Good morning conference.

Let’s start on a point of agreement.

The killing of 15 health and rescue workers in Gaza was an appalling and intolerable tragedy.

Healthcare workers in any context, in any part of the world, should never be a target.

The international community, or indeed any actors in any conflict, all have a responsibility to protect health and humanitarian aid workers and also to protect innocent civilians.

And it’s clear that in Gaza, as well as in other conflict zones around the world at the moment, the international community is failing and failing badly.

So I want to say, as a Unison member, I strongly support the sentiments expressed by our Healthcare Executive.

But on behalf of our government, we want to see a return to an immediate ceasefire.

We want to see aid in, people out of harm’s way, an end to this bloody conflict and a state of Palestine alongside a state of Israel, and the just and lasting peace that Israelis and Palestinians deserve.

I also have to say, having been to the West Bank with Medical Aid for Palestinians and seen first hand the work that they do supporting the health needs of Palestinians across the occupied Palestinian territories, they do brilliant work.

And I would fully endorse the sentiment of the motion in supporting them, and each of us putting our hands in our pockets to do that.

But today, I’m here as the first health and social care secretary to address a Unison conference since my […] predecessor, Andy Burnham, did 15 years ago, and I am proud to do so as a Unison member.

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Now we’re delivering the change people voted for.

It’s not all plain sailing and I expect you’ll want to question, even challenge some of the government’s decisions.

So there’ll be plenty of time for questions.

And I promise to give you honest answers.

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You might not like some of the answers.

I might not like some of the questions, but the important thing is that we show up and we have that conversation.

For all the challenges we’re confronting, and there are plenty, nothing I’ve experienced in the last 9 months as our country’s Health and Social Care Secretary has shaken my confidence and conviction that this will be a government that not only gets our NHS back on its feet, but makes sure it’s fit for the future, and shows the bold leadership required to make sure that we also build a national care service worthy of the name.

Of course, it’s hard.

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Six months ago, back here in Liverpool, I spent 2 hours with one of the most remarkable groups of people I’ve ever had the honour of meeting in my life.

In that room were centuries of training and experience between them of working in the health service.

But all of that training, all of that experience couldn’t have prepared those people with what they were confronted with in Southport on Monday the 29th of July, as they rushed into that community centre to find children and adults lying on the floor bleeding, some tragically dying.

The aftermath of an unimaginable, senseless, mindless attack.

Those people were confronted immediately with the consequences.

For the staff I met, the trauma still runs deep.

But on the day itself, the whole NHS team kicked into action.

From the paramedics who arrived first on the scene and had to make split-second decisions of who to treat first in what order, to give them the best chance of survival.

The porters rushing children through busy hospital corridors, and the security guards trying to shield other patients and visitors from seeing the horror that the staff were confronting.

The lab teams who are mobilising blood supplies.

Receptionists fielding calls from panic-stricken parents.

The surgical teams fighting to save those young girls’ lives.

I’m filled with admiration for their care, their expertise and their values.

As I think about what happened in the aftermath of those brutal attacks, that admiration turns to anger.

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Filipino nurses came under attack from racist thugs on their way into work wearing their NHS uniforms.

GP surgeries closed early out of fear of rioters.

A Nigerian care worker saw his car torched.

These people came to our country to care for our sick and vulnerable.

They bust a gut day in, day out to keep us well.

If those thugs represented the worst of our country, our health and care workers represent the best.

This government will never walk by on the other side when it comes to standing up against racist hate, intimidation or violence.

Because no one should go to work fearing violence, least of all those all of us rely on for our healthcare.

What happened after Southport was an extreme, but it wasn’t a one off.

One in every 7 people employed by the NHS have suffered violence at the hands of patients, their relatives or other members of the public.

This should shame us all.

So today I can announce we will act to keep NHS staff safe at work.

Incidents will have to be recorded at a national level.

Data will be analysed so that those most at risk can be protected.

Trust boards will be made to report on progress they’re making to keep staff safe.

Protecting staff from violence is not an optional extra.

We are making it mandatory.

Zero tolerance for violence and harassment of NHS staff, campaigned for by Unison.

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We invest huge sums of money into training the NHS workforce.

Then they’re treated like crap. Forced to leave the health service and often leave the country.

British taxpayers are investing billions in doctors, nurses, paramedics and healthcare assistants only for them to turn up treating patients in Canada or Australia.

We’ve got to retain the talent we have in the health service and treat our staff with the respect they deserve.

That means more training and opportunities for nurses who want to progress in their career, and making flexible working easier too.

