Looking uncomfortable and sounding contrite, Andrew Lansley came to face his nursing critics yesterday – apologising four times and promising to listen to them in future.
Just hours after members of the Royal College of Nursing had voted overwhelmingly in favour of a "no-confidence" motion in Mr Lansley's management of NHS reforms, the Health Secretary spent an hour and a half answering questions and listening to their concerns.
During the meeting he hinted that when the Government outlined its concessions to the Health and Social Care Bill in June, nurses would be given a greater role, particularly in deciding where NHS funds are spent. Nurses are likely to be given a statutory role on the new GPs' commissioning boards, ensuring that at least one nurse is represented. The boards are also likely to be renamed to show that they represent other healthcare workers.
Mr Lansley tried to reassure the 60 RCN representatives who had been chosen to meet him that he did care about the NHS. He ruled out accepting any other job in Government, suggesting he would resign rather than be moved in any cabinet reshuffle.
"I believe in the NHS," he said. "I am in politics for that. I am not here to do some other job. If there is an ideology behind what I am doing it is a belief in the NHS and a desire to protect it and make it stronger."
Asked how he felt about being the only health secretary to receive a vote of no-confidence from nurses, he said: "It's not something I sought out.
"I think it's a rebuke and from my point of view I take it as a rebuke and I think listening to nurses this afternoon it was very clear some of the reasons why that happened is because they thought I was too focused on general practitioners when I was taking about clinical commissioning, GP commissioning.
"I know that nurses are not only the largest healthcare profession but are responsible for the delivery of most healthcare, and are often in the best place to be able to see the whole of care.
"From that point of view is it a rebuke in the sense that I didn't get to the right place? Absolutely."
Many nurses appeared partially mollified by Mr Lansley's approach. But they all said they would wait to see how his "listening" materialised into concessions.
One of the problems Mr Lansley faces, however, is that it is not just the contents of his contentious Bill that the nurses object to. In the earlier no-confidence debate most were angered at cuts to frontline services as a result of the Government's plans to try to make £20bn worth of efficiency savings over the next four years. This is not something Mr Lansley has much control over as an ageing population means that the NHS will have to do "more for less" and savings will have to be found.
Earlier in the day delegates in Liverpool had voted 99 per cent in favour of the no-confidence motion, to 1 per cent against.
The RCN's leadership had attempted to amend the motion to delay any no-confidence vote until after the conclusion of the Government's listening exercise. But amid angry and passionate scenes on the conference floor the amendment was dropped when nurse after nurse took to the stage to condemn the Government.
"What this is about is how Andrew Lansley has introduced these reforms," said Geoff Earl. "They are being driven by ideological dogma, not by what is best for our patients. This [vote] is about our patients, not about us."
Another nurse went on to the platform and played a tape of David Cameron's promise in 2010 to "stop the pointless reorganisation of the NHS". Birmingham nurse Bethann Siviter added: "If these reforms go through, the NHS is dying."
Andrew Frazer, an emergency care nurse, said: "When Andrew Lansley addressed us last year we listened to him politely and decided to adopt a wait-and-see policy. Well, we've waited and we've seen, and I for one don't like what I've seen.
"We've been trimmed to the bone for years. Trying our damnest to deliver excellent care with limited resources. Here's a message for Mr Lansley: if you cut frontline services, in the short-term care may be a little cheaper, but in the long-term care will be poorer and people will die."
'Does he think we're waste that needs cutting?': The NHS staff who faced Lansley
Mike Hayward, senior clinical manager, south-west London
The first thing we challenged him on was to tell us how many of us he thought were managers and he just looked blank. He goes on about wanting to cut back management waste – but 50 per cent of us round the table are experienced clinical managers – and we play a vital role in looking after patients. Does he think we're waste that needs to be cut back?
Angela Mohamed, nurse in south-east England
If you want to help others you want to be listened to – you want people to take your input seriously. But I've felt Mr Lansley has not been listening to us – these changes are being rushed through with no regard to what is actually happening on the front line. When he came to our table he certainly gave the impression that he's listening now. But that's not the same as action.
Shaunee Irvine, nurse from Worcestershire
He certainly seemed like he was listening – but I want to see what he and the Government actually do. At the moment all these reforms are about giving more power to doctors. But out of 24 hours doctors only see patients for five minutes. We see them for the other 23 hours, 55 minutes. That's why nurses need to be involved in deciding where the NHS spends its money.Reuse content