Labour needs to make the NHS top priority

Like most people reading this, I was born in the NHS, I grew up with the NHS and so have my children. In the UK, the NHS is accepted as ‘ours by right’: a free service for all; a service that does its very best to keep us all healthy; a service that helps cure us when we are sick; and a service that eases our pain when all else has failed. We look on aghast at the US healthcare system and feel so lucky that we in the UK do not have to deal with exorbitant healthcare costs and a system which reserves its very best treatment for those who can afford it.

But now more and more people are finally coming to realise that our NHS — the institution that many of us love the best of all institutions — is being rapidly transformed into the US model. We are not too far away from a pay-for NHS and two-tier levels of healthcare — the best for the rich and the dregs for the poor.

And the vast majority of us want our politicians to stop that happening.

All the changes to bring our NHS to this disastrous situation have been in progress for some time. Way back in the 1980s, when Thatcher’s government realised that even though they wanted to bring in a pay-for system, it would have to be done by stealth, they began the process with bringing in a more ‘marketised’ structure and the use of private outsourcing. Major’s government continued this with PFI (Private Finance Initiatives), the so-called ‘public-private’ partnerships which were used to a wider extent under Blair and Brown’s governments and nowadays, post- world financial crisis, have led to increasing debt for hospital trusts and the bulk of government ‘NHS funding’ being paid into private pockets.

Then, under to Coalition government, we had The Health and Social Care Act 2012, which took the NHS away from being publicly funded and publicly owned and created a competitive market for health services where the government pays for, but does not provide, healthcare. Under the 2012 Act the Secretary of State’s legal obligation to provide comprehensive healthcare for all was removed…and few of us seemed to notice the threat here, including, it appears, many Labour politicians.

Still under the Coalition government, the Five Year Forward View was published in October 2014, by NHS England Chief, Simon Stevens. As well as emphasising preventative care, more patient control, integration of emergency services, and the localisation of care, the ‘view’ looked in depth at a forecast £30 Billion deficit, but rather than demand more government funding to address the deficit, it called for ‘more efficiency’ at all levels.

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Which brought us to May, 2015 and the General Election….

Now, I am one of those millions of UK citizens who see the NHS as our most important institution. I also see the NHS as one of the most important things that the Labour Party has ever brought us. In May 2015, I was not yet a Labour Party member, but I was a Labour supporter and always had been, if only for the NHS alone. I had seen all the changes happening to our NHS and I was afraid that it was under severe threat, so I naturally looked to Labour to see what was in their General Election manifesto concerning the NHS. After all, surely the party that is fully behind our NHS would be pushing this to the limit at election time…wouldn’t they?

Well they certainly had the policies:

These were the NHS Promises in Labour’s 2015 Manifesto:

  • We will recruit 8,000 more GPs and 20,000 more nurses.
  • We will pay for this much-needed investment through a Mansion Tax on properties worth more than £2 million, tackling tax avoidance and a levy on tobacco companies.
  • We will guarantee a GP appointment within 48 hours, and on the same day for those who need it.
  • We will guarantee that patients wait no longer than one week for vital cancer tests and results by 2020.
  • We will also create a Cancer Treatments Fund so patients have access to the latest drugs, surgery and radiotherapy.
  • We will repeal the Tories’ Health and Social Care Act.
  • We will stop the drive towards privatisation, and where private companies are involved in providing clinical services we will cap their profits.
  • We will give mental health the same priority as physical health.

Also in ‘speak’ reminiscent of the Five Year Forward View:

  • We will integrate health & care services into a seamless system of whole-person care.
  • We will make sure vulnerable older people, disabled people and those with complex needs get a single point of contact for their care and a personal care plan, designed with them and shaped around their needs.
  • We will prioritise action to improve care quality and patient safety.
  • etc….
    Labour 2015 Manifesto NHS

All pretty good — not perfect by any means and no talk of bringing the NHS back fully into public ownership. There was also no recognition that the politics of austerity were obscuring the true figures and true beneficiaries. But a good start nonetheless and the promise to repeal the Health and Social Care Act was really important. If pushed hard, the NHS promises would have gained many votes.

So why didn’t we hear more about those promises?

The NHS promises were certainly mentioned whenever Labour’s manifesto was discussed, but somehow they then got sidelined.

The promise to invest £2.5 Billion more than the Tories in recruiting more NHS staff was mentioned at hustings, but to me it always appeared to be taken over by opposing claims that Labour hadn’t got their economic figures right. And as far as I could tell, there was scant recognition that £2.5Billion was but a drop in the ocean to what was really required and that this would take a much more assertive NHS plan, which would rely not only on taxing the rich more, but on taking the NHS back fully into public ownership and in changing the way we understood how the economy works in relation to the public sector.

I remember shaking my head in concern when Miliband was questioned again and again on his unwillingness to challenge the austerity model and he was left to say that there was only so much we could do while we were still in so much debt.

But more than that, I remember again and again the NHS getting sidelined while the discussion turned to the minimum wage, cutting the deficit, the 50p top income tax, protecting tax credits and (note: not taking the railways back into public ownership but…) freezing rail fares for one year. And of course there was always that media attention grabber and number one diverter — immigration.

I cannot have been the only Labour supporter yelling at the TV screen “push the discussion to the NHS — Labour is stronger there and we want to hear what you are going to do about it!” But, either the discussion agenda had not allowed for this, or the subject of the NHS was overshadowed by the so-called ‘immigration issue’, or, (as happened more recently when Corbyn held a meeting on the NHS) the NHS issue was deliberately sidelined by those from the media who asked the questions.

