

Mr Cameron was defending the plans for reform of the National Health Service and the speed with which the shake-up is being introduced.

In an interview, Mr Cameron said that patients should not have to settle for "second rate" healthcare. He corrected himself, fearing that health professionals would take a very dim view of his assessment.

Labour seized on the slip with John Healey, the shadow health secretary, saying that improvements in the NHS were clear for everyone to see.

He said: “David Cameron also seems to see the NHS as second rate when everybody else has seen big improvements by Labour in recent years and public satisfaction is now at an all time high. This is an insult to millions of NHS staff.

“Strong criticism from NHS experts, professional bodies and patient groups shows that those who know the health service best fear the Government will force competition, price wars and privatisation on the NHS at the expense of good patient care.”

When later asked to clarify his remarks Mr Cameron admitted that he wanted to say “second best” and pointed out that there were cases – Mid-Staffordshire being a case in point – where patients did get second best care.

He repeated: “We should not settle for second best.”

In a major speech defending public sector reforms Mr Cameron brushed off criticism that the Coalition was imposing yet another top-down reorganisation on the health service. Among those who have today attacked the plans – calling them “potentially disastrous” – is the British Medical Association and the Royal College of Nursing.

But Mr Cameron, talking about health and education reforms, said: “Every year without modernisation the costs of our public services escalate. Demand rises, the chains of commands can grow, costs may go up, inefficiencies become more entrenched.

"Pretending that there is some 'easy option' of sticking with the status quo and hoping that a little bit of extra money will smooth over the challenges is a complete fiction.

"We need modernisation, on both sides of the equation. Modernisation to do something about the demand for healthcare, which is about public health. And modernisation to make the supply of healthcare more efficient, which is about opening up the system, being competitive and cutting out waste and bureaucracy.

"Put another way: it's not that we can't afford to modernise; it's that we can't afford not to modernise."

Andrew Lansley, the Health Secretary, has been accused by some of exceeding his remit in pushing through reform, including the scrapping of Primary Care Trusts and the handing over £80billion of commissioning budgets to GPs, that were not included in the Coalition agreement. But Mr Cameron said it was right that the issue was addressed head on.

He pointed out that Tony Blair, despite having the right instincts on reform of the public sector, was thwarted by "institutional inertia". But he also pointed out previous Tory failings.

Mr Cameron added: “I believe previous Conservative governments had some really good ideas about introducing choice and competition to health and education - so people were in the driving seat. But there was insufficient respect for the ethos of public services - and public service," he said.

"The impression was given that there was a clear dividing line running through our economy, with the wealth creators of the private sector on one side paying for the wealth consumers of the public sector on the other.

"This analysis was - and still is - much too simplistic. Public sector employees don't just provide a great public service - they contribute directly to wealth creation."

He denied he was planning "a kind of public service version of a laissez-faire economic policy" with the Government's reforms for schools and hospitals, "where winners are created at the expense of those who get left behind".

"The state has a hugely important responsibility to ensure clear, basic standards are met, the rights of users are maintained and independent inspection is carried out in our public services and we are in no way abrogating that.”

He added: “Every year we delay, every year without improving our schools is another year of children let down, another year our health outcomes lag behind the rest of Europe, another year that trust and confidence in law and order erodes," he said.

"These reforms aren't about theory or ideology - they are about people's lives. Your lives, the lives of the people you and I care most about - our children, our families and our friends.

“So I have to say to people: if not now, then when? We should not put this off any longer.”

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