What will David Cameron say today?

The news tells us that David Cameron is going to make a speech today in ‘West London’ – we hear Ealing to be more precise – on the NHS. We think that this will be the first of several speeches before the summer recess where the Prime Minister sets out the need and the vision for change in the NHS. If there is one message that has come through loud and clear over the past months it is the fact that people have grasped the fact that the coalition is causing huge upheaval in the NHS but they have been utterly confused as to why on earth it’s happening.

So, as the BBC tells us he will spell out the financial challenge, cause by rising demand, and that the status quo is not sustainable. He will pledge his allegiance to the Universal State of Access that the NHS promises. He will remind us of how much he personally owes to the NHS. I think he will say things have to change, but not how. That would pre-empt the listening exercise, although he would be on safe ground to say that more clinicians should be involved in commissioning. Our suggestions for clear reasons for change that we summarised after Easter were:

‘smarter spending’ – We need more tax money spent on treating patients, less money spent on administration;

‘improve quality’ – We have to adopt more effective ways of treating illness, targeting prevention and enabling simple choices;

and ‘share experience’ – We must share responsibility and expertise, develop confidence and put community and kindness at the heart of care;

with the aim of bringing clarity to what we need to do and why we need to do it. I wonder though if there will be any hint of apology – for the uncertainty, for the universal maligning of managers, for the confusion? I’m not sure. It would be stating the obvious yet also be a powerful acknowledgement of humanity – that the NHS is mostly about people who care for and serve other people. But maybe he’s been advised to focus on the future….

And of course we would love him to say that there has to be greater plurality in provision. Competition drives improvement in quality of care, the public feel more in control of their healthcare through the availability of choices and history shows that it’s often the private sector that leads innovation (that then benefits us all).

Maybe he’ll leave that thought for next time though.