Summary of the policy agreed by the Labour Party Conference in September 2014, leaving out rhetorical phrases that all politicians love and just including operational commitments. No significant words have been added.
Bring together physical health, mental health and social care into a single service to meet all of a person’s care needs, with a focus on prevention.
Health care publicly funded through progressive means at levels that sustain it as a world leading public service.
Our NHS
Labour’s long-term goal is to break the link between a person’s social class and their health. We will work across government, using the power and influence of all government departments and agencies, to achieve this.
Repeal the Health and Social Care Act 2012 (England). Ensure that the Secretary of State has a duty to provide a comprehensive national service which is free at the point of need, that private patients are not put before NHS patients, and that the conflicts of interest the Act created are tackled. Ensure that the Secretary of State is able to give directions to the NHS. Labour will break down barriers that prevent or deter co-operation. Labour will take competition law out of the NHS by ending Monitor’s role as an economic competition regulator and by scrapping the Section 75 regulations that force services to be put out to tender.
Ensure all outsourced contracts for services, including under the Health and Social Care Act 2012, are properly managed to ensure they are meeting clinical and financial standards. Where contracted services are failing, we will consider all the options, including bringing them back into the public sector. Future contracting decisions will be based on what contributes to integration through the whole person care agenda.
Labour will also ensure that existing and future procurement projects for public infrastructure and services are scrutinised and action taken to ensure they deliver best value for money for the taxpayer and the NHS, learning from past experience, using contractual flexibility to the full and making sure that changes are not at the expense of patient care or appropriate terms and conditions for staff.
The NHS and public services should not be included in any TTIP agreement.
In a planned and collaborative system Labour will reintroduce the NHS as the preferred provider so that NHS services do not needlessly face the threat of competition and destabilisation.
Labour’s commitment to the whole-person care agenda will progressively reduce the purchaser provider split across the NHS, enabling local providers to determine how quality services should be delivered within the scope of a national framework.
All Trusts to be accountable to the public and operate within a collaborative and integrated system. Mixed economy of Trusts and Foundation Trusts will need to be reviewed so that all service providers are fully integrated to deliver the whole-person care agenda in a collaborative, not competitive, way, and fully accountable to the public. Where additional services are funded by the NHS (e.g. from the not-for-profit sector) they must work in close partnership with the NHS and terms and conditions of staff (and public accountability), must be prioritised to ensure we achieve high standards in care and terms and conditions.
There is a role for the third sector and a limited role for independent sector organisations in providing health and care services where there are gaps in delivery, or where the NHS is unable to provide a high quality service.
A small number of targets, focussed on what matters for people and patients, is still an important aspect of maintaining high standards.
Health and Wellbeing Boards will have a central role in the commissioning process for people with long-term conditions, disability and frailty – people whose care is often most fragmented and who are heavy users of health and care services. The Health and Wellbeing Board would be responsible for creating a local collective commissioning plan for this group of people – within a nationally defined outcome framework for the development of whole-person care – with a duty on CCGs and Local Authorities to enact the collective commissioning plan.
Whole-person Care
The next Labour Government will integrate health and social care services into a system of ‘whole-person care’. This approach will bring together three separate, fragmented services into a single service coordinating all of a person’s needs – physical, mental and social – with preventing illness and promoting good health at its heart.
In caring for those with complex needs, where local partners in communities want to move to a single budget for health and social care, or joint ventures, and have the capability to do so, the legislative framework should allow this to happen.
Personalisation, and meaningful control, will be at the heart of Labour’s vision. Meaningful choice is about the type of service that is provided and the way that service is delivered not which organisation is delivering it.
Labour Government will abolish the system of “any qualified providers” that does nothing to provide real choice to patients.
Labour will create a national entitlement, written into the NHS Constitution, to ensure that patients get legal rights to access the services they need.
Bringing healthcare closer to people
Labour’s vision will enable people to stay healthy in their homes for longer, including through prevention and early intervention.
Central to the vision of whole-person care is the idea of a single named contact for the co-ordination of an individual’s care needs.
Labour will develop new funding mechanisms for health and social care providers based on delivering quality, equitable and integrated services and incentivising health promotion and preventative care.
Labour will work towards giving people the right to receive their end-of-life care at a place of their choosing.
Making hospitals and services work for patients
Service reconfigurations, and changes to the way that health services are provided, must be evidence-based and clinically led, not purely financially driven, and that the local community is consulted early and frequently.
The next Labour Government will drive a series of 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.
Labour will undertake a review with a view to ensure a fair system of charging for car parking.
We will ensure patients have a formal role in drawing up and deciding on proposals for service change before they get to consultation stage. We will give communities more ownership of the consultation process, taking the power to run the consultation off the NHS commissioners who are advocating the changes, and giving it to an independent organisation, such as the Health & Wellbeing Board, with a duty placed on them to secure real public engagement. We will reverse the introduction in the care Bill of sweeping powers to force changes to services across an entire region without proper public consultation. We will also extend Freedom of Information legislation to cover all organisations delivering public service contracts, including the private sector.
