Health secretary says bad managers are NHS’s ‘guilty secret’ in broadcast round ahead of first major speech on health service reform

Good morning. Wes Streeting, the health secretary (for England), is giving his first major speech on NHS reform, and there has been almost as much advance pitch-rolling for what he is going to say as you get for a budget. The Department of Health and Social Care has already press released three stories about what Streeting will say, starting on Monday.

“Trusts could be banned from using agencies to cover gaps in entry level positions, and agencies could be banned from re-introducing NHS workers that leave permanent jobs,” the DHSC said on Monday, in its first announcement about the reform package.

Pay arrangements for NHS trust chief executives will be changed so they are linked to performance, with “no more rewards for failure”, Streeting said in another press release about his plans.

“NHS league tables will be introduced to help tackle the NHS crisis”, the DHSC said last night, in a briefing ahead of the speech today.

There’s nothing more demoralising than going to work, busting a gut for your patients, and knowing that despite your best efforts you’re letting them down because you’re not given the tools to do the job, and you’re working in a context where … you’ve got poor leadership.

On urgent and emergency care, for example, there is a wide variation across NHS performance, ranging from 83% of people in one trust being seen within four hours in type 1 A&Es right down to 38.2%. That’s over 44 percentage points difference.