YouSaid · the spoken record

Alan Milburn

lines on the record: 55
first: 2023-01-30
most recent: 2023-01-30
sittings or episodes: 1
sources: podcast

Every line below is reproduced as it was said and linked to the record it came from. Nothing here is summarised or generated. Directory · Search · Corrections

“And you can do the most prevention. And actually, I think that there's been a lot of progress, but not nearly enough. Not nearly enough.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“No, no, we did. I think we did some good things. I'm pleased with some of the things that I did. But I think given the priorities that we have, actually it's interesting. The three clinical priorities I had were cancer and coronary heart disease because they were the biggest killers and mental health because it was the most endemic crisis. Mightn't have been the biggest killer, but it was the most endemic crisis.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“I think the first thing that you've got to do is you've got to give them and other staff in the NHIS and by the way the social care system because they're two sides of the same coin. You've got to give them a sense of hope about the future. And right now, you know, morale is always at an all-time lower than the NHS. But it really, really is. And you can see that in the exit numbers. So I think they've got to have a sense of hope that actually the system can be successful and sustainable. And that's the government's role. It's got to do that. Secondly, I do think that we have to do a deal with the future generation of doctors and nurses for that matter, but particularly doctors, which is that I've always thought there is a deal to be done about, okay, we can be more permissive on things like your fees, the student fees coming out, in exchange for a commitment from you that you are going to commit to the NHS for a period of time. Maybe not for your whole career, but for a period of time.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“To the next there, you just can't do it. It's an odd thing to say because I think people often see being political and being a good deliverer sitting in slightly different positions. They're not. He needs to become more political. And the first thing that he should do, understanding politics is sit down with the nurses, get them into Downing Street, do the deal. There's a deal to be done. The unions want to do it. I know they do. I can hear it in the language that they're using. Get it done. Get that problem off your plate. He's not going to do it. And the reason he can't do it, Rory, is that your party, he's both too weak and your party is no longer a single party. It's a double party. It's a party of Singaporeans who want low taxes, small state, and it's a party of Red Wallers who want exactly the reverse. And that isn't going to work.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“I think he needs to double down as he's trying to do on a really few sharp deliverables. But he needs to be brave in the execution. And I think the thing that really worries me back to the healthbeat, I think they're thinking for perfectly understandable reasons, because even though they won't say the word, the system is in crisis. They think the answer is pull everything back to the center, performance manage the hell out of it, sack the chief executives who are not doing a good job, all of the usual stuff. And I can tell you from bitter experience, because I've been around that course, it won't work. Not in a million years will it work because these people working in this system, look, they're high collaborative people. Doctors are high caliber individuals. You've got to treat them with respect. You've got to treat the nurses with respect. You can't stand clapping them one day and then deriding.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“And I actually think, and I think this is where the Johnson era in retrospect, Rory, might have been a blessing. Well, and let me tell you why. Because I think people have now realized that that style of politics, the bling bling, the big character, the big man, say what you like, rules don't apply, everything's malleable. Isn't it interesting that the two leaders of the political parties that we have today, whether you like Rishi or loath Rishi, and the same with Kia, they're very much sort of, they're cut from the same block in a sense, you know? They are technocratic, probably not that political, actually. Their calling card is around competence and not chaos. And I think that's a reflection of where the public appetite has got post Johnson and Paul Strum.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, unfortunately. And that's the thing. The way that you actually deal with these things is you do end up wearing a, you wear psychological suit of armor. That's the way that you deal with it. And that's not healthy either. It's not healthy personally. And it's actually not healthy in terms of the authenticity of the politicians because the truth of these, okay, so it's fine. Tell them to toughen up and you've got to be more resilient at all of these things. But, you know, people are people. People are different and people feel things. And I think in today's world, I really fear that it is actively deterring people. Because I think no doubt about that. You two guys are an interesting case in point. So here you are. You're doing this thing and it's very successful. And lots of people listen to it. Why they're listening? Because actually you've got different points of view, but you're conducting the conversation in a non-vitriolic, non-venomous and definitely non-violent way.