Labour Government will give all NHS patients the right to a same-day consultation with their local GP surgery, the right to a GP appointment at their surgery within 48 hours or the right to book an appointment more than 48 hours ahead with the GP of their choice. We will invest an extra £100 million a year in general practice, funded by savings made from scrapping the Government’s new competition rules which have led to increased costs in the NHS, and from cutting back on the new bureaucracy created in the Government’s NHS reorganisation. GP recruitment will be a priority for Labour, including through promoting general practice as a career choice, supporting GP returners back to work and encouraging recruitment in under-doctored areas.
Labour has a record of protecting separate budgets for basic and clinical research and believes we need to continue to support both.
Labour believes that what happened at Stafford has no place in the NHS and we must ensure that it does not and cannot happen again.
Labour will ensure that the voice of users, their families and the public are at the heart of local health and care services. Personal control over the care received, regular feedback, community involvement, and a strengthened role for Healthwatch are essential to improve quality and increase the accountability of local services, alongside a robust national inspection regime.
Ensuring a fair care system
Greater localism of services should be a priority for future developments of the NHS.
National minimum eligibility criteria must be used to set a baseline giving everyone the right to be kept safe and well.
Labour believes that the solutions put forward by Dilnot, whilst welcome, do not provide all of the answers. We need a genuinely integrated NHS and social care system which helps older people stay healthy and living independently, in their own homes, for as long as possible.
A 21st century care service that is integrated with the NHS and focused on the person being cared for must be underpinned by professional standards, regulation enshrined in law and a trained and valued workforce on fair pay, terms and conditions, and represented through a sectoral body.
Bureaucratic and misleading Resource Allocation Systems used by councils should be reformed, with personal budgets becoming optional as part of a new focus on making personalisation meaningful.
Local authorities must be provided with the support required to ensure that carers’ needs are identified and assessed with appropriate assistance provided.
The definition of ‘carer’ should be widened so that it specifically includes young carers, and parents caring for disabled children. There should also be greater institutional recognition of the needs and rights of carers including those of young carers and their right to childhood. NHS bodies should have a duty to identify carers, which would help GPs and hospitals signpost carers to the right help and support.
Public Health
Labour will introduce initiatives and measures to reduce smoking and excessive alcohol consumption, excessive sugar, salt and fat in food, food fraud, and air pollution.
We will make healthy choices easier by encouraging affordable healthy products such as fresh fruit and vegetables while taking action to help people avoid the excessive consumption of unhealthy products high in fat (including trans fats), salt and sugar, including through regulation where appropriate. We will ensure that the quantity of sugar, salt and fat in manufactured food is easily apparent to customers wherever it is sold. We will also take action to tackle supermarkets selling dangerous quantities of low-cost alcohol that fuel binge drinking and harm health, and further action to help young people not take up smoking.
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.
Labour will work to eliminate inequalities in providing public health information to ensure improvements in service delivery benefit BAME communities.
Occupational Health
Labour will introduce legislation for a proper compensation scheme for sufferers of asbestosis and asbestos-related conditions, ensuring they are given the payment they are duly owed without delay, by enshrining the levy on the insurance industry in law. The compensation scheme will be extended to include Pleural Plaques should evidence be found to show Pleural Plaques are symptomatic.
Taking care of your health
Labour supports measures on standardised packaging, measures to ban adults purchasing cigarettes or tobacco for children, and a ban on smoking in cars when children are present.
Mental Health
The NHS should support the growth of local voluntary and community groups as a whole, cooperating with the other services which have a mutual interest in this. We will ensure that health agencies play an active part in community development, with the clear objective of strengthening the role of the community and voluntary sector in relation to health. Labour will ensure all health and social care providers are compliant with the Equalities Act. It is also important that mental health providers are compliant with the Equalities Act.
NHS agencies and providers will therefore be expected to play their part in ensuring that every locality has a thriving third sector. NHS organisations will be expected to take an active part in neighbourhood partnerships and to encourage users and carers groups to do so. We will encourage firms to involve employees in businesses so that job control is increased.
Labour will ensure that patients with mental health problems have equal treatment and resources as patients with physical illnesses. Labour should take steps to introduce waiting time and access standards for mental health services.
Local Authority Health and Wellbeing Boards should be informed by Mental Health and Wellbeing Strategies ensuring preventative as well as curative services and interventions.
To ensure that mental illness is treated with the same level of priority as physical illness, the next Labour Government would re-write the NHS Constitution to create a new right to psychological therapies that help people recover from conditions like anxiety and depression – just as people currently have a right to drugs and medical treatments.
Labour also believes that there should be more mental health specialists working in teams with GPs, nurses and carers. Labour will put in place measures to improve the delivery of mental healthcare for BAME communities and in particular treatment, care and services for patients on psychiatric wards and services for young black males.
We must recognise that good mental health doesn’t start in the hospital or the treatment room, but in our workplaces, our schools and our communities. Labour has established a Mental Health Taskforce to produce recommendations on how we can improve mental health in society.
Labour strongly believes that being LGBT is not an illness and it should never be treated as something which is curable, which is why we believe public money should never be spent on ‘conversion or cure’ therapies. Labour will work with the professional bodies to ensure that publicly funded services enforce the Equalities Act 2010.
The health and care workforce
Labour will restore the collection of Race Equality and ethnicity data as part of the specific duty on employment for public authorities bound by the general Public Sector Equality Duty. Labour will develop a framework of action to tackle discrimination in the workforce of the NHS; measures to eradicate institutional racism in the workforce and to remove the ‘glass ceiling’ for workers from BAME communities.