Labour and the NHS

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An evening with Andy Burnham - and hope for the NHS

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You don’t need to read very far through this blog to know that I’m passionate about the NHS. I believe it’s Britain’s, and Labour’s, greatest achievement and the country’s greatest treasure – and that it’s under sustained, ideologically-driven and multifaceted assault by the Tory-led coalition government.

The latest phase in this assault is the undemocratic ‘negative resolution’ that the government initiated, with typical sneakiness, just before the current Parliamentary recess. As I explained in my last post, this little-known procedure, abusing section 75 of the Health and Social Care Act 2012 as its justification, has started a 40-day countdown and if opposition MPs are unable to block it successfully, it will become law – and will break explicit, written government promises in order to force the new Clinical Commissioning Groups to put every NHS service out to competitive tender, even if they don’t consider it to be the best for their patients.

It’s not going to be an easy fight, so it was with some trepidation that I went to a public meeting last night on the NHS with Shadow Health Secretary Andy Burnham and Labour’s parliamentary candidate for Redcar, Anna Turley.

But what I heard was refreshing, inspirational and massively encouraging – not just about the immediate fight against Statutory Instrument 252 (the government’s ‘negative resolution’), but about Labour’s wider commitment to a genuine and even improved NHS. Here are the key points:

SI252

We’ll start with the most pressing matter first. I got the chance to ask Andy about Labour’s plans to block the government’s resolution – and what they could do, if the government succeeds in forcing it through, to minimise its effects until the next General Election in May 2015 or sooner.

On the Parliamentary battle, he responded unequivocally that Labour is busy making plans for immediate action as soon as Parliament resumes next week and will ‘lay prayers’ against the resolution in both Houses of Parliament, and will fight tooth and nail to defeat it. He expressed hope that LibDem MPs, who by now must realise that the Tories have lied consistently to them about the implications of the 2012 Act, will join forces against the Tories – but it was hope rather than expectation, as the LibDems’ record of resisting their Tory leashholders has been woeful so far.

For this reason, he appealed to all of us to be active and energetic in pressuring our MPs to join the resistance against SI252, and to campaign hard to defend the NHS.

With regard to steps that can be taken to minimise the damage of the resolution if it goes through, he reiterated a firm, unambiguous commitment to repeal the 2012 Act as a priority once Labour is back in government, and to restore the lead on the commissioning of health services to local government. However, by that time much irrevocable damage will have been done, so concerted interim action is needed.

His view was that the NHS Constitution would offer the best legal basis for local individuals and communities to challenge, delay and even overturn awards of health tenders to private companies. I’ve been reading the Constitution in detail, and it does contain some rights for the public and staff, and some duties for NHS bodies, that seem to have potential for a ‘rearguard action’ to delay the progress of private tender awards. I’m in the process of contacting MPs, unions and other NHS campaigners to explore what can be done, but I have an idea in mind if it turns out to be feasible, so watch this space.

However, while the resolution is still in process in Parliament, nothing should distract us from the urgent priority of getting it killed at this stage, so please see my last article and get writing to your MP!

Some other highlights:

A confession and a new vision

Andy stated that he felt that Labour had allowed too much ingress of private companies into NHS provision during its last period in office, and that his vision was to restore an NHS closer to its founding principles – but with a new and extended scope.

The Tories have targeted the integration of healthcare and social care, but without question this is a backdoor means of degrading the NHS even further. By reclassifying services from ‘free to all at the point of need’ healthcare into means-tested social care, the Tories hope to introduce health tariffs by stealth – to vastly increase the extent to which people have to pay for care while reducing the cost of hospital care so that they can give further tax-cuts to the wealthy.

This has been demonstrated by their decision to impose a much higher ceiling on social care costs than that recommended by Andrew Dilnot even as they continue to siphon funds out of the NHS toward social care costs and even just to fill Treasury coffers.

This starvation of funds inflicted on both aspects of care is resulting in dangerous gaps and is preventing successful whole-person care – and has added ‘fear of old age’ to the great evils of sickness, worklessness etc identified by Aneurin Bevan, the driving force behind the foundation of the NHS.

