Labour Party Consensus Policy on Health and Public Services

National Policy Forum 2008


Excellent public services lie at the heart of any civilised society, essential to delivering fairness and opportunity for all. Investment in public services also supports our future economic development and can also play an essential role in regenerating local economies and maintaining stable growth and high levels of employment. Public services have improved significantly over the last eleven years, but they can and must be even better, world-class services. Labour is committed to pressing ahead with the next stage of reform to improve quality, increase the responsiveness and enhance the fairness of public services. Our objective is that everyone and not just those able to pay should have access to high quality public services that meet people’s rising aspirations, available when they need them and tailored to their individual circumstances.

To achieve this we will continue to invest in our public services and we will put more choice and more power in the hands of people, giving them a real say, improving the information they receive and ensuring that user satisfaction becomes a key measure of success. In relation to health services, we will work with the EU to ensure British patients are not disadvantaged by needing care across EU borders and we will ensure the approach taken by the EU is consistent with the fundamental principles of the NHS. We will oppose any attempts to create an EU single market for healthcare which could undermine the NHS.

We will extend the range of choices on offer to patients, providing choice not only in elective surgery but in other areas of healthcare including maternity services and general practice and ensuring patients can make real choices about their treatment as well as when and where they are treated.

Labour is absolutely committed to the provision of high quality public services. Public sector organisations with their own directly employed staff deliver a wide range of excellent and innovative services throughout the country, We are committed to maintaining and developing a central role for public provision and a directly employed workforce.

Different sorts of providers will sometimes offer innovative, high quality services not routinely available in the public sector. Where that is the case we will continue to use voluntary and community organisations, social enterprises and the independent sector in providing services. Where they are used to provide services they must offer value for money.

Professional groups and public service trade unions have a vital role to play in service improvement by supporting staff development and involvement and public service employers in all sectors should engage constructively with them. There are also outstanding examples of excellence and innovation throughout the public sector. We are committed to maintaining a central strategic role for public provision in services as a guarantor, comparator, standard setter and leading innovator, We will take steps to ensure that all commissioners give full consideration to in house options and public sector solutions.

Central to everything the public services achieve and to our agenda for improvement, are our public service staff, Real excellence depends on liberating the creativity and commitment of the public service workforce. Labour will therefore continue the process of empowering the staff at the heart of our services – freeing up frontline staff from bureaucracy and top-down control, and ensuring they get proper support form back office services so they can innovate and improve services, for example through the productive wards programme in our hospitals.

The Government remains committed to ensuring that workers continue to receive fair and reasonable treatment, especially where services may be opened up to competition. Among the steps the government has already taken are the Best Value Performance Improvement Guidance and two-tier workforce protections already existing in local government under the Best Value workforce code.

The Government will re-issue the Code of practice on Workforce Matters in Local Authority Service Contracts for consultation. As part of that consultation Labour will propose to clarify that the code applies to all contacts, including those re-tendered contracts that were originally let before the code came into force; Labour will merge the best value codes into one code for all best value authorities to ensure consistency of approach; and Labour will consider how best to effectively monitor the code through the new Comprehensive Area Assessment of Councils.

In the Health Service, the nationally agreed joint statement relating to the application of Agenda for Change for contracted-out NHS soft facilities was issued in October 2005, In the NHS, the Government will seek to extend entitlements to NHS pensions to those staff transferring to social enterprises in the Primary Community sector as part of moves to reform that sector of NHS provision and give front-line staff more control over services as set out in the Darzi review. Enforcement of these rules remains a priority and Labour will consider how best to create a tough approach to ensure that providers meet their obligations on these issues.

The NHS Constitution will emphasis that NHS staff should have rewarding and worthwhile jobs, with the freedom and confidence to act in the interest of patients. It will recognise that to do this, they need a fair pay and contract framework, opportunities to develop and progress, and safe working conditions free from harassment, bullying and violence. The Constitution will commit the NHS to upholding its staffs legal rights, as reflected in employment and discrimination law. While the vast majority of Trusts now implement Agenda for Change, we will work to ensure those remaining Trusts do also.

Labour values the key contribution to effective local services made by staff. Labour will continue to insist that Councils meet their current and future obligations to implement terms and conditions consistent with the principles of equal pay for work of equal value. We will support this process by continuing to allow some financial flexibility, in the form of capitalisation to councils facing these pressures subject to fiscal conditions allowing this,

Labour welcome the measures taken to ensure that no-win-no-fee arrangements operate in the interests of the claimant and are appropriately regulated.

We will make sure the nearly £160bn per year spent by central and local government on public procurement both provides value to the taxpayer and, wherever it can, furthers our progressive objectives on social, equalities and environmental issues. We will foster an environment in which procurers and commissioners ask what they can do to meet these goals, not what they cannot.

We will make sure innovative approaches are used to achieve social outcomes and objectives. The very principle of buying on a value for money basis is about taking account of the whole life cost and wider factors often including social considerations, not just about buying the cheapest. Labour will help ensure that procurers look at imaginative options and talk with customers, interest groups and unions to understand what the market can provide.

This is exceptionally important in priority services such as hospital cleaning, where the decision to use a particular provider must be based on the strongest evidence about effectiveness. Where providers fail to deliver a satisfactory service, its contract should not be renewed or in exceptional circumstances, terminated. Hospital cleaners are an essential part of the healthcare team, playing a vital part in avoiding healthcare acquired infections, There must be rigorous standards of cleanliness enforced in all hospitals to ensure they are clean and safe for patients.