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Thing. It just didn't work for me, and it was really difficult. And I think now. I would say in some senses, it's a million times worse. Because, you know, to And if you're a female MP, you know, seriously, I mean, the stuff. The rest of your syndagot was unlinguous. It's just, I mean, awful. I mean, it is just incomprehensible to me how that is in any way permissible. It's just horrendous. And it does make me fear for democratic politics.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“And it was really difficult because I was away basically five or six days a week. And, you know, Tony kept saying to both me and my wife Ruth, well, you should relug it. Why don't you come to London? But I didn't want to, you know, I'm from the North East. I still live in the North East. It's my home. It always has been. The kids were really happy and stay at schools, et cetera, et cetera. It was fantastic. Actually, it's worked, you know, in terms of our family life. But the strain on family life and just being absent became, for me, personally, that was not something that I could deal with. And in the end, my view, and it took me a long time to get there and even longer to go and have the conversation with Tony to tell him that I needed to go. That was the probably one of the most difficult conversations I've had in my life. In the end, despite trying to manage it, I couldn't find a way of doing so. So I just couldn't reconcile the public and private life.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, look, it's, I mean, you're quite right. It's very different from any other leadership position. I lead businesses, I chair businesses, I chair charities and so on and so forth in my post-politics life. And they're all challenging, but not as challenging as politics for this reason. The accountability is everywhere, everywhere. And it's massively intensified since I left politics. So you've got the accountability to your party, to your constituency, to the media to number 10, to number 11. It's just everywhere and it's coming at you all the time. So you're in this goldfish ball of scrutiny about who you, who you are, what you're doing, and there's no escape from it. And the truth is, for me, I had two young kids. We were living, I think there were two of us in the cabinet at the time. I think there was Alistair Darling and me who had the youngest families.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“So that's the political trick that you've got to be able to perform. And that's sort of what we did with the NHS plan, which you were alluding to. If you remember, there was a forward to that NHS plan, and people talk about how good the policy was. The really important thing was that I got the BMA, the RCN, Unison, the patient groups, the NHS Confederation, all of these various interest groups, I got them to sign up to the principles. And that was a really important thing because for quite a while, people felt that this plan, which was a Labour Party, Labour government plan, was theirs. You've got to find a way of buying them in.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, but it's also such a pitfall for the Labour Party. It only works if you get the doctors and the nurses on board. And this is to Rory's very first question about how you manage this thing. The trick in all of this is to be able to get people to believe that the problem, whether you're a doctor, a nurse, a social care worker, or a patient, the problem is that you're having to fight a system that is not working in the interests of the people who really count”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“The doctors, consultants, as well as GPs, the trap to avoid, and I certainly fell into it at times, was because the trade unions, the trade union and therefore it's good at deposing things, the trap to avoid is to make doctors the enemy.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“I'll Claire. And Blair, if you were asking what was the equivalent of the Thatcher marketization, it was the Blair Modernization. People might have liked it, might loathed it, but there was total clarity. And that is what the Labour Party's got to get to. It's got to get to a position of total clarity. And for Wes, my feeling is, I don't know, he's probably more in the latter camp than the former camp. And I think he's got the idea that we need a 10-year plan. It's got to be long-term. You've got to buy time. And in dealing with the trade unions and the BMA, you're 100% right. They are a very, very effective trade union, the most effective in the country. Okay. And it's not easy to negotiate with them.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“And I'm not in that camp either. Well, not surprise using it all. And I'm slightly caricature in that position, but that's sort of what I feel about it. It's a position of, I think, utter complacency and real danger for the Labour Party. And my view is that you only ever win if you have a project. The big leaders have big projects. People, including me, mightn't have liked Margaret Thatcher, but boy or boy, did you know where she stood? She had a project, which was to marketize Britain. That's really what it was.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yes, it would. And I think worse treating, who I read very highly, by the way, the Shadow Health Secretary, I think he's got that idea. Look, the truth is, you know this as well as I do, there's a sort of debate, isn't there, in labour circles, between those, what I call the advocates of the Mingvar strategy, the people who think that, you know, with 20 points ahead, it's all in the bag, da-da-da-da-da, let's tread carefully, let the Tories continue to screw up, and somehow or other we can get over the line.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“And the answer is no one's thinking about it, and there is no plan to harness it. And that's the opportunity, frankly, that is going to be for the next level, for the next Labour government.