Liz Kendall, Shadow Health Minister, gave an interview to The House magazine last week. It caused a stir in some places, so we are reproducing some of what she said. Though we should add that she has been saying pretty much all this for the last 3 years.
ON…BACKING A PRIVATE SECTOR ROLE IN THE NHS
“There will remain a role for the private and voluntary sectors where they can add extra capacity to the NHS or challenges to the system. I believe what matters is what works. That’s what I’ve always believed in and I continue to believe in.”
On the contribution Tony Blair’s Independent Sector Treatment Centres made in reducing wait times:
“I remember when I worked in the Department of Health a very senior clinician saying ‘you’ve got one of these ISTCs down the road now so I’m going to have to talk to some of my GP colleagues about getting my waits down and stop doing so much private practice’.
“So it did bring challenge to the system. It was the NHS – and the increased investment we put in the NHS – that delivered the vast majority of the reductions in the waits. But some challenge in the system was crucial to that.”
Asked whether it’s time to stop talking about ‘privatisation’ of the NHS:
“I think we need real reforms of our public services, including the NHS and social care, in many different areas. I think people do worry that there is a kind of, in inverted commas, ‘reform’ which is to just ‘put it out to the private sector’, when actually what you want is to reshape services locally and I would argue nationally too. Salami slicing cuts and simply putting things out to tender isn’t what I call real reform. That isn’t to say that there isn’t an important role for the independent and private sectors. But real reform is more difficult than that.”
ON…DEFENDING THE MIDDLE CLASS SHARP ELBOWS IN THE NHS
Backing the idea of more tele-health, with Skype and iPhone medical consultations:
“It is a disgrace how little we have used technology to transform people’s experience. This [she points to her iPhone] is part of my life now and that is how people increasingly expect to interact with the NHS.”
“Some people think ‘oh it’s just some pushy middle class people wanting to get things from their doctor when and where they want’. I don’t think there’s anything wrong with making sure that our NHS needs to meet the needs and demands of middle class people or anybody else. But actually technology is about something much more powerful than that. It’s about allowing people to manage their condition.”
“I went to the States to look at what they are doing there and it’s very interesting that one of the fastest areas for venture capitalists to be investing their money is health and IT. One half was in medical records, the other half was in health apps. Follow the money.”
“People want a sense of control over their lives”
ON…PERSONAL HEALTH BUDGETS
Ahead of Labour’s launch next week of its health and social care plans:
“It won’t work for everybody in every circumstance. And if you really believe in giving people choice and control then it includes the choice not to have that. But when it’s done properly, with the right help and support, and all of those people have had proper support from the people in the system, the right information and help, it has transformed their lives, and we’d like to go much further in that.
“Ultimately if you believe that there shouldn’t be a divide between physical health, mental health and social care services in budgets at the council and NHS level, why wouldn’t you be putting them together at the personal level?
“The people who know best how to join up their service and support are patients, because they don’t see their needs through the prism of separate silos. The people who know best how to shift the focus of care towards prevention are patients, because they’re the ones who suffer if they don’t get services early on. And the people who know best how to root out inefficiency and waste are the people who use services, because they’re the ones who have to spend time talking to people time and time again, which isn’t good for them and is a waste of resources.”
Describing Alex, a military veteran who experienced mental health problems after suffering a stroke, whom she met on a recent visit to Northampton:
“He became very depressed afterwards, for all sorts of reasons. He found driving and remembering routes, for example to his GP, very difficult. He stopped going out and stayed at home, and felt his life was getting worse and worse. And then he got a personal budget for mental health and he bought a sat nav! He started going to his outpatient appointments. Then he decided he was going to go to a stroke support group, and that made him feel better. Then he started picking up other people and taking them there so they could help one another. He said he didn’t want to go on living before he got that budget. But it transformed his life.
“It’s that kind of change we need. Because how can a clinical commissioning group, let alone a national government, know in detail what every single individual really needs for them? It’s about putting power and control back into people’s hands.
“Yes it’s challenging, and actually some of the staff who were involved there say it is challenging, because people are telling you what you think I need isn’t working for me. But when they see it happen and work in practice and they feel that they’re really helping people, the staff, it’s good for them, because they are helping make people’s lives better, which is what they want.
’WEAPONISING’ THE NHS
Asked if she has heard anyone in Labour use the phrase:
“Never. Never, ever from any person I’ve ever had a conversation with in the Labour party or part of the Labour movement. Ever.