It also means paying you for the job you actually do.

There have been too many disputes because NHS staff have not been paid according to their job description, rather than their job.

So we’re bringing in a new digital system to make sure the job evaluation scheme is applied fairly across the board.

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A fair day’s work for a fair day’s pay. Campaigned for by Unison.

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I owe my life to the NHS. Who cared for me when I went through kidney cancer. It’s a debt of gratitude I will never be able to repay. But I will certainly try.

You were there for me and I’ll be there for you.

As the chair said, the scale of the challenge in our NHS is huge.

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So our job is twofold.

First, to get the service back on its feet and treating patients on time again.

And second, to reform the service for the long term so that it’s fit for the future.

And I say it’s our job deliberately, because this can’t be done with one man sat 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 National Health Service.

When I visited Singapore General Hospital in opposition, they told me about a programme they run.

It’s called get rid of stupid stuff.

Does what it says on the tin.

I thought the NHS could probably do with that.

Some of you might think I could do with that.

It’s a common sense idea.

People working in the health service might have ideas about how to fix it.

So over the past few months, just as we did when we were in opposition, we’ve been asking NHS staff about the stupid stuff that’s holding them back.

More than a million people have engaged in what’s been the biggest national conversation since the NHS was founded.

NHS staff have attended more than 3,000 meetings across the country and online, and if you’ve not made your voice heard yet, you’ve got until 5pm on Monday [14 April 2025] to go to Change.nhs.uk.

The plan, published later this spring, will take the best ideas from across the NHS, staff and workforce and patients and set out how we’ll deliver the change the NHS needs.

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.

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

The crisis in the NHS is not the fault of staff, but we can’t fix it without you.

I know how hard it is to battle against a broken system, to give patients the best care you can, only to go home at the end of the day, knowing your best wasn’t good enough.

But there is light at the end of the tunnel.

The cavalry is coming.

My message to everyone working in the NHS is this.

Stay and help us to rescue and rebuild it.

The NHS was broken, but it’s not beaten.

And together we can turn it around.

Change takes time, but it has already begun.

In 9 months, this […] government has awarded NHS staff an above-inflation pay rise, ended the resident doctors strikes, invested an extra £26 billion in health and care, the biggest investment in hospices for a generation.

We’ve agreed the GP contract for the first time since the pandemic, with £889 million more in funding, the biggest uplift in a decade.

We’ve reversed the decade of cuts to community pharmacy.

We’ve delivered the extra 2 million more appointments we promised at the election than we did it 7 months early.

NHS waiting lists have been cut for 5 months in a row and counting.

80,000 suspected cancer patients were diagnosed early, so lots done, but so much more to do.

We know there’s a long way to go.

There’ll be bumps along the way.

It won’t be plain sailing and we’ll make some mistakes.

But we are finally putting the NHS on the road to recovery.

On social care, we’ve been accused of not doing enough.

I totally understand the cynicism after years of inaction.

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Our first step on the road to building a national care service, and I can announce today, will go further for our care professionals.

We are introducing the first universal career structure for adult social care, setting out four new job roles to give care workers the opportunities to progress in their career.

With millions of pounds of new investment in their skills and training.

Keir said his ambition for his sister, who is a care worker, is to command the same respect as her brother, the Prime Minister.

Her work is so important to the future of our country.

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But be in no doubt about the weight on our shoulders.

I’m certainly not.

Not only the responsibility to millions of people who are being failed by the NHS and social care services, but also to prove to a sceptical public that the NHS can change and deliver the timely, quality care people expect in 2025.

On the 75th anniversary of the NHS, an opinion poll showed that the health service makes the majority of the British people proud of our country, greater than the pride we feel for any other aspect of our history or culture.

But the same poll revealed that 7 in 10 believe that the NHS founding principle of healthcare, free at the point of need, won’t survive the next 10 years.

The failure of public services to meet the needs of the people is one of the fertilisers of populism we see across liberal democracies.

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We will always defend the NHS as a public service, free at the point of use, so that when you fall ill, you never have to worry about the bill.

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That’s why I say it’s change or die.

The stakes are high.

The challenge is enormous, but the prize is huge.

A service that values all of its workforce as an asset to be nurtured, not a cost to be minimised.

Where staff are proud to work because their patients receive the best possible care.

An NHS there for us when we need it.

Once again, it won’t be easy.

It will take time.

But if we get this right, we will be able to look back on this time and 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 the future, and built a national care service worthy of the name.

Change has begun, but the best is still to come.

Thank you.