Transcript of Would health secretary meet Elon Musk to compare notes on efficiency?

Now, underperforming NHS trusts across England are to be named and shamed as part of the Health Secretary's new measures, where Streeting's new zero tolerance for failure approach to the health system will also see NHS managers sacked if they don't turn things around. We can speak to the Health Secretary now about those measures in more detail. He joins us from Salford. A very good morning, Health Secretary. Thanks so much for joining us.

Good morning.

What's the headline then of this new plan?

Well, We announced investment for the NHS in the budget, biggest capital allocation since labor was last in government, biggest cash increase of any public service. Today, we're announcing a package of reform that will go alongside that investment. I'm struck by the fact since the budget, lots of people welcome the investment, but they worry that the money will be well spent. Today, what we're setting out is a whole package of reform measures around leadership in the NHS, giving high high-performing leaders in high-performing trusts and providers more freedom, less central diktat and control, because I genuinely think that people who are leading public services are closer to the communities they are serving, are probably better placed to make decisions than politicians or national leaders sat in Whitehall, in Westminster, or in Leeds, where the NHS and the Department of Health is based. We will also provide support to those trusts that behind the leaders of the pack to help them to improve, invest in leadership, management, so we can recruit and retain the best leaders, and where people consistently fall short and where they're just not up to it, then we will manage out poor performance as well.

I think that's what the public rightly expect. They want to know that the investment that's going into the NHS will be put to good use in a well-led, well-managed NHS that delivers great patient outcomes. And that's part of the package we're announcing today. Just one of a number of reform announcements will be making in the coming weeks and months.

What one line of the press release says, persistently failing managers will be replaced and turnaround teams of expert leaders will be deployed. Who are the experts we're talking about there?

Well, we've got some of them going into hospitals and have been going to hospitals in recent weeks. These are people who've got great experience of clinical leadership, of doing things like reorganizing clinics to get waiting lists down faster. But it will also include senior managers who have got an outstanding track record of turnaround and improvement. You talked about naming and shaming. Let me name and praise for a moment. My local NHS Trust, Barking, Havering, and Redbridge, which is on the London-Essex border, has been known as a Trouble Trust for many years. It's been in and out of special measures, and we've had a merry-go-round of senior managers. We now have a great leader in Matthew Trayner, who is leading a really great team who are not only now recognized as one of the fastest improving trust in the country, but are doing nationally leading work in terms of improving the productivity in the elective recovery, so getting through waiting lists faster. We're not chut loads of money at the trust. This is using the same the doors and the same resources that other trusts are doing, but he's a really good example of what outstanding leadership can do.

I want that leadership across the NHS. I want to support great leaders. I want to develop great leaders because they can be the difference between high performance and great patient care or poor performance and poor patient safety. When we talk about very senior managers, I'll make no apology whatsoever for wanting the best and for wanting to incentivise the best leaders going into some of the most challenging areas, but also make no apology for wanting to manage out the worst as we would in any other workplace, in any other business or any other context, but where poor performance is too often being tolerated in the NHS. And what happens with merry-go-round of poor managers is they get made redundant or managed out, be given a payoff in one area, and they pop up in another area, and there have been too many examples of that, too.

Have you been able to make all of the changes that you've wanted to make, or Has there been too many layers of bureaucracy or management or red tape or rules and regulations or pushback that has stopped you doing all that you want to do?

Well, we're just getting started, but I've heard lots of criticism over the years that the NHS is too centralized, too much top-down command and control. And now I sit at the top of that system, at the top of the mountain of accountability in the NHS. I not only recognize that criticism, I share it. That's why a big part of what I'm announcing today is actually about giving away power and control, trusting great leaders, recognizing great performance, and letting go of central control. I genuinely think That's how we'll get better leadership, better management, more innovation. As we do that and as we put more resource and more power and more freedom to the frontline, we will also be shrinking the center because I do think there is a legitimate criticism to be made that as new layers have been introduced in the NHS, we've had new things like integrated care systems, integrated care boards. We have not seen the center shrink at the same time. The The NHS has a culture of and and more, and we need to start learning the words stop and or and make better use of taxpayers money. Then the final thing I'd say is there are lots of people working in the NHS, who when they see some of the headlines around lead tables and transparency, might assume, therefore, more targets, more tick boxes, and more bureaucracy.

