10 Proposed Amendments to health policy

SHA policy

 These proposals were considered by the Central Council on 26th April

1. A commitment to Community and Individual Participation
Following Ed’s Hugo Young speech, the NHS will harness community building/development approaches, ensuring that local communities work with statutory agencies to set the agenda for change that meets their needs. This, within a national framework of entitlements set by government.

The NHS will ensure that clinicians and patients share decisions to the extent the patient wants to. This will require incentives, training and technical interventions such as online access to records and Decision Aids, as well as strengthening Healthwatch and making it more independent.

2. No marketisation, no privatisation.
The NHS will no longer have either an internal nor external market. It will no longer pretend that FTs are free-standing competitive corporations. The duty of the SoS to ensure a comprehensive NHS will be restored. The NHS will be the preferred provider. The private sector will only be allowed to offer patient services if the NHS cannot improve or they can show genuine innovation.

3. Incentives for cooperation for better outcomes
The financial and other incentives within the NHS will promote cooperation between health sectors and between health and local authorities. Intelligent targets will remain where appropriate.

4. Invest in the NHS
Austerity at the same time as cutting the welfare state kills people. We need to invest more in the NHS which is effectively suffering a cut, not a freeze. Renegotiate PFIs where necessary – we cannot any longer allow corporations to hold the NHS to ransom.

5. Invest in community care, including general practice
90% of NHS work happens in the community which needs more investment, not only to offer a better service but to be able, where appropriate, to offer services that would otherwise have been delivered in hospitals.We make no assumption that community care is always cheaper than hospital care, but it may be in some places for some services.

6. Social care free at the point of use
A long-term goal

7. Integration

  • Health and Social Care, either through poling budgets or through better communication and information flows.
  • Services around the patient, ensuring shared information, shared services and shared decision-making
  • Primary and secondary care, through a new incentive structure and shared services
  • Mental and physical health, working within the secondary sector and within community care.

8. Public Health that tackles the social determinants of health

  • Improving control at work
  • Enhancing access to public transport
  • Creating healthy places
  • Implementing a minimum unit price for alcohol
  • Reducing ill-health related worklessness
  • A healthy housing policy
  • Making work pay
  • Minimum Income for Healthy Living
  • Decreasing debt

9. Tackling health inequalities
Implement Marmot in full.

10. Support NHS staff

Less insistence on inspection and more on listening to staff and patients. Whistleblowers will be protected. Staff/patient ratios will be adequate for safe care. On the job pastoral and mutual support to help staff deal with the emotional burden of their work – and to encourage compassion and care.

 Detailed amendments to the current LP document to ensure the idea of community development is consistent and coherent throughout.

 Our NHS

The third sector often plays a crucial role in providing services through supporting people to live at home, and providing advocacy and rehabilitation services. NHS agencies and commissioned providers will therefore be expected to play their part in ensuring that every locality has a thriving third sector

 Bringing healthcare closer to the people

A one nation health service requires organisations involved in providing services to work together to meet the needs of patients, and to empower the people who use them They will therefore be expected to take an active part in neighbourhood partnerships with residents alongside other public services.

 Making hospitals and services work for patients

…step changes in the culture of the NHS, to ensure communities are given a real say in shaping the future of their local services, including hospital reconfigurations. We will therefore ensure support to enable all bona fide local resident groups with a health interest to sit round the table with decision makers.

 Tackling the A&E crisis and improving primary care

 A key cause of the A&E crisis … fewer older people getting the care they need at home and in the community, resulting in more people ending up having to be admitted to hospital. So we will direct all health agencies and commissioned services to support and assist carers’ groups and other groups dedicated to supporting older people in their own communities.

Stronger patient voice and robust inspections

 Labour will ensure that the voice of users, their families and the public are at the heart of local health and care services… (to) increase the accountability of local services, alongside a robust national inspection programme. (In addition to strengthening Healthwatch) we will require health agencies and providers to support and work with the local community and voluntary sector as a whole, since all the issues that they deal with have an impact on health.

Supporting carers

Carers… invisible …too much is left to them We will therefore ensure that health providers give practical support and encouragement to carers’ groups, for example offering them free meeting space in local hospitals.

Tackling health inequalities requires action across government and society

 Future policy designed to tackle health inequalities should reflect the fact that 60 per cent of a person’s health is determined by a range of factors beyond the influence or control of the NHS… reducing health inequalities requires action across all social determinants of health, for example, housing and employment policies We will therefore direct health commissioners and providers to work closely both with other services and with local residents, to maximise the health benefits of the full spectrum of social issues, for example by ensuring that front line workers participate actively in cross-issue neighbourhood partnerships such as those described in ‘People and Services Partnerships

Mental Health

Mental health Taking part in any community activity is another vital way of protecting and improving mental health, which is another reason why health providers will be directed to support the growth of local voluntary and community groups as a whole, cooperating with the other services which have a mutual interest in this, as described in the paper on stronger, safer communities. For all these reasons we will ensure that health agencies play an active part in deploying community development, with the clear objective of strengthening the constructive role of the community and voluntary sector in relation to health.