The Association, or any affiliated organisation, can submit a motion to the Labour Party Conference.  The deadline is 21st September and it’s got to be under 250 words, and adressing a topic which has arisen since 31st July.

We’ve put together a proposed approach to future health policy: Improving the Health of the Nation; a policy for the NHS and its partners, and that underlies these short motions.

Suggested motions are below.  Comments, or better ideas are most welcome.

1. Public Health

Before the General Election Andrew Lansley said that he wanted to be judged on his record in Public Health.  His recent departure is an opportunity to reflect on the sad record of this Government in Public Health.

This Government’s policies are careless of the health of the population.  The attack on the wider welfare state and benefits for sick and disabled people, the assault on security of tenure and failure to build homes, and indifference to rising levels of unemployment are leading to increased levels of mental and physical illness. The mechanisms which help people to cope with stress are being undermined by cuts in funding to local authorities and voluntary organisations. GPs are spending more time dealing with the practical problems of their most vulnerable patients.  Inequalities in health between rich and poor are increasing.

At the same time businesses who make a profit selling unhealthy products are invited to run public health policy. The healthy standards established by Labour for school meals are abandoned. It will be no surprise if this generation of children are the first since 1840 to have shorter lives than their parents.

2. Healthcare

Our advice to the new Secretary of State for Health:

To ensure quality and broadly equitable service provision right across the country, Government must directly own and manage hospital (secondary and tertiary) components of the system;  the NHS locally may choose to use competent private sector clinical skills in clearly defined circumstances, for example where these offer novel services otherwise unavailable, to remedy persisting inadequate standards, or to meet peak service pressures when NHS capacity is not immediately  available. There should be local accountability for the services provided and the outcomes achieved to the community of people using those services and their families.

Market-style behaviours and incentives have limited application in delivering high levels of consistent quality care. Much more important are:

  • Skilled and motivated clinical, support and managerial staff who share the aims and ideals of the NHS and who take responsibility for their own continuous learning and who are themselves well-cared for as staff.
  • The use of regularly updated evidence – based diagnostic, treatment, and rehabilitative care standards and pathways that accommodate patients care choices wherever sensible
  • The engagement of patients and family / carers in the care process as co-producers of health outcomes and the provision of good information to patients to enable them to be actively engaged. Values of known importance to patients such as dignity and respect should be fully demonstrated in every service provided for each patient.

3  Democracy and accountability

The appalling story of the conspiracy to deny responsibility for events in the Hillsborough stadium is only the latest is a long line attempts by wealthy and powerful people to hide wrong doing.  In the NHS there is a long record of reports into the ill treatment of patients who are unable to complain. There is also a shameful record of persecuting staff who are brave enough to speak out.  Reports started in 1967 and the Mid-Staffs report which is expected in October will not be the last.

These scandals in health are the product of a culture where openness and accountability to patients and local communities is proclaimed loudly across every policy document, but the reality is that decision making is centralised, elitist and secretive.  The introduction of more commercial pressures and competition is not going to make this better, but a return to centralised direction is not a solution.

What we want under Labour for the NHS is local democratic accountability.  The only easy way to introduce this is to give elected local authorities more power over decision making in the NHS.  Health and Wellbeing Boards should have the power to veto plans by Clinical Commissioning Groups. But there will be no accountability without openness. The price of taking public money to provide services must be complete transparency. Contracts must not be hidden behind the cloak of commercial confidentiality.