Labour’s vision is different. Andy Burnham referred to a World Health Organisation definition of health at around the time that the NHS was first founded:

A complete state of physical, mental and social wellbeing.

The NHS, treasure though it is, has primarily focused on physical wellbeing – mental health has been run largely as a separate service, and social wellbeing has been even more discrete. His vision for the NHS is to integrate all of these into a single service – but crucially, while maintaining the NHS’ founding principle of ‘free to all at the point of need’.

How this would be funded is still under investigation, but the fact that Labour has a huge, ambitious vision for a truly integrated, truly socially-funded NHS should give massive encouragement and inspiration to all people of good will and be, as Andy said, ‘an election-winning proposition‘.

Preferred providers

Andy said very clearly that he doesn’t believe in the principles, so beloved of the Tories, of a marketised NHS and 'any qualified provider'. If Labour win the next General Election, he will reintroduce a preferred provider policy that will allow genuine NHS organisations to be named as the providers of choice, thus ensuring that the NHS remains, at its core, a public institution. This will restore the NHS to leadership of health service provision, alongside local government as the commissioning lead.

Rebalanced nurse training – and increased status for care workers

Andy quoted a nurse who said to him that there was, compared to when she qualified 20 years ago, a big swing toward patients in their 80s and 90s. He said that we should be celebrating the fact that many of us are living longer, rather than treating it as a scenario of doom and difficulty as the Tories do, but that in order to ensure that nurses are equipped to be able to provide the standards of care that they want to provide – he doesn’t believe that nurses think they are ‘too posh to wash’ - he will be looking at the balance in nurse training between the academic and the ‘hands-on’.

He also talked about care workers, condemned the penny-pinching, profit-driven approach of private care providers and spoke of the need to lift both the standards and status of social care staff:

How can caring for us in our old age and need be a minimum wage business?!

before addressing the conflict that the current system creates between acute and social care, with patients forced to stay in expensive hospital beds as a false economy because of under-investment in social care structures, and promising to use successful examples of any type of care as the model for ‘best practice’ around the country.

A more equal society – and we’re not afraid to say so

We need to stop squabbling over the centre ground and launching micro-initiatives..we’re going to say clearly: we want a more equal society.

This is exactly what we need – and should start to break the ‘they’re all the same’ paradigm that the Tories carefully foster to keep people apathetic and bereft of hope for genuine change.

The NHS is the best solution – period

Andy spoke of the NHS as Labour left it in 2010: the highest-quality health service in the developed world – and the only one in the G20 that could say it provided comprehensive, social healthcare for less than 10% of GDP. This, he rightly insisted, is an absolute bargain and the idea that privatisation with its profit-layer could provide a better, more cost-effective solution is just nonsense.

The NHS is not just the fairest and most cost-effective solution now. The only way to face 21st-century healthcare challenges is a fully public, truly national NHS!

I could only rise to my feet and applaud.

I went to the event last night with serious concerns but excited about the chance to ask questions about those key issues. I left uplifted, inspired – not without concerns for what will happen over the next couple of years under this woeful, malignant government, but and filled with renewed hope and renewed appetite for the fight.

Because what will follow this government’s downfall is worth fighting for, and the more we can protect the NHS up to 2015 the sooner we’ll see the bigger vision realised.

Thank you Andy Burnham for taking the time to come and communicate the vision, thank you to Anna Turley for setting up last night’s public meeting – and thank you Labour for returning to core principles and being prepared to stand up and speak out for ordinary women and men that this government is trying to grind into the dirt.

I get enthused by very few politicians, but I have always felt that Andy Burnham was a cut above so many of the others. The Tories must hate him. Good luck to the chap - and especially good luck to the NHS....

The sheer size of our NHS must in itself be daunting for any Reformer, and the Law of Unintended Consequences hovers menacingly over any proposed change.

One thing which does cry out for urgent attention however is the overlap of reponsibility between NHS (sick people) and a Local Authority (Dependant people.) Too often, a cash-strapped Council Welfare Department is only too pleased to shift responsibility for an individual onto the Hospital, or conversely reluctant to take over when said Hospital wants to discharge someone with nowhere to go.