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Of Rory's point about technology and the sort of cultural reaction to that within the system is often right. I think the big change, Rory, from when I was doing the job or even when you were 10 years ago, is that technology now is capable of doing things that we always wanted to be able to do, but we really didn't have the tools in the box. So remember, you know, we participated in the Human Genome Project with Bill Clinton and all of that. It took billions to decorb the first human genome. And now you can go and buy a test for it in New York City and it'll cost you $90. And by, you know, in five years time, it will be for free. So we're able to do things that we were never able to do. And the hope has always been that healthcare will be able to do what the founders of the NHS wanted to do, which is to focus more on prevention than on treatment. And we've now actually got the tools to do it. The question is, who's thinking about it? And what's the plan to harness it?”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“how staff are trained, how the workforce is configured, how resources are provided, what the infrastructure is that is required. So my message is a message of possibility and optimism. And that's the thing. There's one four-letter word that is above all else missing from the debate about the NHS, and that is hope. And the hope lies in technological change.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Some of it's about money, but some of it is about where we get the system focused. The third thing, therefore, that you have to do is, you know, it's quite hard to get visibility on this because everybody's drowning in pessimism. It's broken. It's finished. It's over. We've got to fundamentally tear it up, start again, introduce social insurance, all of this, frankly, bollocks. Social insurance would not add one jot of difference. Not a jot of difference. It would cause turmoil for 10 years. Well, we've got turmoil. You know, what we want is order. What we want is sustainability. And the way to do that is to recognize that healthcare is going through a fundamental revolution where you've got the alignment of data analytics and genomics science, which are going to allow us, indeed, a beginning to allow us today to rather than focus purely on diagnosing and treating patients instead, we can predict and prevent ill health. That's what we can do. But in order to do it, we've got to fundamentally change.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Period of time, and increasingly it's gone there. And primary care, community care, the things that could be utilized to keep patients healthy and out of hospital are underinvested in massively. 7% fall in GP numbers since 2015.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“have to have a plan to deal with it and right now there's neither if you're looking at the strategy lens the only option is for them to go short in order to try to prove that they can turn it around a little bit therefore let us finish the job that's going to be their argument at the next general election it's perfectly obvious but the big problems are deep structural and fundamental and long term back to the 10 year plan so you need a plan first of all secondly you need a recognition which is that the way the system is currently set up neither has the capacity but nor does it have what I'd call the alignment with today's problems. Biggest problem for healthcare throughout the world including in our country is the rising tide of chronic disease. All of these sort of issues. And our system is not set up to deal with any of that. It's set up to deal with episodic care in hospitals. That's where the majority of the budget goes. And indeed you look at what's happened over”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“And that worked really well. Now, it wasn't everywhere, and we were quite strategic about where we locate those new providers, largely in areas where there was very long waiting times for treatment. But one of the reasons, and the academic studies verified this, one of the reasons that waiting times fell so dramatically is not just that those guys brought new capacity, including new staff with them, clinical staff, but it also provided competitive pressure for the NHS in those areas to up its game because we also introduced a system of payment by results, which basically said, the more you do as an NHS hospital, the more you get. And that was a big change. Today, there's the short term and the long term. And what there isn't, first of all, is a recognition that this is a crisis. I mean, this is, I've been around health policy for 30-odd years. This is of a different order. It's a million times worse, probably arguably the worst it has ever been. So the first thing is you've got to recognize it. The second thing is you...”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, if the size of the cake is static and all that we're doing is dividing it between public and private in terms of staffing, doctors working here and working there, it doesn't really add to the overall volume. And we've got a volume problem, which is one of the reasons, by the way, if you remember back in the day, one of the things that we did is we didn't just sign a deal with the existing private sector to use private sector capacity to treat NHS patients. We also enticed new private sector providers to come to England.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Services. So, if there's capacity available and we can do the right sort of deal to get value for money for the taxpayer and the right quality of service for the patient, why wouldn't you do it?”