I think it would be fair to say that many people can’t remember life without an NHS. We have little idea of the unfairness and inequality that existed in healthcare before it came into being.
Before the NHS existed, life was in some instances quite literally a lottery. It meant that if you were poor, you could not afford even the most basic treatments. You simply had to put up with whatever illnesses came your way.
As someone who worked in the NHS for over 20 years I have seen what the founding principles of free healthcare meant in practice to patients and their loved ones.
Now, as Health Minister, I want to make clear that the NHS in Wales will not deviate from those founding principles that brought it into existence. I believe in a high quality NHS, delivered by the public sector, that is free for all, no ifs, no buts, no maybes.
Whilst I’m Minister the NHS will continue to offer high quality services that include free prescriptions and increasingly fairer health outcomes for all.
Fairer outcomes can come about in different ways, through society itself being fairer, through using policy to give people a better chance in life and through personal choices. Where a person lives or their social circumstances should not lead to a lesser quality of life and a premature death.
Whilst the principles that underpin our NHS remain as relevant today as they did when it was formed, that does not mean that changes to the way the NHS works and delivers services cannot happen. Striving for progress and excellence means that change must occur in order for service improvements to take place. To argue otherwise is disingenuous.
The current Welsh Government was elected based on a manifesto that contained bold policies to improve and modernise the NHS.
I believe in strong public services that places public interest above private profit, with quality services available to all. Working with the NHS we have now put improving health and preventing avoidable ill health at the heart of the planning process.
We should have high expectations in the services that are provided. We have brought together all of the work of the NHS in new streamlined Local Health Boards. These Boards are responsible for the health of their local population, working with local authorities and supported by Public Health Wales. They plan and develop their own services without the threat of market-driven health care and privatisation of services that exist over the border in England.
Creating the new bodies was the first step in the change. The second step will be a shift to an NHS based on personal health outcomes rather than performance targets, careful financial management and high standards of care across Wales.
To achieve this, the NHS needs to start measuring and reporting more clearly what health outcomes it achieves. We have a plan that sets out the development of a measure of healthy life expectancy for Wales and we will use this focus our actions.
A focus on outcomes can really support efforts to make change happen. Using outcomes and indicators intelligently will help guide the NHS into strong partnerships with local government and the third sector to make a combined effort to tackle inequities in health. Fairness is about distribution and I want the NHS to consciously look at who gets what outcomes.
People have different needs and should be treated accordingly. I want every NHS encounter to count as a health promotion opportunity. This means the NHS needs to understand how to deal with every individual in a unique way and we benefit from the 85,000 staff being able to contribute to this, particularly if we give them access to the information they need, when they need it.
Over the next five years there will be major changes that will transform the NHS in Wales. We must allow changes to take place that make services safer, more sustainable, and more effective. They must also be fair.
Bringing about these changes will not be easy. They won’t be easy for the dedicated staff that work in the NHS, and in some instances, they won't be easy for some patients to accept either.
On a personal level, I know the changes will not be a 'walk in the park' politically. There will be difficult decisions that will be made by health boards that I may ultimately have to consider.
Despite what ever political flak lies ahead in delivering the bold policies we have for improving the NHS, or in making the right decisions for Wales on how services will be delivered in the future, one thing is for sure: I will not shirk from the work ahead because I know change is necessary and in some cases long overdue, if we are to create the modern, dynamic NHS in Wales we all want to see, and the healthier nation we want to become.