Jeremy Hunt had one job since his appointment as the Secretary of State for Health – to make sure the NHS was not an election issue. He almost succeeded.
Despite the Tories recognition that the 2012 Act was their biggest mistake it is only in the last year that the chaos, fragmentation and lack of accountability has really impacted on the frontline – on the availability and waiting times for patient services. It is clear that the NHS will only just survive this coalition government. It needs rebuilding.
Labour’s Shadow Health Team has worked doggedly to learn lessons from our time in Government, has consulted, engaged and debated with experts and pressure groups and considered how to bring hope where there is despair. As they say
“It [the ten year plan] offers a positive vision of what the NHS can aspire to be in a century when people’s needs have changed; that answers the question of how it can be afforded; and that, after the divisive change of the past, is something for people to believe in and unite around; that offers something in short supply in the NHS right now: hope. Hope that the NHS is not on a slow path out but that it can be rebuilt as a 21st century service.”
Health bodies broadly welcomed the plan, want to see more detail and expressed a desire to see the plans of the other parties. So far there is silence on that.
The Times and Telegraph led with it bringing chaos and a poll disaster. The Guardian hedged its bets with ‘good in part’.
There is so much to commend in the plan. Andy Burnham’s speech starts in the home, making care personal to each family. It starts with people. Not structures, not markets or purchasers or providers. Personalisation, prevention, the role of carers, our responsibilities as well as rights, reducing demand and not just more supply a supporting role for the voluntary and private sectors. We should also praise the references to younger people’s roles in forging the future. I’m really pleased to see recognition of the NHS role as a major employer, mainly of women, an opportunity for apprenticeships, and new ways into proper jobs with real pay.
Is it another wholesale reorganisation? No, given the current level of chaos in the still evolving structures and short term fixes, many being applied behind closed doors, Labour’s plan looks to bring much needed clarity and purpose to the roles of existing bodies.
Funding will dominate the debate because the cost of increasing demand without reform is well known. Labour was first to commit to some increase funding last Autumn. The Tories responded with the Autumn statement and found a lot of money for the short term fix. All future funding plans depend on a growing economy.
Our immediate workforce plans are costed and the plan talks about the zero spending review and savings from abandoning competition, undoubtedly a rich seam. The Marmot Review in 2010 estimated the cost of health inequalities at around £40bn. Ultimately the long term funding position depends on the public’s view and the public are not currently minded to spend more when they perceive there is inefficiency and waste. We need to start to see patients and the public as assets and not nuisances in driving change. Local accountability makes that possible. Why should decisions about resources for health provision be so different to those about any other public service?
We have shown our plans, now let’s see what the others have really got.
Karin Smyth is PPC for Bristol South