Key Recommendations for Labour Election Manifesto

Election SHA policy

The Socialist Health Association has been developing health policy for some months under the dedicated leadership of Dr Brian Fisher, building on our wide and deep experience of the health system, going well beyond the NHS. We suggest 4 key recommendations for England, recognising that the devolved nations make their own policies. We have also suggested 3 more secondary recommendations which could also be considered.

Four Key Recommendations:


Bringing together our separate health and social care systems to become one unified care system driven by the political values and professional / organisational principles that underpin the NHS. This can be achieved by a gradual, non-disruptive process.

The political values are:

  • a system with national standards;
  • funded from progressive taxation;
  • delivered by locally accountable bodies that rely on committed staff many of whom have professional training and professionally established responsibilities;
  • evidence based; relies on the notion of “co-production” between service users and professional staff – people playing an active role in their care and professionals welcoming, respecting and responding to that role.

Funding; At least 10% of GDP should be for health and care funding, and all parts of the system should be appropriately funded.

Mental Health; We support parity of esteem and funding for mental health and the continued development of integrated services which jointly address mental, physical and social needs.

This offers other significant opportunities for improving health and care:

  • Social Care free at point of use, beginning with conditions such as end of life care and extending as the situation permits and in as short a timescale as practicable.
  • There must be a full commitment to the universal right to the support necessary to enable independent living, consistent with the United Nations Convention on the Rights of Persons with Disabilities.
  • Boosting community care and community services for the frail elderly
  • Hospitals should be funded to deliver best care, using the best equipment, medications and methodologies according to the evidence base.
  • Hospitals should be funded to provide sufficient beds and services where the community option is not in the patients’ best interests.
  • New drugs, treatments and methodologies should be appropriately funded for patients according to the evidence base.
  • Research in publicly owned hospitals, universities and laboratories should be appropriately supported and funded.
  • The importance of informal carers to be recognised. They should be fully supported and their sacrifices recognised. We support the recent proposal to increase carers benefits and we support extending them to all carers.

Care, free at the point of need and funded out of general taxation, provided by public bodies. Labour will restore the duty of the Secretary of State to deliver a comprehensive, universal NHS publicly provided and managed service, meeting clinical need. This needs to be achieved with as little disruption as possible. The NHS Bill 2016-17 provides a model for legislation in the first weeks of a Labour Government. Legislation should include the relief of NHS bodies from PFI debt.

This has implications for what is currently called commissioning. Commissioning outside the market is called planning which still must be done somewhere based on needs and assets assessment. Wales and Scotland offer excellent examples.

  • Commissioning/planning must be separate from provision and free of any form of conflict of interest or undue influence.
  • Planning functions must be democratically accountable and cannot be given to the private sector under any circumstances.

It also has implications for Trust status:

  • The NHS will no longer regard Foundation Trusts as free-standing competitive corporations. Foundation Trusts will be reintegrated into the NHS family.

Labour will fund the NHCS to enable a comprehensive service which will either mean reaching the EU average, or at least 10% of GDP.


Addressing the social determinants of health is an important foundation for the health and wellbeing of our citizens. The fundamentals of life such as access to clean water and safe waste disposal; social and affordable housing which provides enough space, good oral health delivered via the NHCS with active interventions, clean air and efficient heating; education to achieve universal literacy and numeracy; jobs that protect health and ensure adequate income; and an environment which promotes healthy transport, green spaces and public amenities should all be assessed and developed as a holistic approach to public health. We support the child poverty abolition target for 2020.

This has implications for the service:

  • Chief Medical Officers and District Directors of Public Health need to be professionally independent.
  • They would be required to report annually on the health and health inequalities of their populations and their recommendations on priorities.
  • Communities and our relationships with them and between them and the statutory sector are key to health protection and resilience. The SHA is committed to creating the conditions whereby communities can increasingly share decisions with the statutory sector, thereby increasing confidence and health.

Three  Secondary Recommendations: 


There are advantages and disadvantages to the independent contractor status. The SHA would recommend a trial of a mixed economy, where in some areas, primary care is salaried and in others as it is now, the benefits and risks to be evaluated.


Co-production is the process of working with NHS users. This applies at a macro level, planning local and national NHS services in collaboration with citizens and users; it also applies at an individual level in the consultation between patient and clinician where shared decision-making takes place.

  • A commitment to responding not only to needs as defined by clinicians, but needs as defined by users, carers and citizens. We see the process as a meeting of experts – the NHS offers its clinical expertise. The patient is an expert on their own strengths – and the impact of ill-health on them.
  • The community can, with help, identify key issues that matter to them and work with the statutory sector to address those issues – evidence shows that this process protects health. Community development is one key mechanism.

The NHS and social care are utterly dependent on labour from overseas. Without them the NHS will struggle. We would like to see recruitment and employment of staff from the EU and other countries allowed. We want Labour’s policy on Brexit to focus on the economy and free movement.