We can’t just campaign against the Government.  We need a positive vision as well.  The NHS was pretty good in 2010, but it wasn’t perfect, and Lansley is right when he says the NHS needs to change.  We don’t think the Government’s changes will help.  In fact we think they will, over time, ruin our NHS.

We are in a position to feed into Labour’s health policy for the next General Election, and we want to hear from our members, supporters and critics.

Firstly we don’t think any government has put enough emphasis on primary prevention of illness through healthy living. People who don’t smoke, drink in moderation, take enough exercise and eat enough fruit and veg live on average 16 years longer than people who don’t. We could do a lot more to make it easier to live healthily. But the real problem is economic. There is a fairly steep economic gradient on access to most health determinants – decent housing and good education for a start. As the top 1% have increased their proportion of national wealth our society has become less mobile. The life chances of people at the bottom have hardly improved over the last 20 years. Life expectancy for the rich has increased enormously. For the poor by very little. This cannot be remedied by the application of healthcare – though it has to be acknowledged that poorer people don’t get quite such good service from the NHS as richer people that is a small part of the problem..

The key public health issues we think need to be tackled include:

  •   Wellbeing and mental health
  •  Abuse of drugs, smoking and alcohol
  •   Food policy, especially in relation to children
  •    Transport and exercise
In health and social care it may take some time before we can see clearly what effect the Government’s reforms of the NHS have had, but we think the key issues include:
  •  Social care — the boundary between health and social care, the  personalisation agenda, supported housing andresidential care, and  our response to the Dilnot Commission
  •  The balance between central and local health care and the future of the District General Hospital. Developing community services,   telecare etc.
  • Competition, markets and choice, the role of the private sector, commissioning and the internal market
  • Family support, health visiting and dysfunctional families
  • Integrated care, continuity and primary care
  • Quality standards and regulation, transparency, safety, dignity, whistle blowing,  mortality rates, Hospital acquired infections— and consideration of  the factors which hamper the spread of innovation. This area is going  to be dominated by the fall-out from the Stafford enquiry.
  •  Democratic accountability and patient involvement (both individual  and collective), role of local authorities, Community Development,    central and local decision making
  • Rationing, and the comprehensiveness of health services
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2 Comments

  1. socadmin says:

    I would add ‘Organisation and Management’ as you know I’ve produced a paper on this. John Lipetz

  2. socadmin says:

    – ££££ gap between demand and supply – key issue – John Appleby’s future projections are scary
    – hence managing effectively the increasing demands of dementia/ -OH/ obesity
    – but perhaps more fundamentally demand from people’s expectations more generally? Unholy alliance of politicians’ timidity and people’s often unrealistic expectations that no constraints to be tolerated. This is tricky, of course, politically
    – or demand fuelled by doctors, for which there is good evidence
    – Innovation boosting demand on one hand but also improving efficiency and effectiveness on the other
    > – wide range of variation quality of primary care (KF enquiry demonstrated the highly variable quality but the issue is the power of the medical profession, used very defensively and conservatively so this might be a more political take on the issue)
    – quality of nursing care
    – atrocious quality in many less high profile services, Learning Difficulty / geriatric etc

    Policy Commission needs to come to a view about thorny issues about the inevitably awkward interface between the market (internal or external) and planning; how does the left articulate what is the most efficacious and desirable mix, say between an internal market and planning? I think – contentiously perhaps for some – that commissioning – being clear about the needs and wants – of a given geographic (rather than registered) population, specifying and procuring healthcare on that basis from a range of providers has merit.

    Jane Roberts

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