We welcome the recent fall in infection rates and the improvement in standards of cleanliness across the NHS, and the part that the recent deep clean has played in delivering this, as part of a package of measures. Deep clean should be part of good practice in the future. All hospitals must give full consideration to in-house options for their cleaning contracts with a view to maintaining and developing critical public sector capacity in the management of cleaning and hospital hygiene.

Workforce development is a vital ingredient of successful public service delivery, whether those services are directly provided by the public sector or commissioned from other providers, and Labour will continue to support workplace rights.

We want to see contracting authorities encouraging training and development of skills in the workforce. Procurers of relevant services and works contracts should make use of their right to require a proportionate amount of work to be undertaken by apprentices or staff involved in a training programme.

For the UK to compete in the modern global economy, a world class skills base is needed. Government has set a challenging target to ensure almost all adults have basic literacy and numeric skills by 2020. It is important for government to lead by example in making progress on this agenda, and to provide a frame work for others to do the same. The joint statement agreed by government, trade unions, business and the third sector aims to improve the quality of services delivered under government by raising the skills of employees working on these contracts.

Improving skills in the workforce is as important to our ambitions for world class public services as it is for the competitiveness and productivity of employers in the private sectors.

Labour’s skills pledge is a commitment from employers to support all their employees to improve their skills and gain qualifications. Over 3,000 employers have signed it, covering over 4m employees, Every government department in Whitehall has already signed the pledge, and has committed to offer training to all their lower skilled workers. Labour will work systematically to ensure that the public sector, including local government, schools, colleges, hospitals and their supply chains are taking up the skills pledge and increasing the opportunities for ail workers to take up training to improve their skills and improve the services they offer.

We are challenging public sector employers to offer greater numbers of apprenticeships to people of all ages and also to take part in programmes such as Train to Gain. A Labour government will lead by example. We have committed to a first intake of at least 500 apprentices in September 2008 in central government. If the current consultation is positive, Labour plan to introduce a legal right to request time for training in 2010, covering over 20m workers in both the public and private sectors.

Labour is committed to make Britain among the European leaders in sustainable procurement. We will make the central government estate carbon neutral by 2012, and to reduce carbon emissions by 30% by 2020. We will seek to recycle 75% of waste by 2020 and reduce the amount of waste and water consumption by 25%.


Government has a key responsibility in ensuring that the food we eat is safe, Meat inspection will continue to be undertaken by independent government inspectors with sufficient resources and backing to undertake strong enforcement action on the meat industry.

To promote healthier eating for NHS staff and patients, we are developing a new kite mark for public sector canteens that provide healthy, nutritious food to public sector staff and those in their care. This will initially be piloted in the NHS, HM Prison Service and central government staff canteens, before eventually being rolled out across the public sector, Our ultimate aim is for healthy food to be the norm across England – in hospitals, care homes, prisons and in all public workplaces across the country.

Both public and private sector organisations should work to promote good practice in occupational health for all workers.

We will ensure that there are sufficient hospital places for the acute mentally ill, where it is clinically appropriate for them to be treated in hospital.

Patients on low incomes are among those who qualify for free prescriptions, and it would not be a good use of public money to extend free prescriptions to those who can easily afford to pay, However, exemptions from charges could be better targeted to tackle health inequalities more effectively.

We have legislated, in the Mental Health Act 2007, to modernise mental health law for the first time in a generation, to benefit patients and the public, to allow some people who need compulsory treatment to get it in the community instead of having to be detained in hospital, to allow a wider group of health professionals to treat patients, and to give people receiving compulsory treatment access to independent advocacy We will also address the impact of the service provision on black, Asian and minority ethnic people.

All patients want to access the high quality treatment they need as quickly as possible, free of charge, Many will want to do this at their local hospital. Others will want to be treated in a hospital further from their home but closer to their family, or at a hospital or clinic which specialises in their particular condition. All of these preferences are legitimate, and allowing real choice means that patients, and the NHS, can act on these preferences. So we will take choice further, providing patients with real choice not only in elective surgery but in other areas of healthcare including maternity services and general practice.

Information about independent and third sector providers of NHS services is usually available from the public authority under existing Freedom of Information rules, except where valid exemptions apply. However, we will consider introducing a voluntary Code of Practice for private organisations which provide public services to provide information about their public activities.

We will support NHS staff by continuing to implement the European Working Time Directive in a way that retains labour market flexibility while offering protection and choice for workers, enabling staff to deliver high-quality services in a manner consistent with good employment practices.

While the majority of Trusts now implement “Agenda for Change” we will work to ensure those remaining Trusts do so also.

We are currently reviewing student support funding for nurse trainees, with a steering group including representatives from trade unions and SHAs.

The Constitution should emphasise that NHS staff should have rewarding and worthwhile jobs, with the freedom and confidence to act in the interests of patients. It should recognise that to do this, they need a fair pay and contract framework, opportunities to develop and progress, and safe working conditions free from harassment, bullying and violence. The Constitution should commit the NHS to upholding its staffs legal rights, as reflected in employment and discrimination law.

Labour is committed to ensuring that all carers are given practical assistance which allows them to get and maintain a job if that is what they want.

We have amended the Health and Social Care Bill to ensure that the Human Rights Act protects everyone who receives public money to live in a care home, whether the home is private or council-run.