Actually, what we want to do is to have less of that and a real focus on the that really matter in terms of patient care, patient safety, and good quality outcome. So as people see more from us in the coming weeks and months with things like the NHS mandate, the mandate, the instructions to deliver given by the government, the operating plan from the NHS, people will see a shift in that direction because we've got too many targets. And if you're measuring everything, actually what you end up doing is measuring nothing. And that's part of the reform that we're leading in the NHS.

It's so interesting, Health Secretary, hearing all of those points and that rhetoric from you because it sounds not dissimilar from the rhetoric we've seen in the last couple of weeks from the new head of the Department of Government Efficiency in the United States in Elon Musk. Do you think you and he share similar sentiments towards driving government efficiency?

That was not the comparison I was expecting this morning. But I do think there is an issue here about reform of public services. Let me tell you, there are two bosses that I am accountable to, my direct line manager, which is the Prime Minister, and then, of course, there are my ultimate bosses, which are the British people and the people of Ilford North who send me to Parliament, I know that they're going to judge me and they're going to judge this government on whether at the next election, waiting lists are lower, waiting times are shorter, and whether they see an NHS that is improving rather than failing. That's why we've got to make sure that alongside the investment announced by the Chancellor is reform, to make the NHS more efficient, to make it more productive, and to give the staff the tools to do the job. Because let me tell you, it's not the frontline staff the public have doubt in. In fact, they consistently rate doctors, nurses, other frontline NHS staff as the people they trust most, not just in the NHS, but in the whole country. But we definitely need to improve the leadership, the management, the accountability of the NHS.

In a year's time, though, as both of you have worked hard to try and drive efficiency in big government departments with big budgets, would you welcome meeting with Elon Musk to compare notes of what works and what doesn't work?

I'd be very surprised if I see that meeting in my diary Sorry. But one of the things that I have been doing as Health and Social Care Secretary, not just the last four months, but actually the last few years when I was shadowing the job as well, is learning from frontline NHS staff, learning from our best NHS leaders and also learning from people who lead organizations, whether public services or businesses, in a whole range of contexts. Because what I've got on my hands is a big change management challenge in one of the biggest public services in the world, a vital piece of critical national infrastructure, one that has enormous potential, but one that has also been failing. The NHS is broken, but it is not beaten. What we are doing as a government on both investment and reform should give people the confidence that we can turn this around and make sure that the NHS publicly funded, free at the point of use that's been there for us for the last 76 years, will be there for us in the next century. But we've got to get this right, because if we fail Then the NHS will not have a future.

Final question, Health Secretary on assisted dying. Is your mind made up on how you're going to vote, or are there any changes to the bill, any amendments that could alter your perspective on the issue?

My view on this is pretty settled. As I told Kay when I was last on, I'm voting against the bill. But I do welcome two things. Firstly, this is a free vote. The government is neutral. The Prime Minister is still deciding how he's going to vote. He's studying the bill, but he's been very clear to all Labor MPs, this is a free vote and people must make up their own minds, and it is a genuinely free vote. The second thing I'd say, I might be voting against this bill. I really to welcome the way that Kim Ledbeta and proponents of the bill are conducting the argument, the way in which they're engaging with arguments, and the way in which the debate is playing out. I actually think in the coming weeks, we're going to see Parliament at its best in terms of the quality of the debate, the integrity of the debate, and the way in which people study and scrutinize the detail, because this is both a principled issue about assisted dying, and it's also one about the practical challenges, the practical issues. I've very much fallen down in opposition to this bill on practical issues, but I have huge admiration and respect for colleagues and friends who are taking a different view.

I hope that in the coming weeks on such an important and sensitive issue, we'll not only give the public the debate they deserve, I really hope that we'll start to rebuild public confidence and trust in politics because of the way that Parliament is currently debating what is a really important issue.

Health Secretary, thanks so much for joining us. We appreciate it, as always.

Thank you.