Wes Streeting warns Labour members about ‘nostalgia’ for the NHS and says improvements rest on reform rather than pouring money into a ‘leaky bucket’
These are todays headlines … but the message is more subtle.
In some senses Wes is right – the health crisis can’t be fixed without major reform. But perhaps not the reform he suggests.
Today people who dial 999 struggle to get an ambulance: in fact long queues of ambulances and patients wait outside hospital. Yes we do need to ask what’s gone wrong.
The first and easiest answer is that patients can’t be discharged into hospital because there are not enough beds and staff. The capacity of our health service is woefully inadequate; we can see by looking at international comparisons.
We need more NHS not less NHS.
This means a return to at least funding levels seen under the last Labour government – but also taking account of our older and sicker population. It means looking at the social determinants of health – dreadful housing, poverty pay and overwork. It means training our own people so we don’t have to pay agency middlemen to source the workforce (yes Wes we do agree).
There is also a short term problem of what used to be called rather disrespectfully ‘bed blocking’ – delayed transfer of care. Many people in hospital simply shouldn’t be there. They are not ill. It should be possible to discharge them either to a care home or to their own home with the support of carers (yes Wes we really agree). The problem is that social care, originally run by councils has been outsourced, privatised and asset stripped (homes and land have been sold on for a quick profit and rented back at extortionate rates). This, incidentally, is the very process being proposed for the NHS by big corporate interests – with some cross party political support which the corporations have quite literally bought (not too sure we agree on this point Wes).
Creating a public National Care Service would have an immediate positive impact on the NHS. This will involve creating a properly paid workforce and building on the skills and professionalism of many of our grossly exploited carers.
Wes has spoken about improving productivity in the NHS. Certainly staff need the best equipment to do the job. Capital expenditure on the NHS is inadequate, again international comparisons are damning. We all want to see staff with cutting edge kit. We also need to understand that previous cuts have been wrong and clearly misdirected. For instance if you protect ‘frontline staff’ by cutting administration all that happens is your doctors, nurses therapists etc have to cover reception, type appointment letters, collect data etc.
So how do we fix all these problems? Not by calling in private companies who will divert NHS funding to shareholders. Labour needs to negotiate with the NHS workforce to ensure they have proper support and pay (the problem of forcing people to take on then repay student loans is you have to pay them a lot more – not less). We also need to get rid of the costs of buying and selling and contract monitoring and legally defending market decisions. We need to return to a rational, planned, public NHS with improved integration with the new National Care Service. This was the unanimous view of the 2022 Labour Conference but it was a position which we were unable to put to conference last year.
If that’s nostalgia so be it Wes.
We think, looking at the evidence, it’s common sense.
Below picture publicising one of last year’s NHS 75 events
