Minister Smyth address to Medicine 2025 conference
Source: gov.uk (2025-06-01)

Minister Smyth addressed the annual conference of the Royal College of Physicians (RCP).

Since 1948, this organisation has been one of the greatest allies advocating for universal access to healthcare, high standards in clinical practice and evidence-based medicine.

And today, I really want to thank our members for everything that you have done over the past 14 years to hold our NHS together.

Through no fault of your own, you’ve been through the worst crisis in the history of the NHS, with waiting lists at historic highs, patient satisfaction at record lows, people struggling to see a GP, ambulances not turning up on time. Any department is full to bursting. That founding promise, that the NHS will always be there for us when we need it, broken.

But as someone who had my own career 30 years ago in the health service, I completely understand how demoralising this has been for so many staff, how powerless people have felt desperately trying to stop standards slipping or holding a broken system together.

That’s how I felt as an NHS leader locally, watching the disastrous 2012 reorganisation imposed from the top down, despite all the warnings from frontline leaders and staff. And since then we’ve also had to deal with underinvestment and the global pandemic.

But while those blows may have left the NHS broken, it’s not beaten. Every day there are amazing people delivering outstanding and compassionate care. Despite all of those challenges, day in, day out, you show up for work and you fight to deliver the very best care possible for your patients.

Since coming into office, this government has done everything we can to support you. To restore that basic founding principle that the NHS should always be there for us when we need it. With our Plan for Change, we have hit the ground running.

As our first step, we promised 2 million more appointments in our first year. Promise made, promise kept: we delivered our promise 7 months early and we’ve reached our target, delivering not 2 but 3 million more appointments since July, and counting.

We’ve got waiting lists down by over 200,000 people.

We ended the strike within 3 weeks and have now delivered 2 above-inflation pay rises for NHS staff.

We’ve invested an extra £26 billion in health and care.

We’ve recruited 1,500 more GPs, and agreed a GP contract for the first time since the pandemic.

We’ve delivered the biggest investment to hospitals in a generation.

The biggest expansion of carer’s allowance since the 1970s.

A boost for older and disabled people through the Disabled Facilities Grant.

The biggest real-terms increase to the Public Health Grant in nearly a decade.

We’ve given pharmacies the biggest funding uplift in a generation.

For patients, we’ve frozen prescription charges.

We’ve struck a new deal that will mean women will be able to get the morning-after pill from pharmacies across the country, absolutely free of charge.

A lot done but, we know, a hell of a lot more left to do.

But from day one we have been clear that investment must come with reform.

Our job is twofold.

First, to get the NHS back on its feet, treating patients on time again; and second, to reform the service for the long term, so it is fit for the future.

This summer we will publish our 10 Year Plan for health. Shifting the focus of healthcare out of hospital and into the community with more investment in primary and community care.

Bringing our analogue health service into the digital age, arming staff with modern equipment and cutting-edge technology.

And thirdly, turning our sickness service into a preventative health service to help people live well for longer and tackle the biggest killers.

We’re supporting the effort of prevention through our smoking and vapes bill, to protect children and the most vulnerable to make this generation of kids the first smoke-free generation, and to save untold billions spent on their future care.

The ban on junk food advertising targeted at children will be a first step in addressing the growing problem of childhood obesity, and those same kids are benefiting from breakfast clubs, so they start school with hungry minds and not hungry bellies.

Our Mental Health Bill will stop the disgraceful incarceration of learning-disabled adults.

We’re working with health unions, councils and employers to deliver the first ever Fair Pay Agreement for social care staff.

And Louise Casey is leading the commission on social care, which will finally get a grip on a system that is broken for too many families.

Because, as you all know so well, the pressures facing hospitals don’t start in hospitals, just as the problems facing the NHS don’t necessarily start in the NHS. They are a reflection of wider society.

Fixing broken Britain will require more than fixing a broken NHS.

After this speech, I’m going to add my own Post-it note to your interactive map.

When my team asked me to think about the most pressing issue in my constituency of Bristol South, I was very quick to answer. Poverty.

The health service can fix people when they’re broken, but we don’t want people broken.

The factors that make my constituents unwell are wide-ranging, socioeconomic and environmental.

In other words, the conditions in which we are born, grow, live and work. Secure jobs. Fair pay. Decent housing. Safe streets. Clean air. Accessible transport. The time and affordable facilities to exercise, and nutritious food.

These are the essential building blocks of a healthy life.

And that’s why this government is focused on economic growth and improving healthy life expectancy for all, while halving the gap in healthy life expectancy between different regions of England.

And it’s why reform of the health service is so important, because every pound we spend on the health service is a pound that can’t be spent on what you and I call the social determinants of ill health, but what everyone else calls feeding hungry children, building warm homes and cleaning up our water and the air that we breathe.

The NHS has often been compared to an oil tanker that has immense capacity but is slow to change direction. Shifting the focus of our health service will be an immense task and one that we can only accomplish with your help.

We’ve already been clear that we’re embarking on a decade of national renewal and that’s why we’re launching a 10 Year Plan.

Since coming into office, we’ve sought to reset the relationship with medics to improve working lives and restore value.

This government was never going to be able to completely reverse a decade and a half of decline in only 10 months, but this year’s pay awards, the second above inflation pay rise in a row, demonstrates our commitment to rebuilding the NHS and rebuilding the pay conditions and morale of all NHS staff.

When I joined the NHS 30 years ago, I saw the NHS at what I thought was the worst.

I remember later on working with the team at the Bristol Royal Infirmary on urgent care, discussing those awful trolley waits, coming into work every day, people trying to find a space or somewhere to discharge people from A&E, conversations that, sadly, are all too familiar again today.

But I also saw, especially in the years leading up to 2010, the pride people have when they’re working in an improving, well-run system.

When you’re able to go home at the end of the day, knowing that your patients received the best possible care, and the pride, you know that you’re working at the top of your license as part of a team rebuilding a healthier Britain.

The NHS cannot be saved by one person sitting behind a desk in Whitehall.

We will only succeed if this is a team effort. From the Prime Minister to the 1.5 million people who work in the service, and the millions of us who use it to take decisions needed to lead healthier, more active lives.

Turning the NHS around will take time.

It really won’t be easy, but the prize, the prize available to us is huge and if we get this right, we will be able to say that we were the generation that took the NHS from the worst crisis in its history, got it back on its feet and made it fit for future generations.