A public sector NHS ‘as if people mattered’

Labour Health Policy

This is from the Labour Party policy website

Integration

Physical and mental health and social care should be provided by a single, public sector service. This should be operationally managed and delivered by local government, but most policy – and funding – should be defined and set centrally so as to avoid postcode lotteries.

Integration means collaboration and coordination between all services – this has nothing whatsoever to do with ‘integrated care packages’ used by US Insurance companies and HMOs. Health and social care should not in any way involve or require co-payments, top-up fees, user charges or insurance.

Prevention and intervention

Preventive services should always be prioritised. Intervention already receives and will always receive adequate priority, because of the Individualistic way doctors and other health professionals are trained and because of the profit motive.

Health inequalities

Long-term health inequalities can only be tackled by addressing their root causes. There is evidence that when, as is normally the case, only proximal, lifestyle causes like smoking are addressed, there is no long-term impact on health inequalities. To reduce health inequalities it is necessary to directly engage with what have been called the fundamental courses of health inequalities – inequalities in power, prestige, income and wealth, knowledge, and beneficial social connections.

Personalised care

This will only be achieved if all services are part of a single public sector provider. Feedback from patients, relatives and friends should be prioritised and high levels of patient satisfaction, together with good patient outcomes, should be the basis of service objectives, indicators and targets if these are used.

Voice

Health and social care workers and service users often know best how services need to change and improve. Labour’s 1976 NHS initiative ‘participative management’ should be revived and staff at all levels should be represented in management. Community health councils were very popular and should be reintroduced

Integration at the heart of the service

As previously proposed, this is best achieved by having the management and delivery of all services under one public sector organisation – the National Health Service. And it is best reinforced operationally by having performance management of integration-oriented and patient- / user-satisfaction-oriented service objectives, indicators and targets.

Better integration

Better integration looks like coordination and rapid sharing of information between all services in the demonstrable interest of patient care.

Repairing damage

This will be done by returning the health service to the public sector as rapidly as possible. This will obviously involve terminating all external contracts as early as possible and bringing health related professionals back into NHS employment under unified conditions of service. The secretary of state will resume responsibility for the service. Early announcement of these intentions will discourage private providers from bidding for contracts.

Funding

Health and social care should be entirely funded from the public purse. A substantial contribution could come from the defence budget. UK citizens will hopefully prefer a strengthened welfare state to an unnecessary armed forces budget. Once we stop attacking other countries they will stop attacking us.

Reducing inequalities

As previously suggested, the best ways of reducing inequalities address root causes like inequalities in power, status, income and wealth. A good way to commence this task would be a substantial reduction in the very large pay inequalities within the health service. No one needs to earn a six figure salary – this includes both doctors and managers. The resulting reduction in earnings inequalities will similarly reduce power inequalities. A Royal Commission on the NHS would ensure the service achieves everything the public wants in order to make it once again a central element of a welfare society.