Recorded in Wythenshawe Forum with Mike Kane 7th February 2014

Andy: “There is a broader point about cuts in local government.  You are going to be forced to cut all the things that promote good health in the community. Swimming pools, leisure centres, things that keep people healthy, or mentally health – libraries. All the things that help keep people active and involved.”

Medical student: “What I’m scared of, is the appeal of putting different areas out to tender, out to private companies.  What I hear is that there is a ten year plan for Wythenshawe to create a new private maternity centre that’s going to be at the back of the education centre – a private hospital.  So this is the kind of thing that I think we need to make everybody aware of, and see what we can do now to stop it before it gets to a place where even if we get a Labour government back in again we can’t reverse these changes.

Andy: ” The NHS is on a fast track to fragmentation at the moment.  Its just being pushed down that path.  You’ve got more and more people dealing with the same person, haven’t you, and then you get the potential for the kind of problem you’ve described.

As far as I’m concerned the future is integration and collaboration.  The crucial thing I think we want  local government  more in the driving seat on commissioning. We’ve got to make the linkage between the  health services and the  broader determinants of health.  Health and housing, health and planning, health and leisure, health and education.  That’s what a place like this was all about.  That’s why I’m so sad to see the closure of the walk-in centre.  We’ve got to make the linkages between the two rather than having the separate.   I think this current government has shown no leadership at all on public health.  It’s almost like a vacuum on public health.  It’s taken us from opposition to take a clear position on smoking in cars with children. It looks like next week the Commons will pass that. But we were left to do that because the Government didn’t take a view on that.

I think the answer to your question, Martin, is I think we need to have a much bigger ambition for physical activity.  Why? Because sometimes public health can be a bit finger wagging. You know it goes straight to don’t do this, don’t smoke drink don’t eat this, don’t eat that.  and I think we’ve got to give people the keys to their own health. It doesn’t make sense to me that about about a quarter of adults in England are physically active compared to  half the population of Germany, Netherlands, Scandinavia.  For a country that loves sport as much as we do we can do better than that.  The thing that I know is that when you become physically active, the reason why its right to focus on physical activity, is that it then helps you to make other healthier choices.  You tend then to feel more in control and so you probably eat a bit better, you may be drink a bit less, if you are smoking you probably cut down on it.  I have a policy around 50% of the population physically active by 2025.  Because local government have the lead on public health.  They’ve got a delivery system for physical activity in places like this.

The second one though you asked how do we make people healthier in places like this?  I’ve looked at our time in government.  I think we’ve got to go on a similar journey with food and alcohol policy as we did with tobacco. Let’s take food.  The voluntary approach doesn’t seem to be cutting obesity. The content of food products seems to get more dangerous as we go along. What I proposed is maximum fat salt and sugar content in children’s food.   I’m not comfortable with the idea that any child in Wythenshawe sits down to a bowl of food at breakfast time that is 38% sugar. In the end I think that’s going to build in time a healthier population.  The time has come for a bit more leadership on particularly food policy.  You’ll see that from the shadow Health team in the next couple of months.”

Mike Kane: “We need to build a stronger civil society as well. I’m a life long member of Stretford Wheelers. I go out with the lads and girls every couple of week. We go 40 miles in the Cheshire countryside. It’s a voluntary activity. People come together to do that.  We develop leaders. In Chorlton recently they started a running club about 300 people turned up to it and now we have a few of them established across Wythenshawe. From my perspective we need to find those leaders in health.  There are not always state solutions. The state should be there to encourage those people to take responsibility for themselves so that they can bring people together to act on health in their own way”

….

Andy: “I just don’t think we’ll be able to do it in  2020 it will be gone too far. Once the genie is out of the bottle you know its gone and we are getting quite close to that point.  You are right about the EU/US treaty. What that would mean is that if somebody let a contract here and a US health care company said it was done badly they could challenge legally from the States. Then you are in  a completely different world. We’ve got a chance to pull it back out of that in 2015. The Labour Party has got to make a really clear statement about that.  It’s made us confront what we really think about it.

Let me say this to you just so you are in no doubt about it.  I believe  passionately in the public NHS. In what it represents.  There was someone even on our side at times who said it doesn’t matter who provides so long as the service is good.  I actually don’t believe that. I believe   the country benefits from a service which puts people before profits. The NHS is a service where anybody can walk through the door and it basically doesn’t matter who they are or where they are from. It’s what their need is. That is a precious thing.  Its not shareholders or any of that. We’ve got to protect that at all costs. I had a policy as health secretary of NHS as preferred provider and that would remain my policy. Protecting and cherishing the public NHS. You seem to be saying that’s the kind of system you want to work in.   I’m not against a role for others – the voluntary sector or even the private sector – playing a supporting role, but that’s what it should be for me, a supporting role, never a replacement role. That really crystallises the difference between the current government and us. That is the ground on which we will be fighting. Public integrated NHS versus what’s becoming basically a free market,  free for all , a health market.  Because of the way Cameron used the NHS before the last election – he was the biggest friend of the NHS.  I think in the fullness of time his promise of no top-down reorganisation is going to become to Cameron what no rise in tuition fees is to Nick Clegg.  He personally made a commitment on it. He broke it, and people are going to hold him accountable to the damage he has inflicted on the NHS.”

Andy’s interview with the Manchester Evening News

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