“There is no doubt that Cameron plays the political card on the NHS when it suits him. I think one of the most disappointing things about Cameron and Hunt, the NHS is all about politics for them. He started off trying to neutralise the NHS, then he totally cocked that up with the huge reorganisation. Now he tries to politicise it, whether it’s about Wales or Mid Staffs. But actually what you need is a man with the plan, and the men – and woman – with the plan is Ed Miliband and Andy Burnham and myself.”
ON…GETTING SCHOOLS TO WORK AS NHS SITES
Asked about Simon Stevens’ idea of ‘multi-use’ facilities that allow ambulances, police, schools and hospitals to work from one site.
“We’ve got to get the best out of all our assets. If I look back to my greatest passion in life, which is about giving kids the best start in life: we need to make sure that our health visitors, midwives, Surestart and schools are all joined up.
“Why don’t we look at things like saying, if we want to get parents understanding that the way they interact, talk with and play with their baby can have a huge impact on their later life chances, why couldn’t your first midwife appointment be at your SureStart or your local school? It’s about joining all that up to get the best outcomes for people.”
ON…LABOUR IN AN AGE OF AUSTERITY
“Without doubt, post-financial crash, and the constraints in public spending that there rightfully has to be, it was very clear that the NHS needs to contribute to that as a whole. But the reason I’m so passionate about reform is two-fold. One is, on the left we do have to show how we can deliver our goals of social justice and fairness when there’s less money around. But also because we need to make services work better for people. Look at diabetes. We spend £10bn a year on diabetes. 80% of that money is spent on complications from the condition, many of this could be prevented
.
“Now you want to get better results for people, that is our primary goal, but you often find that’s also about delivering better value for money. There’s nothing socially progressive about wasting money on services which aren’t achieving outcomes for people. So I’m passionate about getting the very best value out of every single penny that’s spend on every public service. And that means big reform.
“As Bill Clinton once said it’s down to the people who believe in the power of the state to improve people’s lives, the onus is on us more than anyone to be pro-reform, because it is the people without power, wealth and opportunity who suffer when public services fail.”
ON…LABOUR’S NHS PLAN
“If you think about the three previous prime ministers and their health policy, whether it’s Tony Blair, Gordon Brown or David Cameron, they had nowhere near as clear analysis of the problems and the solutions as we now have.
“Successive governments have continually reorganised the backroom structures of the NHS, and it’s rarely if ever achieved the savings or the outcomes people want. We have learnt about what works and what doesn’t work in driving change. I think Ed Miliband will have a stronger and clearer and bolder vision for how we need to reform health and care services than any of the last three prime ministers.”
ON…MOANING POLITICIANS
“You can’t be the moaning man in the pub. Actually the moaning man in the pub often has a real point underneath it all. But mostly you end up not listening.”
“I think it will be incredibly close, it’s all to play for there are still a lot of people still undecided. The challenge and the prize is to set out a credible message of hope that things can be better for you and your family and this area. It’s about credible hope. The party that nails that message I think will be the one that comes through.
“You can have easy headlines like UKIP or the SNP make, it’s always somebody else’s problem, it’s Europe’s problem or all the problems in Scotland are down to Westminster. Or the Greens who say it’s all this awful globalisation. Easy answers to very tricky problems.
“I think people understand that if we are straight and honest with them is that we can make a big difference if we work together. Not simply thinking that somebody else is always to blame. For me this is the big choice.”
“People want us to hold the government to account but they want a credible solution. And I think many people understand that most of the big changes we need to say people will have to play a role themselves, it’s not just something you can just click your fingers from here [Westminster]. We can’t really turbo-charge our economy unless we also change what’s happening in the European economy. We can’t really transform our kids’ life chances unless we work with parents to give their kids a start in life, we can’t improve our health unless we all take on more of a role. That’s where we started as a party.”
ON….RUNNING
Revealing she takes a morning run 5 or 6 times a week:
“I run from near Vauxhall Bridge to the Millennium Bridge and St Paul’s and back round for Westminster.
“I do the Great Central Way when I’m at home and the big difference is you smell stuff in Leicester. You can smell grass and flowers and damp. You don’t smell anything in London,”
“I love it. I run for myself not as competition against anybody else. Haruki Murakami in ‘What I Talk About When I Talk About Running’, he’s the only person who’s ever described it well. You don’t think about all the separate things in your professional life and your personal life and focus on them, they just kind of percolate around in your head and afterwards you feel a bit more sorted. You feel great.”
“I’m properly addicted to running, but I have to find something else because I can hear my knees. Yes, I can *hear* my knees. It’s a disaster. It’s not good.”
How about taking up cycling?
“I would worry that I would get road rage,” she laughs, imagining the run-ins with cabbies and bus drivers. “I can’t do that, an MP shouting abuse! And I would, I know I would.”