"We left the best service in place in 2010". What utter nonsense Steve. Labour left the most expensive which should never be confused with the best. Check out Germany if you want efficiency and they don't pay through their noses for an inferior service. This bunch of quasi socialists in power have spent more on the nhs since taking control year on year with no improvement. Where are the changes we were promised, I know lets give IVS to women over 40 (tha'ts radical) and right out of the "feel good" claptrap that drips out of the mouths of socialist wannabes.

If you want real change then lets stop worshipping at the door of the nhs, it's meant to be a service (one that's well funded) not an alternative religion.

Ah, yes. That Teutonic efficiency.

But not everything is as clear before breakfast.

Can the overcrowding of A&E departments be pinned down to the negotiations held with former Health secretary Alan Milburn who negotiated GP's contracts allowing them to opt out of "out of hours cover". This allowed the private health companies to vie for the contracts to run (often badly) the services. Strangely one of the major players at the time was a company named Harmoni who gained substantial contracts for their services and who "strangely enough" are now Mr Milburns employer. Weird world innit.

Doctors can now charge over £1,000 to cover the night shift that was formerly part of their contract, which simply shows that throwing money at an object doesn't equate to improvement.

tlttf wrote: Where are the changes we were promised, I know lets give IVS to women over 40 (tha'ts radical) and right out of the "feel good" claptrap that drips out of the mouths of socialist wannabes.

If you want real change then lets stop worshipping at the door of the nhs, it's meant to be a service (one that's well funded) not an alternative religion.

Nice manipulation of the facts there, and going out on a limb here but when you mention IVS, I think you might mean IVF? (In vitro fertilisation), Would it be more cost effective to provide IVF to any women who can't conceive on her own after her first try? Majority of women that receive IVF have been trying for years on their own, and considering the issue of women are now having children much later in life it seems logical that the age of women receiving IVF would increase.

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Well spotted DN, yes I meant IVF (I won't change it now). I have no problem with IVF being used, I don't see it as a an NHS concern though. If at 40+ somebody decides to have a kid fine, why should the state pay for the privilege of an ego trip when the body is coming to it's natural cyclic end regarding creation?

tlttf wrote:Well spotted DN, yes I meant IVF (I won't change it now). I have no problem with IVF being used, I don't see it as a an NHS concern though. If at 40+ somebody decides to have a kid fine, why should the state pay for the privilege of an ego trip when the body is coming to it's natural cyclic end regarding creation?

If that were the case but, I don't think the NHS would step in to help, IVF is only provided for those whom have had "those who have an identifiable cause of infertility such as an absence of sperm, or blocked fallopian tubes". quote is taken from the site linked in my last post. The issue of women using the NHS to conceive mainly because they have decided to wait is contradictory, as the older a women gets the higher the risk of problems for both her and the child, the NHS is not going to readily support a mature women trying to conceive later in life purely for her own reasons, knowing that it could cause more problems as a result.

Deadly Nightshade. I'm sure you're right, but the truth doesn't usually provide a simple soundbite for, and a guaranteed knee-jerk reaction from, cerebrally charged 'Daily Mail' readers.

The protocol used to be - you attended out-patient clinic for several years, reporting on your sex life and basal temperature, getting your husband to provide sperm samples, taking hormones, having exploratory x-rays, pelvic examinations and surgery etc.
If none of that worked, and you were proved to have a plumbing problem preventing conception you were then, if you were lucky, put on the waiting list for IVF, which, as an expensive treatment, you had to wait for.
None of that could start until you'd been trying without help for at least three years. I was finally offered a place on the waiting list at age 37, seven years after initial referral to the fertility clinic.
Not surprising women are in their late 30's or early 40's before they get a chance. It's not a priority area for NHS spending, or at least wasn't in my younger day. I expect the procedures are a bit more refined now, but there's still a lot to rule out before you can justify committing resources to IVF.
Given the amount of hoops you have to jump through, I doubt if anyone would consider it as a viable lifestyle choice.

There is an absurd disconnect between the number of "unwanted" children born, and childless couples desperate for an heir.

Britain's record on adoption is not especially admirable.

It seems absurd, but for various reasons not every couple who could be good parents is capable of adopting successfully.