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  1. On the second motion, there are two parts I’d alter:

    I suggest deleting the following clauses, and replacing them with the suggested text underneath.
    “the NHS locally may choose to use competent private sector clinical skills in clearly defined circumstances, for example where these offer novel services otherwise unavailable, to remedy persisting inadequate standards, or to meet peak service pressures when NHS capacity is not immediately available. ”

    replace with:
    “this conference rejects [or is wary of] attempts to introduce private sector provision with the justification of ‘novel services’ or ‘peak service pressures’. Given the context of changing health care needs and NHS budget cuts, conference is concerned that such caveats could give far too much scope for private sector provision to replace properly accountable, publicly owned provision”

    and this bit
    “Market-style behaviours and incentives have limited application in delivering high levels of consistent quality care.”

    replace with “There is no robust evidence market-style behaviours and incentives have any benefit on delivering high levels of consistent quality care. Indeed, an evidence based approach, drawing on the experience of health professionals and patients shows that (outside of carefully stage managed and unsustainably sweetened ‘pilots’), market-based approaches are in fact harmful and damaging to health services, create perverse incentives, and damage the nations health.”

    I’d also like something like:
    “Conference commits itself to protecting and re-invigorating a non-marketised NHS, funded by progressive taxation, as the ultimate expression of social solidarity, and the proudest achievement of any Labour government. Conference rejects any attempts to introduce insurance principles and practices, means testing, increased private provision, or a two-tier service by any other means. The evidence is clear that such attempts are both inefficient and unpopular, and can only be conducted by underhand methods which damage democracy.”

    Or something like that! What do others think?

  2. Clare Bambra says:

    I like the public health one – though you may wish to note rising obesity levels and government indifference.

    In terms of the NHS – I think we should put an explicit cap in – say 5%

  3. Jacky Davis says:

    I dont undestand the point of these motions as they dont call for anything to be done. Surely whats needed is a motion calling for a public statement from Labour about their plans for the NHS when they get back in, in particular how much of the ‘reforms; they will throw out.

    If there is no public committment to reversal of the H&SC Act then the National Health Action party will start to look attractive to Labour voters who are thoroughtly fed up with the betrayal of the NHS, begun sad to say under the last Labour govt

  4. socadmin says:

    Andy Burnham has repeatedly committed the Party to repealing the Act. That’s the easy part. The question is where we go from here. These motions are very limited. No space to elaborate complex positions

    1. Clare Bambra says:

      Labour does need to take a firm stance though – I guess this will come out later though once the policy review process has completed and we move into a manifesto development phase. Ed’s interview in the NS was about predistribution – this is also important for health.

  5. VAL HUDSON says:

    My first thought is the same as Jacky’s especially in relation to the first motion, What are we asking Labour to do? On the second motion I agree with the wording of Caroline Malloy rather than that in the original motion. We need to remember that contemporary motions are incredibly difficult to get accepted, and although one of the suggested policy areas is the NHS I would imagine that there are going to be masses of them. So we either need to try and predict what else is going to come through and hope that ours might be accepted by the CLPs or composited, or we could try and see which other NHS motions are going to be put as CM’s before 21st September. Is anyone in a CLP that has putting a CM on the NHS and what does it look like in relation to the two above? I think repeal will be a favourite

  6. Fiona says:

    Thank you for the opportunity to contribute to this discussion. I agree with the comments above that it should link to a positive action we would like to see and something we would like included in Labour policies nationally and locally – given the roll out of Health and Wellbeing Boards for the public health one it could be about ensuring these are used effectively to tackle public health issues and for the second re-demanding what Andy Burnham has committed to would make sure this is restated. The motions always get media coverage and while this shouldn’t be the primary focus, I’m not convinced voters fully appreciate our position yet.

  7. John Lipetz says:

    The health care motion is far too bland. We need from labour a statement that the party will reestablish a publicly funded, publicly provided and publicly accountable NHS and will immediately on return to government repeal the H & S C Act. They need to produce firm statements now and warn private providers that their contracts will be terminated asap. We should understand how speedily the coalition is implementing the Act. The process of fragmentation and privatisation is going on apace.

  8. Brian Fisher says:

    In the one on democracy, I would like us to add something like.” Community development is a key approach that promotes responsive services, health equalities and health protection. Commissioners should be required to spend a dedicated part of the budget on community development, as in Northern Ireland.”

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