A socialist organisation
The SHA is a socialist organisation. It is affiliated to the Labour Party and actively supports it, as it has done since it was established as the Socialist Medical Association in 1930.
These two positions are not regarded as contradictory. By socialism is meant a concern for the common ownership of social capital, the relief of poverty, for equity, and a belief that money or influence should not buy better treatment for human suffering.
Even in a capitalist society, human relationships cannot and should not be reduced to mere commodity transactions. The SHA recognises that everyone has a duty to one another, however well or badly endowed with wealth, education, genes or physique. The alternative to the universal provision of health care, free at the point of need and paid for out of general taxation, is a multi-tiered service that gives access to the richest, insurance to the middle classes, charity to the deserving poor, and neglects everyone else.
The SHA is affiliated to the Labour Party because it is the only political organisation that entertains this agenda and has any prospect of delivering it.
Since its foundation in 1930 the SHA has also pressed for all health service staff to be salaried and wholly committed to public service.
The SHA is committed to the establishment and extension of democracy. Within health, the democratic involvement of the people is an essential component of successful advance. The SHA therefore advocates an extension of free democratic debate within the Labour Party, and an extension of democratic accountability within the health service.
The fundamental principle of the National Health Service is that treatment is provided according to need and is free at the time of delivery. For the reasons eloquently described in The NHS Plan, charging has no part to play in the funding of the health service, and the SHA campaigns actively against the imposition of those charges that remain.
The SHA accepts that not every possible treatment or service can or should be provided by the NHS, but any decision to provide or refuse a service should be based on need and not on the ability to pay.
A public health approach
The SHA is committed to a public health approach. It accepts that medical treatment and other therapeutic approaches will not, on their own, achieve the advances in health that are possible and desirable. The SHA is concerned to address the problems of the poorest and most disadvantaged members of this society, and throughout the world.
The SHA wants to see the resources of the country directed to the most disadvantaged areas. This should include the development of a policy on food and nutrition for the whole population. The SHA believes that the gross inequalities in UK society damage not only the poorest in society, but every one. These problems cannot be addressed by medical services but demand wide partnerships involving the whole community.
The SHA welcomes the erosion of the boundaries between health and social care, but believes there is a need for more debate about charging policies. The NHS should work closely with local government as the civil authority representing the local population and having a key influence on the health and well being of all its citizens.
The next five years
Over the next five years the SHA will be addressing these issues as a political organisation by encouraging public debate and by campaigning for these principles within the labour movement and the health services, and outside. In particular it will address the issues of:
- The inequalities in income and wealth, their effect on health, and the need to address relative as well as absolute poverty
- The lack of effective local mechanisms for involving people in health issues, the absence of a democratically accountable health service, and resisting proposals to reduce the democratic responsibility for social care.
- Easy access to health and social care, and the range of barriers currently imposed, including charging policies, the centralisation of specialist care, the absence of good public transport, and the failure to address the physical, cultural and language needs of disadvantaged groups.
- More effective delivery of health and social care for the most disadvantaged members of our society.
- The increasing trend towards the privatisation of health and social care through the Public Finance Initiative, Public and Private Partnerships, Best Value and other mechanisms.
- The need to recognise that health and social care is best delivered by valuing all the members of the care team. This will include effective workforce planning, and the provision of high quality education, training and development for all staff. The stress faced by staff during the time of major changes to the NHS must not be under-estimated. Reducing staff pay and conditions to achieve financial savings is often a racist and sexist attack on workers who are already low paid, and can jeopardise standards of care and undermine the public service ethos of the whole NHS.
- The need to devolve power to the English Regions. The approaches taken to health in Scotland, Wales and Northern Ireland are impressive. The devolution of responsibility for the health service to elected regional assemblies in England will go a long way to addressing the democratic deficit in the NHS. The SHA encourages all its regional branches to participate in these developments.
- The need to develop an international aspect to the SHA’s work by opposing government aid to oppressive regimes, recognising that inequalities are international, and arguing the case for aid that promotes health and acknowledges the health dimension in international planning and trade
Influencing Labour and the government
Influencing Labour Party and government policy has become far more complex over the past five years. There are no longer opportunities to propose resolutions at the Labour Party annual conference without careful planning and preparation.
The SHA is an active member of the Socialist Societies‘ executive, and of the Health Commission that meets regularly with ministers. The SHA has had limited success recently in putting its point of view in the media and at conferences, but if it is to punch above its weight within the Labour Party it must devote more attention to this issue during the next few years.
Position statement agreed by Central Council 14th July 2001