We are asked our members for ideas about what they thought would constitute a Socialist Health Policy, now we are allowed to discuss such a possibility.  This is a list of the issues they raised – not approved by anyone – which will feed into our discussions.  More ideas welcome!

Public health and prevention

  • The Marmot agenda especially the importance of the early years
  • Put the public health perspective in all the  work of all departments of local and national government.   All policies from whatever ministry must have a public health impact assessment.
  • Sort out food manufacturers .Taxation of sugary drinks and food – VAT on sugar
  • Further measures to reduce smoking. Steadily raise the age at which people can buy tobacco. Schools to monitor smoking.
  • Unit pricing of alcohol
  • Sound public health nutrition, with affordable nutritious food being made available to all
  • Air pollution, both outside and inside buildings
  • An active travel strategy
  • Funding and staffing of public health
  • Reunite Public Health England with the public health departments around the country
  • Climate change
  • Children should learn basic anatomy and physiology, about mental health and diet, and have encouragement and opportunities to play safely outdoors as well as a variety of sports and exposure to natural (wild) areas

Social care

  • Social work and social care
  • Converting the health/social care split into a community/personalised split
  • Eradicating means-testing and reducing private practice and other inequities
  • Personal budgets

Health care

  • The dominance of pharmaceutical companies
  • Stress and mental health in young people
  • Dentistry and eye services
  • Thinking more broadly about how the welfare state, including the NHS, might fit into constitutional reforms
  • Driving up innovation and the use of local community capacity (and exploring the proper role – if any – of private finance)
  • Personal budgets for health and social care
  • a Royal Commission into the costs/savings to be had from improving Mental Health provision across the board with an eye on the crime, prison population, ASBOs and the assorted machinery of ‘justice’ used to ‘manage’ so many of the afflicted.

NHS

  • Exploring how a radically localised NHS might work
  • Bring NHS Trusts Boards into the local democratic process. Members could be elected at the same time as elections to local council
  • Acknowledge the problem of the NHS financial crisis
  • Generic prescribing
  • Hospital food to be managed by dieticians.
  • What parity of esteem for mental health services really means
  • Change the tariff structure so there are no trusts forced to provide loss-making services.
  • Change the way we pay for new medicines. Instead of paying £X, pay £0.5X up front and then the remainder for collection of real world audit data proving the drug has done its job (or otherwise).
  • Alter rules for medical trials with respect to repurposing old drugs.
  • Move more GP’s and their services into hospitals so people simply know to go to their hospital and get triaged to the right service. A reframing so we get “Better healthcare closer to where people seem to want it to be”
  • Repeal the 1990s Act that exempts VAT on outsourced NHS services
  • Abolish Public Dividend Capital
  • Freedom of Information on all contracts

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4 Comments

  1. JohnWattis@aol.com says:

    Explore the role of Social Enterprises in providing localised services. See the very innovative NAViGO CIC (http://navigocare.co.uk/) for a successful example providing mental health and other services in N E Lincs

  2. "A Nutritionist" says:

    “Hospital food should be managed by nutritionists'”
    ‘Dietician’ is a protected title and indicates both proper training and the existence of a Regulatory body. Anyone can call themselves a ‘nutritionist’, and many random, unqualified, and frankly strange, people do. There is no sense in replacing dieticians with ‘nutritionists’ in hospitals, and much possible harm.

    1. Martin Rathfelder says:

      I don’t think the person who suggested this knew the difference.

  3. Terri Eynon says:

    “Move more GP’s and their services into hospitals so people simply know to go to their hospital and get triaged to the right service.”

    Sorry, no. Can’t go along with this. Have you any idea how mad this sounds outside London? Most people in rural and semi-rural areas want the complete opposite.

    They want more services in their GP practice so they don’t have to drive miles to a city hospital (and park…). We are having a dialysis suite put into our surgery for the people of Hinckley and Bosworth. Colleagues in the villages nearby are doing minor operations.

    It also misunderstands completely the role of General Practice. We still see most of the patients and manage most of them without needing to refer to hospital at all, ever.

    I agree we need to blur the primary-secondary care boundary. I need to have a geriatrician on my team who can help me care for the hundreds of frail elderly patients my surgery looks after in their own home and in residential care. I need to be able to do that without admitting them to hospital.

    Labour has been too hospital-centric and metropolitan in its approach to health. It also sees healthcare through the lens of the relatively healthy person who has a one-off health condition such as a sprained ankle or heart attack.

    The health care crisis we are facing is not due to these patients. Even when the worried well do ‘clog-up’ A&E with their coughs, colds and minor injuries, they are a doddle to deal with.

    The real crisis is due to our failure to tackle the multi-morbid patient who has Diabetes, Emphysema, Angina, Arthritis etc and who is now so frail a simple urine infection causes a catastrophic collapse requiring urgent care.

    These are the people who get stuck in A&E for hours. Every hour a frail person spends in A&E adds days to their length of stay once admitted. Every day they spend in hospital adds to their dependency on discharge. The difficulty of finding a care package big enough delays their discharge further. Cuts to social care are adding to the risk of readmissions and so the vicious circle revolves again.

    Sending GPs to work in hospital is solving the wrong problem. Think again, please.

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