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NHS Expenditure (Reduction)

No, I will not, if the hon. Gentleman will forgive me. I have only a few minutes left. The vision of high-quality care for all is one of local clinical leadership, of empowered patients shaping their own health care, of prevention being as important as treatment, as the hon. Member for Wyre Forest said, and of unstinting demand for higher-quality care. We must not for one second consider stepping away from that. Improving quality can also reduce costs. Our record on reducing health care-associated infections demonstrates that. We have made great strides, reducing MRSA by 74 per cent. and clostridium difficile by 37 per cent. That has not only improved care and saved lives, but saved the NHS £240 million. There are many areas with the potential to improve quality and increase productivity. In the time allowed, I shall give a few examples. Enabling all hospitals to meet the levels of staff productivity currently delivered by the best could deliver annual savings of up to £3.5 billion. The hon. Gentleman talked about the productive ward programme. As a result of that, nurses in London were able to spend an extra 500,000 hours—500,000 hours—with patients, because they themselves have worked out ways in which they can improve the quality of what they do in productive wards to give that time to patients. We are talking about the equivalent of an extra 255 full-time nurses, costing about £7.5 million. So far, the productive ward has been introduced for only 12 per cent. of London's wards, but the ideas that underpin the productive ward programme have also been applied in mental health wards and operating theatres and in the delivery of community services. Pilots of productive community services have already produced promising results and suggest potential reductions of time spent: on travel by more than one fifth; on administration of referrals by more than 80 per cent.; on finding stock and supplies by two thirds; and on dealing with interruptions by more than half. That has led to an increase in time spent on direct patient care and, not surprisingly, staff morale has gone up by more than 90 per cent. That is the type of measure that can change the quality of care and save money. Reformed community services and transforming the care of those with long-term conditions, delivering integrated, efficient and people-centred care, has the potential to improve the quality of millions of people's lives and to save up to £2.7 billion in the process. The next area of our focus is improving health as well as treating sickness. That has the potential to save the NHS further billions of pounds. For example, screening by pulse palpation to improve detection of atrial fibrillation improves the quality of care by reducing the risk of stroke, and it avoids the costs associated with stroke and its complications, particularly through emergency hospital admissions. The Government have made clear their intention to drive down the costs of management, back-office support and procurement across the public services. The NHS wants to find ways in which that can be done sensibly, rewarding good-quality management but also ensuring that innovation in management and administration is acknowledged in the health service and rewarded, too. All too often, managers who are innovative in how they run things and who deliver higher-quality care for patients are forgotten, because that is just the administrative side, not the flashy, operating theatre, medical style of care, but they too are contributing to the quality of health care. We need to acknowledge where good management has reduced costs and improved the quality of care through administrative changes, rather than just medical changes. All this cannot be administered from Whitehall. Instead, we need to empower clinicians and their patients. It is through innovation, through looking for new ways to do things, assessing them and, most importantly, spreading them throughout the health service—the NHS is great at innovation, but it does not spread it—that we can ensure that we unlock productivity gains. To support that, we have published the best examples of quality and productivity improvement on the NHS Evidence website. That has already been seen by more than 10,000 visitors to the site. The hon. Member for Wyre Forest highlighted the debate that we had the other day on self-care. That is an important debate and one that we need to take further, but we also need to give people more access to information about the care of their own health, both through the internet and through interactive television, which presents a great opportunity. Let us say that someone has a problem such as asthma. Interactive television can be useful for someone who is not perhaps as technology-literate as younger people often are. We face a great challenge, but we can overcome it by improving the quality of care, reducing the costs at the same time and delivering within NHS budgets, while recognising that the highest priority of the NHS must always be patient safety and ensuring that we improve the quality of patient care.