The Health Secretary Jeremy Hunt came under fire from NHS staff today after launching an attack on the culture of the health service. He said mediocrity was too readily accepted - and accused some hospitals of coasting. It could lead to another scandal, like mid-Staffordshire, he suggested.
Jeremy Hunt has said that the NHS should not concentrate solely on meeting targets. The Health Secretary said, "targets can be very important, targets help to bring down waiting times. But what we don't want is a culture of targets at any cost."
At the moment Jeremy Hunt is still considering his response to the Mid Staffordshire NHS report and I think we can read some mood music in to what he is saying today.
Take for example his phrase about 'box ticking' - everyone knows that at Mid Staffs the hospital authorities were preoccupied with meeting targets about waiting lists and hospital infections and took their eye off the ball.
The key phrase is 'hit the target and miss the point' and he has pinched that phrase from the boss of the NHS David Nicholson who you might remember is currently under very heavy attack - 25 MPs have now signed a motion calling for his resignation.
Mike Farrar, chief executive of the NHS Confederation, told BBC Radio 4's Today programme: "The Secretary of State is right to say we should aspire to be world-class. We all do that.
"The fact is that you shouldn't infer that we are not trying. The key thing is how do we make sure that everybody can get to be world-class in every bit of their organisation and hospital. That's the challenge for us."
Mr Farrar said a key factor in driving improvement was the publication of data on performance, which he said can spur better outcomes across the service.
"The NHS has failed, I think, in comparing performance in a transparent way," he said. "Where we've seen the NHS compare its results, that's been a great catalyst for staff to want to improve.
"But you do then have to put the resource in to train and educate people how to be the best in the world. It's not just about aspiration, you've got to give them the resources and the wherewithal to be the best in the world."
Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing (RCN), has said while he agrees with the Health Secretary, hospitals need more support; "our members will agree that all hospitals should be aiming for excellence, but this requires investment and leadership.
"Front-line staff want to work in excellent hospitals, but they need the proper support to be able to do this. Team GB's fantastic success is down to a combination of ambition supported by proper investment and resources, and this needs to be emulated in the NHS."
The Health Secretary is expected to say later that; "the lesson of Mid Staffs is surely that we need to understand why they fail in the first place - which means tackling mediocrity and low expectations before they turn into failure and tragedy.
Jeremy Hunt is expected to tell the Nuffield Trust's health policy conference in Dorking, later today:
Imagine for a moment that the main objective for our Olympic athletes was not to win but to 'not come last'. How many gold medals would we have won then?
It sounds ridiculous, doesn't it? But today I want to suggest that too much of the NHS is focused on doing just that.
Not on achieving world-class levels of excellence - the gold medals of healthcare - but meeting minimum standards, the equivalent of 'not coming last'.
Coasting can kill. Not straight away, but over time as complacency sets in, organisations look inwards, standards drop and then, suddenly, something gives.
Hospitals must not be allowed to cruise along, hitting the targets but missing the point.
Because 'not bad' is not good enough. Not if we want the NHS to be the best in the world. Not if we want everyone to have access to the best healthcare. Not if we are to meet the challenges of increasing expectation alongside increasing age.
The Health Secretary is expected to warn that too many middle-of-the-road hospitals are "hitting targets but missing the point."
Jeremy Hunt will tell the Nuffield Trust's health policy conference in Dorking, Surrey, that hospitals which simply meet minimum standards should tackle "mediocrity and low expectations before they turn into failure and tragedy".
Mr Hunt will warn hospital bosses about the dangers of simply aiming for "not coming last".
Average hospitals which meet national targets but are not doing anything to improve their services are "not good enough", he will add.