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“We confuse means and ends. That's basically why. So we associate public service with public sector. And actually, I understand why, because there's a deep emotional attachment, as I have, to the NHS. But they're not the same thing. And I actually think both then and even more so now, frankly, it's an ideological extravagance to say that NHS patients can't use private sector hospitals when the taxpayer is paying the bill to provide NHS care according to NHS principles. You know, my view then and now is that every bit of capacity that you can get, because one of the essential problems that the healthcare system has is a mismatch between supply and demand. We don't have enough capacity. You don't have enough doctors, enough nurses, arguably enough beds, certainly not enough primary community and mental health.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“That is the argument. That is absolutely the argument that the unions were making. God rest his soul, Frank Dobson, was making, these were a Trojan horse for privatization. Wind forward 20 years, and our foundation trust, still part of the National Health Service. Yes, of course they are. The idea was never to sort of privatize them. The idea was to liberate them, to allow them, just like we did with schools, to allow the schools to get on free from political control, to be able to manage their own affairs.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Work better. And the conclusion I reached might be right, might be wrong. I think actually if you look at the track record, particularly around access and waiting times, I was proved right, you know, because there was a moment when they began to fall. And honestly, it wasn't really about the money. It was about the reforms. It was when the reforms went in, however difficult they were, that the system then began to work. And it was only by disaggregating decision making and allowing the people at the front line who actually knew far more about it than I ever could, that then you began to get really changed. And that was a philosophical argument and it was an argument about how government works in practice in relation to public services.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“And there was a very legitimate treasury point of view. And as the Chancellor, that was a perfectly reasonable thing for him to have a debate about. What it really came down to was the fact that he felt that if I think you need to speak to him in a sense, but I think the argument was if you set up these foundation hospitals that were freed from centralized control, that were able to do their own thing, there was always a risk that they would fail. And even though they were autonomous, in the end, the buck would rest with the taxpayer through the Treasury. So the Treasury felt like they had to have more locus of control than I was prepared to give them. Perfectly reasonable argument. But the big debate wasn't really about that. That was a sort of mechanistic argument. The big debate, a Rory's point, right at the beginning of this, was what was going to make the system work?”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yes, it never got leaked, by the way. You said it got leaked. It never got leaked. No, it never ever got leak No, I think it didn't get leaked in part because I think John Prescott sort of had a quiet or probably quite a loud work.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“No, it was I think it was post that awful period. I think, I remember Fraser saying to me about 18 months before I resigned, saying to me, something's happened to you, you look like and feel like a different politician. And it was true because I sort of, personal ambition became a second order issue for me. I really did decide I was going to try to do the things that were right, even though, as you say, they were deeply unpopular in the Labour Party. Choice for patients, the use of the private sector, market mechanisms, foundation hospitals, every one of these, as you know, was a dogfight inside the Labour Party.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“No, I didn't really. I mean, that's the interesting thing. I mean, I think if Gordon had had his way, we wouldn't have had foundation hospitals. But we did. I got to the point in the end where, look, there was sort of deep treasury obstruction.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“I was extremely angry for good reasons, you know, because look, I mean, the truth is without going through the whole sort of thing about the TBGs, as you put it, you know, there'd been a shared project at New Labour. And in the fundamentals, there remained a shared project. all the way through, but personal ambition is a very funny thing, isn't it? On both sides, you know, both for Tony and Gordon, and it can be deeply distortive. And unfortunately, what then began to happen is that the sort of the policy consensus that these two guys had, which was fundamental to labor's success, it began to come apart because not I believe a fundamental policy differences between them, but because increasingly there was personal antagonism and personal ambitions. And that unfortunately, the face of that was policy differences. And I was in it.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, I mean, my one criticism of your wonderful diaries is that every entry which mentions me, I sound like I'm insane. And as you know, I'm not. So anyway, never trust a journalist, Rory.