The Future of the NHS

Notes on our meeting on the  Future of the NHS at Labour party conference 2012

Lord Phil Hunt:
Is getting angry about what the government is doing to the health service.
Our vision is staying true to the vision of comprehensive care irrespective ability to pay. Tories have fragmented marketed Approach treating health as a commodity, letting rip a market based approach. If the Tories win in 2015 we would see the NHS decline. THe more you focus on a vision where commissioners define what is provided the easier it is to restrict services to poorer people. Things are changing already. Monitor is the economic regulator, employing economists to make sure the ‘re is no collusion in the market place . Hospitals are not to be allowed to cooperate. Some NHS organisations are marketing services for money under the NHS brand. PCTs cutting back on services which are clinically justified.

Hospitals increasingly squeezed between rising demand and falling income. Will eventually have reduce nursing staff and quality

What would Labour do?

We would repeal the Act. It doesn’t mean more restructuring. We have learnt the lesson that it doesn’t work. We will want to work with the current organisations but take out part 3 competition. We want incentives to get people, including social care to work together. Worried about GP conflict of industry. We need proper public accountability. Health and well being boards should be strengthened. A cooperative system.

Duncan Enright elected district councillor in Whitney: Can now see the local health and well being boards. We need to look at local accountability..
My day job is publishing the BFN providing medicine information a link between various clinicians. We need to focus on evidence based care. Hunt is a supporter of homeopathy. We need more research on what works including looking at international evidence.
I am the parent of a girl with disabilities. As a father I know people with multiple disabilities have to cope with multiple systems, there needs to be integration often between clinicians in the same institutions, as well as between systems. Lots of resources get spent on these complex cases.
NHS should not be hidden inside hospitals. Clinicians could come out for example to special schools.. care should be provided in the context of peoples real lives pharmacists for example are convenient and under used

Dr Ivan Bennett Clinical Director of central Manchester CCG. admitted he was thrown out of Labour Party for standing as an independent in the 2005 general election
The experiment with CCG s began a couple of years ago. In Manchester have reversed the deficient without cutting services. Reduced hospital use. The key has been to bring all the GPS on board and to work with the Central manchester trust and local authority. Integrated care board. Attendance at casualty has gone down as GP access has improved, and more active intervention with people with long term conditions. Referral management system has reduced hospital referralls Investment in community services. Integrated care teams health and social care.
Communication between hospital and primary care needs to be improved.
CCG not yet authorized. We want to
Big problem in variation in access some monopoly providers which hold us to ransom. There are examples of poor care. Variations in performance in practices and management of long term conditions. Resources per patient varies. Variation in outcomes. Variation in access to services. Probably
5 priority outcomes
Improve life expectancy by 1year
Identify and Long Term Conditions
Reduce harm in primary care
Shift resources into prevention

Prevention has a long time frame. How can we get resources in the short term. We waste allot of resources. Has to reduce hospital use. But we have to avoid the market approach? Local authority could provide leadership.. we need planning and community.
Costs of litigation. CCGs will be in court regularly because of conflicts of interest. We think we can take the NHS out of competition law.
Hiv+ blood donation.

What will labour say about resources.? Ivan says there is plenty of waste perhaps 30%. There are too many hospitals. Sometimes nurses are better than doctors. Disruptive innovating may help. It need not be private. Can we learn from Scotland and Wales?

Many of the things we object to were introduced by Labour. People may need to know that that lessons have been learned. How can we remove central control and have local accountability? There were too many targets. But we did transform the NHS. Some consultants wanted to keep waiting lists long. We might need the private sector if NHS can’t deliver. We used managed competition, not a free market intended to breakup the NHS.

Microorganisation often very inefficient.
Can increase the time we live without disability.
Very hard for MPS not to defend local hospital. We need external clinical evaluation perhaps from Royal Colleges. CCGSs won’t be able to reconfigure hospitals.