THE SHA - A WAY FORWARD
2005 - a consultation document
HISTORICAL BACKGROUND
The Socialist Health Association can trace its ideological roots back to 1912 when the State Medical Service Association was established by a Dr Benjamin Moore, a Liverpool physician; and its organisational roots back to 1930 when its lineal antecedent, the Socialist Medical Association, was established by Dr Charles Brook.
The constitution of the new Association was framed with three principal aims:
- To work for a Socialised Medical Service both preventive and curative, free and open to all
- To secure for the people the highest possible standard of health
- To disseminate the principles of socialism within the medical and allied services
And from the start a close relationship with the Labour Party was seen as a sine qua non; and it still is.
The next important milestone came in 1981 when, under the leadership of Dr Cyril Taylor, the Socialist Medical Association transformed from an organisation mainly populated by doctors and others connected with the NHS to one open to all with an interest in seeing socialist principles applied to health and healthcare, namely, the Socialist Health Association that we know today.
OUR MISSION - OR WHAT ARE WE FOR?
In 2003 we proposed that our mission should be as follows:
To promote health and wellbeing, social justice, and the eradication of inequalities through the application of socialist principles to society and government.
This clearly includes the three aims of the SHA as set out in 1930 as well as much more besides. The new ingredient which dominates public health and socialist thinking at the beginning of the third millennium is the reduction and ultimate eradication of inequalities.
And to achieve this MISSION we believe that we need to be an actively campaigning organisation as well as one that supports critical debate about the wide range of issues that comprise health and wellbeing in the third millennium.
And the point about being a campaigning organisation is that we want to make a difference by having influence at the highest level, that is on the government and on the Labour Party as well as on other bodies that influence them such as trade unions; and on other socialist societies.
OUR VALUES AND PRINCIPLES
Underpinning our Mission are a set of core values and principles as follows:
- DEMOCRACY - informed participation with election not selection
- EQUALITY - of opportunity and respect supported by affirmative action
- UNIVERSAL HEALTHCARE - meeting the prevention, treatment, rehabilitation and care needs of all, free at the point of use and funded by general taxation.
- PREVENTION RATHER THAN TREATMENT - emphasis accompanied by investment on prevention of disease rather than on treatment wherever possible
- WIDER DETERMINANTS AS MUCH AS HEALTHCARE - recognition that the wider determinants such as income, education and employment are as important in promoting the nation's health as healthcare
- INTERNATIONALISM - recognition of this country's international obligations to developing nations in respect of trade agreements and the importation of scarce healthcare personnel
- SOLIDARITY - working in close collaboration with other like minded bodies such as trade unions, the other socialist societies and health related bodies such as the UKPHA
- LOCALISM - decisions as near to where they will have their impact as possible and at community level where practicable
- AN INTEGRATED, WHOLE SYSTEMS APPROACH - health, social care and wellbeing services provided through partnership working as integrated packages tailored to the needs of users rather than providers
- COOPERATIVE ENDEAVOUR - a cooperative approach to the running of public services with worker and user participation
OUR AIMS
At its outset the SHA had a predominant aim - the introduction of socialised healthcare in the UK. This really was a big idea in its time and of course it was delivered by the Attlee government in1948.
A limited number of new aims, should be identified to provide continuing focus and direction of travel for SHA. They can be conceived as necessary steps towards achieving our mission. Examples of these might be as :
- ELIMINATING CHILD POVERTY
- SECURING AN ADEQUATELY FUNDED NHS ( at the level of Scandinavian countries)
- SECURING A FAIR DEAL FOR CARERS
- ACHIEVING LOCAL DEMOCRATIC CONTROL OF THE NHS
- DEVELOPING OCCUPATIONAL HEALTH / HEALTH AND WELLBEING IN THE WORKPLACE
- REDUCING INEQUALITIES IN HEALTH
- COMBATING ANTI HEALTH FORCES particularly the food, alcohol and tobacco industries
Inevitably other issues will crop up which, because of their relation to our overall mission and to the aims listed above, will require a response from the SHA. These, what could be termed topical priorities, might include the following current issues:
- ·mental health which is currently under the spotlight because of Parliamentary attention to a proposed new Mental Health Bill.
- ·the English Public Health White Paper
- ·the Diversity and Choice policy in England - are public sector values secure?
- ·the regulation of all clinical staff in the light of the 5th Shipman Enquiry Report (Dame Janet Smith's Report) etc
Such topical priorities would normally be agreed at the AGM as part of the prospective work programme
OUR VISION FOR 2020
Applying our values and principles to the achievement of our Mission and our Aims results in a Vision of Health, Social Care and Wellbeing in the year 2020 as follows:
Healthcare/ NHS
- ·an adequately funded NHS ie public sector revenue funding equivalent to at least 10% of GNP allocated to the NHS
- ·no charges for any NHS services including prescriptions
- a democratically accountable NHS ie NHS Boards at all levels elected by universal franchise preferably on a specific health ticket, and coterminous with local authorities
- General Practice provided predominantly by salaried primary care doctors
- a salary range for NHS employees of not more than fivefold
- social partnership developed within the NHS with active worker participation in the management and governance of the Service
- a comprehensive occupational health service for all NHS staff
- major increase in capital funding for NHS provided from the public purse and possibly from publicly subscribed NHS Bonds with PFI discontinued
- Community Health Councils ( in Wales and Scotland) empowered and adequately resourced to represent community interests and values effectively
- public health function transferred back to local government
- unified management of health and social care services involving transfer of social care functions to a democratically governed NHS or vice versa.
- health and social care funded by an identified hypothecated tax to promote ownership and accountability
- reconstitution and redefinition of professional regulatory bodies such as the General Medical Council to have majority lay representation and to focus primarily on performance and standards of practice ie accreditation and re accreditation
- separation of political control of the NHS and the Public Health function ie Minister of Public Health to be located in DETR or Cabinet Office, not in Department of Health
- major expansion of NHS rehabilitation services
- complete separation of private practice from the NHS and promotion of whole time NHS consultant contracts with no private practice allowed
- quality assured information on health and healthcare readily accessible to all in hard copy and electronic forms; and further development of Health Direct concept
- maximum devolution of responsibility for healthcare to regional, area and neighbourhood levels ie a moving away from the single monolithic national blue print model but with retention of national standards
Health
- ·establishment of local health partnerships for coordinating action on health with community sector taking the lead
- adoption of policy of healthy public policy making with health impact assessment universally applied
- restructuring of local government in England to create a universal pattern of unitary authorities as in Wales and Scotland
- development of co-terminosity between the health service "units" or multiples of "units" and local government
General
- Child poverty abolished using generally accepted measures to assess this
- general income redistribution via graduated progressive taxation
- · social security benefits and the minimum wage to be geared to measured minimum needs such as the LCA - low cost but acceptable - standards with regular updating
- inner city use of private cars to be restricted to those unable to use public transport eg disabled people
- promotion of the cooperative model of private, voluntary and public enterprise