Lansley accused of failing to protect NHS managers from media onslaught

After a 20-minute speech to the NHS Confederation's annual conference in Manchester last Thursday, Lansley was asked to be more vocal in his support for NHS leaders, helping to raise their profile in the media. A young man in the audience, who only started working in NHS management two years ago, said: "I have quickly recognised the role that leaders play and the absolute benefits they bring. I do not, therefore, understand why I have to go home and convince my friends and family of the pivotal role we all play. Can you not do more to make clear the difference between bureaucracy and essential leadership - in the public arena and through the press - so that I do not have to go home and convince people myself?"

Denying he had failed to stop NHS trusts from being vilified by the press, and adding that he could not 'control the Daily Mail', Lansley said: "I have been absolutely clear. If people interpret a determination to reduce the cost of administration and levels of staff as a way to denigrate managers, then that is wrong."

The Government was also criticised in a speech by the NHS Confederation's new chief executive, Mike Farrar, who argued that great management, irrespective of whether the person is from a clinical or administrative background, would create the context needed for the delivery of the improvements laid out in the Health and Social Care Bill.

He said: "We need to persuade the Government to stop attacking and start valuing management as high-quality management is essential if we are to achieve high-quality care. Second, we need to convince politicians to support NHS leaders when we make tough decisions on service reconfiguration. The major barrier to reconfiguring local services is the lack of political support for change."

Lansley also faced criticism that the introduction of competition would leave the NHS at the mercy of private firms more interested in making a profit than improving patient outcomes. But he told delegates: "People wrongly believe that the legislation changes competition law. It does not."

Instead, he claimed, the NHS tariff - the amount paid to providers for health services - would be extended and improved so that it covers key future functions such as mental health and community services. We are not just changing what the tariff applies to, but how it is designed," he said. "We do not want to pay for activity in the future, but compensate for outcomes."

And he said managers would have a key role to play in both pushing the reforms through and improving morale among their staff.

He said: "Management is vital. Without high-quality management, we cannot hope to meet the challenges we face. Without good managers, we can't achieve the efficiency gains so vital to the NHS. Without good managers, we cannot reshape NHS services and without good managers we cannot create a streamlined, integrated NHS. I know this is a tough time; I understand the difficulty of the position some of you find yourselves in, but not changing is not an option. Patients need you to keep at it; to do what is necessary to make the transition to the new system a smooth one. So it is time now to look these challenges in the eye. To do what is necessary to meet them; to regain the momentum. So I ask you to return to your organisations with one simple message: The pause is over. It is now time to act."