Children being placed for adoption have already been victims of a failed parental relationship and the various agencies try very hard to guard against another failure.

Because of this, the screening process is very intrusive, and people who may well perform well as adoptive paarents are rejected because of factors such as age, health history, family background etc.

Plus, with adoption, you very rarely get a baby - you will usually adopt a small person who already comes with a bit of baggage - first time parents have enough trouble coping with the little blank canvas they've made themselves.

Possibly I should have mentioned fostering alongside adoption.

The mismatch between would-be (though infertile) parents and the numbers of unwanted children is a waste of human resources.

We've gone a long way from the theme of the thread here, but, being a woman, I just want to say one more thing, then I'll stop - honest.
The rules about fostering are just as strict as those for adoption and fostering carries the disadvantages, for a relatively inexperienced childless couple that
a) you usually get an older child who has already experienced some form of misfortune and may present with difficult behaviours and
b) your efforts to negotiate a modus vivendi with the child may well be hampered rather than supported by the quite oppressive oversight of your two (count them) social workers, by the requirement for twice yearly reviews, seeking permission for medical treatment for the child etc etc etc.

I suspect we need a different model for child rearing - bringing them up within the nuclear family only works for some.

Prostitution seems to be favoured in some quarters. By which I mean that there are a hundred-and-one explanations for the vast number of children held in Council Storage Tanks, but few people agitating for a revision of current policy, which appears to be distilled into a single directive: "Guard your back."

See how easy it is to reach targets when quality of service and cost mean nothing.

There’s more to fixing the NHS than chasing A&E waiting times


NHS workers used to enjoy hearty backslaps for their ‘jolly hard work’ to bring down accident & emergency waiting times. Such praise was delivered by the Labour government’s chief nursing officer at a conference I covered back in 2003. Back then, talk was of shrinking queues rather than impending ‘A&E crisis’. Nurses should congratulate themselves, she beamed, for helping speed patients through casualty in fewer than four hours.
This apparent success was just the beginning, if this graph, circulated in a campaign e-mail by Labour’s shadow health secretary recently, is to be believed:

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We won't even bother about highlighting how to hide data that doesn't suit the statistics.

This info shows that Mid Staffs hospital scandal was the norm rather than the exception. Do people really want a return to a government that hides information that doesn't suit?



Comment: Andy Burnham's responsibility for the secrecy of the NHS
Thursday, 20 June 2013 4:23 PM
By David Morris MP
It is right that Jeremy Hunt has apologised for failings of the NHS at Universities of Morecambe Bay NHS Trust, but we must remember that the secrecy culture in the NHS built up under the last government. We are now awash with scandals about how things were run in the NHS before the coalition began to clean up the mess. Today, the names of those involved in the scandal were released and I welcome this move to make our NHS more transparent.


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The proof of the pudding will be in whether today's revelations of quashed Hospital reports have any tangible result.  (Apart from "Lessons have been learned" platitudes)

Here's an interesting article regarding the NHS.

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Sunday 23 June 2013
Worshipping the NHS costs lives
This toxic institution, believed to be the envy of the world, has been poisoned by individuals' self-promotion at the expense of the sick




Imagine if an airline crashed 10 planes each year, killing 3,000 passengers in avoidable accidents; after its most disturbing disaster, wiping out 1,200 people, the two managers responsible were promoted to the firm's top jobs – one as chief executive, the other in charge of safety. Then it was discovered that the company silenced whistleblowers while covering-up serious failings that led to fatalities.



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Well worth reading and thinking about for all those that can see no wrong.

The NHS has a problem found also in Sporting organisations.  Administrators are necessary but are not necessarily proficient in the professional discipline which they are administrating.  Thus Doctors and Nurses know what they need to do their job, but cannot at the same time run the wages department, admissions, catering and all the other essential but peripherals like building maintenance etc.

In Sport, the players just want to enjoy their game, not get involved with Rules and fixture-planning or spectator-provision.

An interesting observation from an NHS anaesthetist who is a volunteer TA part-time medic just back from three months at the Army Field Hospital at Camp Bastion in Afghanistan.

"Their system works perfectly, it is very clear and focussed on the specific task. Returning to the National Health Service, which creaks a bit, was difficult. The problems were not in Afghanistan, they were here."