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When Labour lost the 2015 General Election it was devastating for our NHS, particularly as we now had a majority Tory government, with several members known already for ‘suggesting’ a future pay-for National Health Service, but I at least hoped that Labour in opposition would put up a strong fight to save the NHS and to put forward a bill to reinstate the NHS. The thought of Labour doing nothing whilst in opposition for 5 years was terrifying.

But of course, with Miliband’s resignatkion, we first had the 2015 Labour Leadership contest to take up Labour’s time.

And of the 4 leadership candidates standing, we had one who supported bringing the NHS back into full public ownership, rather than just tinkering at the edges of the privatisation model being used.

This was part of Jeremy Corbyn’s article on PFIs in the Guardian in August 2015:

“Labour has a duty to remove the PFI burden from the NHS — this really was our mess, and we have to clear it up….
“In opposition we need to campaign for a fund to be set up to bail out NHS trusts from PFI schemes forced upon them. This will save our NHS, rebuild our economic credibility and, most important, save lives.”

See: Labour must clean up the mess it made with PFI, and save the health service.

In other words, get the PFI model out of the NHS so it could no longer drain essential funds and campaign for that while in opposition.

It was a start.

But what about that promise to repeal the Health and Social Care Act? There are ways to get this done whilst in opposition.

Green Party MP, Caroline Lucas, has presented two private member’s bills calling to reinstate the secretary of state’s responsibility for the health of UK citizens. The progress of the first bill presented in March 2015 was halted when Parliament broke up for the summer recess. The second bill brought by Lucas and presented to Parliament in July 2015 was supported by Jeremy Corbyn and John McDonnell (signed when they were Labour back benchers) and the SNP. However, when the bill was read in March 2016, it was ‘talked out’ by Tory MPs. What was also noted was that, despite calls from their constituents and many concerned members of the public, many Labour MPs failed to turn up to the bill’s reading.

We now have a third bill, this time presented by a Labour MP. On 13th July 2016, the NHS Reinstatement Bill was successfully presented in the House of Commons by Margaret Greenwood, Labour MP for Wirral West. A second reading of the bill is scheduled for 4th November 2016.

(See more on the Campaign for the NHS Reinstatement Bill here )

The whole campaign for the NHS Reinstatement Bill has gained many thousands of supporters. We can only hope that this time around all Labour MPs attend the bill’s reading. This is not only essential action to take on behalf of our NHS, it would also gain a huge swell of electoral support if actually presented fully to the general public.

And, apart from the obvious reason that the NHS needs to be back in public ownership and accountability, Labour needs to be fully involved because we are now at the next privatisation stage — STPs — and this time the general public are taking notice.

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“Sustainability and Transformation Plans” — or STPs for short — are meant to detail how each local NHS will deliver Steven’s “5 Year Forward View”. STPs are being drawn up in 44 areas, officially called “footprints”, which cover the whole of England. These plans will set the stage for a major restructure of our health service and hidden within them is the requirement to save billions of pounds (after all, that is also part of Steven’s ‘view’). STPs will mean cuts to services, closure of departments and in some cases whole hospitals, and the amalgamation of services to save money.

Although NHS England have announced that STPs are happening, there were few details of what exactly was occurring and there are no plans to show the STPs to the public until October of this year. They will then be produced as ‘consultation documents’, but by this time it is felt that the plans made will already be in place.

The campaign and petition site, 38 Degrees, published a question and answer page on STPs on 4th August this year called “Is our NHS at risk of cuts? NHS England’s “Sustainability and Transformation Plans” explained.” Thousands have read and shared the page with thousands more. Along with this, 38 Degrees lobbied MPs and the media until the BBC actually took notice.

On 26th August, the BBC News told us that “NHS England have announced sweeping changes to the NHS” and they outlined some of what these changes would mean for all of us. (See more at Wake Up! Our NHS is under its biggest threat since it was founded! ). Within minutes those plans were being discussed all over social media and still form the basis of media articles as I type this piece.

It will be hard to ignore the cuts to A&E departments; the closure of whole hospitals; the amalgamation of already hard-pressed emergency services; the cuts to hospital beds; the cuts to many local outpatient services….

The Labour Party needs to get fully involved in the fight to save our NHS and they need to be doing it now.

  • What the Labour Party should be doing now is campaigning to stop cuts to NHS services and the closure of hospitals and hospital departments.
  • When Parliament returns after the summer break, Labour MPs should be asking questions about STPs at every opportunity.
  • We should see Labour MPs talking in the media, explaining about the NHS changes and what they mean to patients.
  • When Labour politicians talk about the NHS, they must refuse to be sidelined by issues considered more important by media spokespersons. And we must thank those MPs for sticking to their principals over this.
  • Labour should be producing leaflets to inform local communities what is happening to their health and care services and what Labour intends to do to stop what will be ill-thought-out cuts produced under pressure.
  • We should see Labour Politicians and Councillors speaking at NHS rallies alongside other campaigners.
  • We should be seeing Labour MPs and Councillors standing in solidarity on the picket lines when Junior Doctors make their next round of strikes on behalf of patient safety.
  • And we should see a full house in Parliament on 4th November when the NHS Reinstatement Bill gets its second reading.

Anything less will not be good enough. The Labour Party is the party of the NHS and the electorate want to see them in action doing their utmost to save it for them.

So yes, Labour needs to make the NHS top priority and they need to get on with doing so as soon as they possibly can.