This is from the Labour Party policy website

Integration

Physical and mental health and social care should be provided by a single, public sector service. This should be operationally managed and delivered by local government, but most policy – and funding – should be defined and set centrally so as to avoid postcode lotteries.

Integration means collaboration and coordination between all services – this has nothing whatsoever to do with ‘integrated care packages’ used by US Insurance companies and HMOs. Health and social care should not in any way involve or require co-payments, top-up fees, user charges or insurance.

Prevention and intervention

Preventive services should always be prioritised. Intervention already receives and will always receive adequate priority, because of the Individualistic way doctors and other health professionals are trained and because of the profit motive.

Health inequalities

Long-term health inequalities can only be tackled by addressing their root causes. There is evidence that when, as is normally the case, only proximal, lifestyle causes like smoking are addressed, there is no long-term impact on health inequalities. To reduce health inequalities it is necessary to directly engage with what have been called the fundamental courses of health inequalities – inequalities in power, prestige, income and wealth, knowledge, and beneficial social connections.

Personalised care

This will only be achieved if all services are part of a single public sector provider. Feedback from patients, relatives and friends should be prioritised and high levels of patient satisfaction, together with good patient outcomes, should be the basis of service objectives, indicators and targets if these are used.

Voice

Health and social care workers and service users often know best how services need to change and improve. Labour’s 1976 NHS initiative ‘participative management’ should be revived and staff at all levels should be represented in management. Community health councils were very popular and should be reintroduced

Integration at the heart of the service

As previously proposed, this is best achieved by having the management and delivery of all services under one public sector organisation – the National Health Service. And it is best reinforced operationally by having performance management of integration-oriented and patient- / user-satisfaction-oriented service objectives, indicators and targets.

Better integration

Better integration looks like coordination and rapid sharing of information between all services in the demonstrable interest of patient care.

Repairing damage

This will be done by returning the health service to the public sector as rapidly as possible. This will obviously involve terminating all external contracts as early as possible and bringing health related professionals back into NHS employment under unified conditions of service. The secretary of state will resume responsibility for the service. Early announcement of these intentions will discourage private providers from bidding for contracts.

Funding

Health and social care should be entirely funded from the public purse. A substantial contribution could come from the defence budget. UK citizens will hopefully prefer a strengthened welfare state to an unnecessary armed forces budget. Once we stop attacking other countries they will stop attacking us.

Reducing inequalities

As previously suggested, the best ways of reducing inequalities address root causes like inequalities in power, status, income and wealth. A good way to commence this task would be a substantial reduction in the very large pay inequalities within the health service. No one needs to earn a six figure salary – this includes both doctors and managers. The resulting reduction in earnings inequalities will similarly reduce power inequalities. A Royal Commission on the NHS would ensure the service achieves everything the public wants in order to make it once again a central element of a welfare society.

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5 Comments

  1. Richard Grimes says:

    “Physical and mental health and social care should be provided by a single, public sector service.”

    I think it is important that these budgets are integrated and that, as a patient, you do not feel you are going from provider to provider. When I had my kitchen replaced I had to have a plumber, an electrician, a plasterer, a tiler and a joiner. All from different companies (well, most were self-employed) which means I had to determine which one to use and I had to schedule them to do their work at the right time. This government thinks that healthcare should be like that: you have to section up healthcare into discrete units, then tender each unit separately. Healthcare is not like replacing your kitchen: care for one condition is affected by care for another. Monitoring and treatment for my retinopathy is connected to monitoring and treatment for my type 1 diabetes: does it make any sense to have two separate providers?

    But can we talk about money?

    “Health and social care should be entirely funded from the public purse.”

    Yes, however, I don’t think any government will announce that they’ll fund NHS care by cutting the military budget: it simply will not happen. However, when the true personal cost of Hunt’s ludicrous plans for social care become apparent (particularly on the “squeezed middle”), there will be a demand for the tax system to be used to ensure that those that can pay should pay via their taxes for the NHS.

    However, Labour needs to re-think the involvement of local authorities. The care budget (physical health, mental health and social care) should be ringfenced. It is not acceptable to have a waiting list for cataracts because there’s no money since some funding has leaked out from the care budget into another area of council spending. I know that some people will argue vigorously that spending money on a cycle path is “health”, but it is unjustified to tell people they can only have one cataract replaced to pay for it. Consequently, there will have to be some ringfencing of the care budget.

  2. Richard Grimes says:

    Oh, one other thing. Have a look at council budgets meetings at the moment. Have a look at how some councils are closing day centres for people with mental or physical disabilities. There are some councils who appear to deliberately target cuts on the most vulnerable in our society. And you want *them* to have control of healthcare budgets?

  3. There is little doubt that we need the Labour Party back in Government asp and the sooner the better before the present Government privatise the NHS, not openly but by devious ways they are so good at. The NHS is the peoples means of receiving what they are, and have been paying for for many years.

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