Dr. Rajen Nathwanee interviewed for The Sunday Times.

Anyone who is taken in by the defeatist nonsense that “all the parties are the same” should read these extracts from an interview with Andy Burnham, in which he labelled the health reforms, which were not in the manifesto of either of the coalition parties, “a democratic crime of monumental proportions”. I doubt if his comments will be reported in the tabloids or by the Bullingdon Broadcasting Corporation.
 
Privatisation agenda drives Tory policy on NHS
 
“Jeremy Hunt has been on a mission to run down the National Health Service to serve a privatisation agenda that will lead to the end of free, universal health care in the UK. The Tories are crippling the NHS with competition law and setting it on a path towards charging patients for their care. They want to say: ‘These services aren’t good enough, the NHS is failing the public, we need any qualified provider, we need to open this up, we need other people to come in and replace this failing, uncaring NHS’. There is a political agenda and an ideological agenda underpinning what they are doing.

Privatisation of the NHS was the core purpose of the Health and Social Care Act. The Act freed up NHS organisations to make 49% of their income from paying patients – a huge increase on the 2% permitted previously.  £1.5m has been donated by private healthcare investors to the Conservative Party, and £1.5bn worth of NHS contracts granted to private health firms.

US healthcare companies will be able to say to an NHS clinical commissioning group: ‘We have a legal right to bid for that service’. Dragging the NHS down that path will destroy it, it will devour what’s precious about it. The legal advice I am getting says, while we will just about be able to pull it back at the 2015 election, after that, it will be gone. That’s the choice voters face. We left with the lowest-ever waiting lists, the highest-ever public satisfaction and no amount of Tory spin can alter those facts.”
 
For the whole interview:-
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It's been clear for at least thirty years that Tory policy was to allow much of Britain's welfare provision - including the NHS - to wither on the vine as Chancellor Lawson put it.

Although Maggy repeatedly parrotted the "NHS is safe in our hands" mantra it was evident that her notion of that service's function was rather like those street-cleaners who remove the mess left behind after the Lord Mayor's Show.

This is no way to run a national health service

by Andy Burnham

"Four years ago, this government published the Liberating the NHS White Paper. I can still remember the shock I felt turning through its pages. Just six weeks earlier, I had stood alongside Andrew Lansley at hustings events and heard him say there would be no top-down reorganisation.

We said the biggest reorganisation in its history would drag the NHS down - and it has. Hospital A&Es in England have now gone a whole year since they last met this government’s A&E target. Patients are being held in the backs of ambulances as they queue outside. NHS waiting lists have hit a six-year high. It is harder to get a GP appointment too and some practices are on the brink of closure. But perhaps the most worrying problem of all is that the NHS recently missed the national cancer treatment target for the first time ever.

Under David Cameron, NHS privatisation is proceeding at pace and scale. He needs to be reminded that he has never been given the permission of the public to put the NHS up for sale in this way. Further forced privatisation of services should not proceed until the public has had a proper debate at the 2015 election and decided what kind of health service it wants in the 21st century.

The next Labour government will repeal the Health & Social Care Act to restore an NHS based on care over competition and people before profits. By starting to bring social care into the NHS, we will build a health service for the whole person. If after 2015 the NHS has another five years of the same, England will have a very different health service at the end of it."

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A Tory administration is a Danger to your Health.

A Labour government introduced the NHS structure in 1948 - three years after the end of WW2 which had left Britain bankrupt, and also meant an end to free food and supplies from the US under "Lend-lease".

Britain borrowed $4billion from the USA, which was at the same time encouraging the defeated nations to restore their post-war economy. The Labour Government had sacrificed the modernisation of Britain as an industrial country for the sake of using Marshall Aid to support a world power role - strategic and financial.

Britain's estimated defence expenditure for 1950-1 - the final year of Marshall Aid - amounted to 7.7 per cent of GNP - at a time when Germany and Japan were not spending a pfennig or a yen on defence. And in spring 1950, Hugh Gaitskell, Chancellor of the Exchequer, reported that the Sterling Area's dollar reserves were 'still at a lower level than when Marshall Aid began'.

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