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“That's the difference between today and then. We had the permission to think in 10-year terms because I worked out, and you remember these discussions, I worked out the system was incapable of being saved. That was our promise before the election over a period of a few years. It was going to require deep and fundamental reform. And the rule of thumb, by the way, when you're doing change management of that order, it always takes twice as long as you think.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“And I think the other shortcoming that is often very obvious in politics and in policymaking is that you have people who are unnecessarily focused on the short term when many of the structural problems that any future government is going to face are long-termist in nature.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Maybe, but look, I you know, this is something that we probably share in common, Rory. I sort of believe in markets, really, providing they're managed. I don't believe in untrammeled markets. And certainly what we did in health was not an untrammeled marketplace. It was the use of market mechanisms to provide the necessary ginger within the healthcare system to get it to do the things that needed it to do. So I think it's all about how the market is managed. Markets, as you know, of their own volition will always go in one direction. The question is, does government, local, national, regional governments do they have the wherewithal capability? But critically, do they have the foresight to be able to plan to use markets to the advantage of the citizens that in the end we serve?”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“That's such a guiding the witness in one direction. So I think there's a systemic asymmetry of skills between the public and private sector. I think we've got brilliant public servants in many regards, but what they're not good at is they're not good at doing commercial deals. That's not their skill set. And it's not what we say to people coming into the civil service, is it? Oh, by the way, you've got to be really good at negotiating a deal with somebody whose job is to negotiate deals. So there's a real question, in my view, which I think is a real pertinent one about what is the skill set that is going to be required for the future in order, particularly when you're in a fiscalally constrained environment, like the next government will be, how do you ensure that you get the best value for money and the best deal? That means you've got to change the skill set. And we've got to think more broadly about what a modern civil servant really is.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah. However, you know, the pragmatist in me continues to believe that when I walk past the UCLH building, as I often do on my way to the various places that I work, the truth is it wouldn't have been built without PFI. It just wouldn't.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“There have been no PFI market until Labour made one. The truth is that those first contracts were pretty expensive contracts. That's the criticism that you hear. Didn't we, you know, the argument goes, didn't you mortgage the future? Wasn't it more expensive than using public sector capital? The truth is, because of a decision that Labour took before the election, which Gordon and Tony took together, it wasn't only public sector capital. So you were stuck in this sort of ice.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“No, I think that's a very fair characterization of it. Look, I think on PFI, I think it wasn't an ideological thing. It was a completely pragmatic thing. I remember doing the press conference with Frank Dobson when we announced the first wave of PFI hospitals. And he used this phrase about it's PFI or bust. Because if you remember, Labor came into office in 1997 agreeing that we would stick by the Tory spending plans. So we were snooked in terms particularly of capital. So it was very much a pragmatic thing. It was driven by pragmatism. How could we get more money and particularly capital into the NHS? Because remember, in those days, the vast majority of NHS hospitals had been built before the NHS itself was created. So there was dilapidation and they just weren't fit for purpose. But increasingly, I took the view that there was an additional benefit, which is what you were being able to do was harness not just private sector capital, but also some private sector expertise. Now, the truth is, because”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Especially in Britain because of history, because it's funded from general taxation, it's the last great remaining or was the last great remaining nationalized industry. My learning was that all of the levers that had been successful in transforming other industries, some competition, some citizens, greater transparency, obviously a framework of standards and all of that sort of stuff. You had to be able to apply these to healthcare because they'd worked elsewhere.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Less than that was well over a million. It was one of the biggest institutions in the world. And you might have been as brilliant as you think I am, but it was unmanageable. So what you had to do was you had to disaggregate it. You had to make sure that the people who were actually responsible for the managing and the running and the provision of services, because as a secondary estate, you never do any of that in truth. All that you do is create permissions and frameworks to make things happen. So my learning was it was unmanageable. And my second learning, which was probably even more important, was that we treated the NHS as governments around the world treat their healthcare systems as if they're different from any other system or institution.