If Labour is elected in 2015 it will inherit a demoralised and financially challenged NHS and a social care system on the edge of collapse, with challenging economic background. What should it do?
Two things are clear – the NHS needs a period of stability with clear direction and social care needs more funding.
Labour has already set out its vision for whole person care, the principles of which have wide support. It has undertaken to consult widely before it commits to specific policies.
When elected in 1997 Labour took some remedial actions to improve the parlous state of the NHS but then consulted before publishing its 10 year plan in 2000 – a plan signed by almost every key stakeholder group. That has to be the right approach.
In the run up to the next election and once in power Labour needs to be clear on what it will and will not be doing.
So it needs early on to:-
- Share a new vision for what a whole person care system should be like – viewed through the eyes of those who will be using it.
- Publish a 10 year plan to move decisively from where we are to where we wish to be.
- Restore the emphasis on quality – of outcomes, safety and experience of care
- Support those who work in the care system, giving a clear sense of direction
- Support measures that help to bring beneficial change; accepting setbacks and mistakes along the way without knee jerk reaction
- Remove legal, structural and financial obstacles to cooperation, collaboration and partnership working
- Encourage and incentivise innovation in how services are delivered but within a clear national framework which sets out entitlement.
- Make a few immediate changes, but without any kind of whole system top down reorganisation. Keeping to an absolute minimum changes that are imposed by directives from the centre.
At the earliest opportunity it needs to:-
- Remove from the NHS the whole paraphernalia of markets and competition; restore the powers and duties of the SoS to ensure we have a universal comprehensive NHS.
- Increase the funding for social care; moving the workforce onto a proper set of terms and conditions; setting an appropriate national level for entitlement to care; set out a long term approach to social care funding.
- Shift from commissioning that is used to support a market with competing providers to planning how best to use all the public resources to get the greatest health gains for defined populations.