It’s time for new models of care.

Over recent years the the National Health Service and social care have been in a state of almost permanent crisis as they struggle to respond to the demands being placed upon them. It is obvious that the present models of care are not delivering and radical change is is needed.


But what are “the present models”?

The two main elements that are leading to the present unacceptable state of affairs:-

1. The under-resourcing of the NHS and social care.

We know that the investment that was provided during the last Labour government made a massive difference to cutting waiting times as NHS capacity grew. Some use was made of the private sector to clear backlogs but the overwhelming amount of work was done by the NHS and its dedicated staff.

This clearly showed that the most effective, fairest and efficient way of meeting patients needs was to use a public service model.

2. Commercialisation of health and social care.

It has been with us since Margaret Thatcher’s1989 “Putting Patients First” ( no irony intended). Can anyone say this ideological dogma has led to a better service?

It has created divisive and wasteful competition as well as uncoordinated care provision. The continuing failures of the commercial model as led to endless changes and reforms in England in an effort to improve things, the latest being the Integrated Care Systems (ICSs).

But there is no evidence that any of these changes have made any difference other that to make things worse. They are certainly not delivering better care to the public and are undermining the morale of the dedicated staff who provide the service.

The market models of care are not working. In the light of over thirty years experience it must be obvious that it is an ideological experiment that have failed.

The problem here is certainly not with the health trade unions. Their members, along with the general public, have the victims of this failed experiment and under-resourcing.

Even the BMA has in recent decades come to appreciate the value and importance of the NHS. It has been vocal in expressing alarm the serious underfunding of health and social care and it has expressed serious reservations about many of the ideologically driven experiments with the market that has undermined the public service ethos of the NHS

This is not to say the BMA is above reproach. Many of its members have a vested interest in the perpetuation of private health care and its continuing resolute defence of GPs independent contractor status as the prime model for delivery general practice rightly deserve criticism.

It is time for a new models of health and social care. We are on the one hand living through the legacy of over a dozen years of austerity and over thirty years of a failed ideological dogma.

We have the clear evidence from the last Labour government that investment and resources really matter. And we can see the waste and division generated by the attempts to commercialise health and social care. It is time to re-discover the value of public service delivery.

Labour’s 2022 Annual Conference unanimously passed a resolution proposed by the  Socialist Health Association which called for an “ unequivocal commitment to a publicly funded, publicly provided, publicly accountable, universal and comprehensive National Health Service  … (where there ) must be direct employment of NHS workers, ending commercialisation and fragmentation and the use of outsourcing, private providers and public private partnerships within the NHS. “

This resolution linked to a resolution on social care which calls for a National Care Service provide the new radical models of care which these desperate times demand.

Jim Gralton