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yes. So totally rang me and said, oh, blah, blah, blah, blah, blah, blah. He said, I want it off you. And I said, yes, I know the job at health. He said, how the hell do you know? I said, because Alistair's briefed it to the BBC. And anyway, then we had this interesting conversation. I said, what do you want me to do? And he said, we need a policy. Because in truth, labour in opposition didn't have much above policy. So I spent the first five or six months literally sort of working out what the hell was it that needed to be done, what were the levers that you needed to be changed, etc. And my view then, and this is what changed Rory, my view then was if the center got it right in terms of the policy prescription, then everything would be all right out in the field. And that would sort of make it work. And my learning was, to your point about managing this enormous thing, my learning was it was unmanageable. How can you possibly manage something, which then, by the way, it wasn't 1.8 million people then?”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“The first instinct, I remember when Tony rang me to offer me the Minister of State position to Frank Dobson in 1997. And the truth is, by the time he'd around, because it was sort of two or three days in, and he'd obviously not got round to recognizing the brilliance that Rory has been able to spot. So it was two years later, you'd clearly got bored because you'd briefed to CFACs if anybody could remember what CFAX is. CFAX was that ticker-tape thing. I never breathe CFA. On the BBC that Alan Milburn was going to be the Minister of State.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“It's the best job I've ever had in my life. It was fantastic because it's sort of meaningful, right? You know, it's a meaningful thing. And unusually in modern government, it's one of the few institutions that remain where if you're a minister who wants to get their hands on levers, when you pull the lever, not always, but something happens. Because a lot of government nowadays, if you think about it, it isn't actually a delivery mechanism. Government doesn't deliver much. Local authorities and schools are kingpins in education, for example. Transport is privatized, et cetera. But the NHS remains an institution that is subject to political influence. The debate is how much political influence should be subject to. And a lot of the changes that I was trying to make were about actually devolving power away from the center, recognizing that in the end, look, it had to be...”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“about the public, they're worried about doctors and nurses, and they're worried about the course reform. And Alan Milburn did things. So there we are. That's why he's my hero. So, Alan, how do you respond to this peal of praise from the right honourable Rory Stewart? Well, all I can say is that Rory is a man of impeccable judgment, unlike you. So Rory, I think you and I can have a really civilized conversation for the next whatever it is, 30 minutes. So that's very, very kind and completely unwarranted, by the way. So you're right about a couple of things. Look, I mean, the NHS is, I mean, it's traditionally viewed as the elephant's graveyard, isn't it? For a politician, you go there, it's incredibly tough, you try hard, you get kicked out, you fail for all sorts of reasons. And some of the you've described. And I have to say, look, it was all of those things. It was incredibly difficult, you know, really challenging.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“They enjoyed fighting the other side, they enjoy getting elected, they often enjoyed serving their constituents. But the business of running stuff didn't necessarily appeal to them. Even when people were interested in running things, they weren't necessarily that good at it because it's very, very tough working out how to work in government. It's not like running a company or running a small charity. It requires very, very particular instincts to work out how to make the civil service adjust. And in the case of the health service, our guest today was running by far the largest and most complicated part of the British government, hundreds of thousands of employees, hundreds of billions of pounds of expenditure, quite literally dealing with people, life and death. And of course, the NHS is also as close as we have in many ways to a sort of secular religion in Britain. It's something that we've been deeply proud of since the Second World War, and which many politicians find easier not really to do too much of because they're worried.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“I think it's a really big problem. And I think you've got this amazing industry that touches people's lives that we get totally animated about, World Cup, Burnley, Newcastle, all that sort of stuff. I don't know who Rory's. Rory Switch, Croatia. Yeah, yeah. Very good. And here you have this industry that is vast, that's financially extremely lucrative, and it's run to use a very bad metaphor. It's run as an amateur sport with incredibly poor governance. And I think that's not sustainable. And the government, whoever it is, needs to change it. Just stepping back into the general for a moment. I think it's very unusual to have politicians who are genuinely interested in reform and administration and running things. That sounds a strange thing to say because obviously one would expect ministers to be primarily driven by that. But many, many of my colleagues in the House of Commons came into it because they enjoyed politics.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source
“No, of course not. But I mean, so am I happier with the team? And I'm happier with the club than under the Mike Ashley regime. Yes, I am, actually.”
2023-01-30 · The Rest Is Politics: Leading · 3: Alan Milburn: Can the NHS be saved? · IDENTIFIED FROM THE TRANSCRIPT · source