Health and Social Care: Tackling health inequalities

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This is the document presented to the Labour Party National Policy Forum in February 2018.

Labour’s vision

This year sees the 70th Birthday of Labour’s National Health Service; a service set up to provide universal healthcare for all, to improve people’s physical and mental health and crucially, to reduce inequality in our society. Over the years, the NHS has been vital in ensuring that everybody is provided with healthcare from cradle to grave, regardless of how much they earn.

Despite this, real health inequalities in our society persist. That’s why the Labour Party is prioritising this issue for wide ranging discussion and consultation this year. Health inequalities can have significant, detrimental impacts on physical health, mental health and life expectancy, and present a significant cost to society as a whole.

Alarmingly, recent research has shown that life expectancy is starting to slow or even stop in England after decades of increase. The research also shows that inequalities in life expectancy between local authorities continue to exist, highlighting the link between social and economic inequality and health outcomes.

Since 2010, funding for health services has been cut back and provision has been reduced. For example, we have seen cuts to public health budgets, a fall in the number of health visitors in England, and cuts to social care budgets are forecast to reach £6.3 billion by the end of this financial year. Sure Start Children’s Centres, a major Labour achievement which have a vital role to play in the promotion of public health and reduction of health inequalities in society, are being put at risk by this Government. Furthermore, cut backs to vital services are having a disproportionate effect on those in our society who are often most at need – for example, older people and those with disabilities, BAME and LGBT communities and women.

Alongside funding cuts to our health services, comes the toxic issue of privatisation within our NHS, being driven by the 2012 Health and Care Act. The expansion of the internal market in the English NHS has led to one third of contracts being awarded to private providers since the Act came into force. There are numerous examples of failed private contracts having was ted millions of pounds worth of public money and in many instances, because of underfunding, some local health bosses feel compelled to turn to the private sector, with serious consequences. Pr ivatisation of our health services is increasingly, and disproportionately, affecting the most vulnerable people using our health service. Labour will take act ion to reverse damaging privatisation in the NHS, by repealing the Health and Social Care Act, and reinstating the powers of the Secretary of State for Health to have overall responsibility for the NHS when in Government.

Issues

Addressing the impact of health inequalities in all parts of our society

Health outcomes and inequality are inextricably linked, with those living in the most deprived areas likely to experience fewer years of good health compared to those living in the least deprived areas. Issues such as poor-quality housing, insecure employment and lower incomes have a detrimental impact on people’s health and wellbeing. There are fears that Sustainability and Transformation Plans, as well as failure in private sector healthcare provision, could lead to increased health inequalities in society. In addition to this, we know that certain groups within our society (e.g. BAM E people, LGBT people, women, older people, those suffering from mental health issues) are more likely to experience health inequalities, and as a part y we need to be aware, and ready to deal with the specific challenges facing particular parts of our society. It is vital that we recognise and address specific challenges facing those who suffer with mental health issues, including the impact on people who are forced to travel outside their local areas to get access to specialist services. In addition to this, Labour is determined to improve prevention and early intervention in mental health provision, with a particular focus on specific groups in our society that are detrimentally affected. Labour is also acutely aware of the impact loneliness can have on people’s health and wellbeing, and has pledged to work with communities, civil society and business to reduce this increasing problem in our society. Furthermore, Labour’s 2017 manifesto focused on a number of issues which aim to reduce inequality in our society such as improving access to sexual health services, increasing the allowance for unpaid carers, and guaranteeing dignity for pensioners through keeping the Winter Fuel Allowance, free bus passes and maintaining the triple lock on pensions.

Questions:

  • What measures should a future Labour Government put in place to help reduce health inequalities across all parts of society?
  • Are there specific measures to help tackle health inequalities that currently work well in your local area?
  • What specific areas of policy (e.g. housing, criminal justice) do you believe we should focus on in order to reduce health inequalities in all parts of society?
  • What plans could a future Labour Government put in place to address health inequalities faced by particular groups in our society?

Public health funding

Labour believes it is vital to ensure that sufficient funding is made available to all health services, particularly those services which play a key role in reducing health inequalities in our society. Labour supports the promotion of prevention and early intervention to help reduce health inequalities, and believes that investing in Sure Start Children’s Centres, smoking cessation and measures to reduce levels of teenage pregnancy is vital. In its 2017 manifesto, Labour pledged to increase funding for health and social care by a total of £45 billion over five years. Looking specifically at public health, the manifesto pledged to invest in children’s health, introducing a new Government ambition to make our children the healthiest in the world. Specifically, the manifesto pledged to break the scandalous link between child ill health and poverty, to introduce a new Index of Child Health to measure progress against international standards, and report annually key indicators and to set up a new £250 million Children’s Health Fund to support our ambitions. Labour believes that it is vital to address health inequalities in society at an early stage, by investing in prevention and early intervention.  Labour’s task now is to build upon pledges made in the manifesto, with a specific focus on how health spending can be used effectively to combat health inequalities in our society.

Questions:

 How best can a future Labour Government ensure that funding to reduce health inequalities in our society reaches those who are most in need?

  • What does Labour need to do in its first term in Government regarding access to services, health outcomes and service quality in order to reduce health inequalities?
  • Building on pledges made in the 2017 manifesto, what more could a future Labour Government do to reduce childhood obesity in society?

Workforce

 Making sure we have highly trained and skilled health professionals working in our NHS is vital if we are to reduce health inequalities in society. Under the Conservatives, and as a result of damaging policies the y have pursued, we are seeing workforce shortages in many areas in the English NHS. For example, we have seen shortages of GPs, psychiatrists, nurses, midwives and crucially for public health, cut backs in the numbers of health visitors and school nurses. Labour’s 2017 Manifesto addressed the issue of the NHS workforce in England in detail, pledging a long-term workforce plan for health and care. Measures in the manifesto included scrapping the NHS pay cap and putting safe staffing levels into law. Labour believes that there needs to be a clear focus on the quality of training staff receive and we support reintroducing bursaries and funding for health-related degrees. Furthermore, our manifesto made clear that we would guarantee the rights of highly valued EU staff working in our health and care services. The manifesto also acknowledged the role carers play in our society, pledging to increase the amount unpaid carers receive and increasing funding to allow providers to pay a real living wage to those caring for the most vulnerable in our society. The Labour Party highly values dedicated, hardworking staff that work in our health and social care sectors, who play an invaluable role in helping to reduce health inequalities in our society and believes that they should be supported with the right policies and planning.

Questions:

  • How can we ensure that all parts of the health and social care workforce are working together to reduce health inequalities?
  • Which other parts of society should health and social care professionals be working with to address issues of inequality in our society?
  • What steps does the Labour Party need to take in order to create a sustainable health & social care workforce strategy that will truly assist in addressing health inequalities?
  • What steps can we take to improve staff retention in the NHS, particularly in areas of the country with a high cost of living?