First as Health Secretary, and then as Shadow Health Secretary, I have given long and careful thought to the future of the NHS and social care in the 21st century.
My answer to the challenges of an ageing society is a National Health & Care Service – bringing social care into the public NHS and creating a single service for the whole person, meeting all of their needs (physical, mental and social).
As Mayor, I would lead the building of the country’s first National Health & Care Service here in Greater Manchester and show the rest of the country that there is a better way than the Tory way. My vision is based on collaboration and integration and a rejection of the fragmentation that comes with the market and privatisation.
While I am optimistic about what we can achieve, I am under no illusions about the scale of the challenge facing our health and care system. A&Es across Greater Manchester are under intense pressure all year round. Mental health services are inadequate. And, with a £115 million deficit in our NHS and on-going cuts to council care budgets, there is a looming financial crisis.
So the risks facing the NHS in Greater Manchester are considerable and we know that, just as they did to the NHS in Wales, the Tories would waste no time in devolving a funding crisis and trying to blame Labour for it.
Given all this, you need to have confidence that the person in charge knows the NHS inside out, have a track record of fighting for it on the national stage and, most importantly, has a clear vision for where it is going. This is what I can offer.
In the last Parliament, as Shadow Health Secretary, I fought the Tory Health and Social Care Act 2012 alongside colleagues from the trade union and the Socialist Health Association here in Greater Manchester culminating with a rally in early 2012 outside Manchester Town Hall. I look forward to working with you again to nullify its most pernicious effects and actively rolling back the privatisation we have seen.
But we need to do more than that and show that fully integrating services is the only route to easing pressure on our hospitals and improving the care we provide to older and vulnerable people. Put simply, it makes no sense to provide sub-standard privatised domiciliary care based on 15-minute visits only to then spend thousands keeping people in hospital. But that is what we are doing. We can’t afford it and it’s not right – the ever-increasing hospitalisation of older people is no answer to the ageing society.
In the 21st century, the home and not the hospital should be the default setting for care. Wherever possible, vulnerable people with complex needs should be supported by a single NHS team providing high-quality, personalised care with the aim of helping them get the most out of life. We need to look at powerful rights for individuals to pull the system towards a person-centred service, with more options for care in the home particularly at the end of life; with family carers supported not ignored; and with equal value placed on people’s mental, physical and social needs.
I would expects each of the 10 boroughs to develop a single commissioning voice and a lead integrated care organisation, bringing care assistants into the NHS structure. I want to end the culture of 15 minute visits and give all staff who care for others the employment status and respect that they deserve.
Unlike the Government’s lip service to parity between physical and mental health, I will work to make it s reality. It is nothing short of a national scandal that, according to the Children’s Commissioner, 40 per cent of North West children referred to mental health services in 2015 were turned away – the second highest figure in the country. As Mayor, I will tell the NHS that any child in Greater Manchester referred to mental health services must be given the support they need.
It is not just mental health services that are often not there when needed. Parents of children with autism often face a monumental battle for support. There can also be long waits for services like speech and language therapy and crucial support like specialist wheelchairs. As Mayor, I will have a clear focus on improving the support for children with special needs. Even though the Tories have abandoned it, I will return Greater Manchester to an “Every Child Matters” approach and commit to GM-wide strategies on disability and autism.
More broadly, we need to set high ambitions for improving public health and reducing the health inequalities that still scar our region.
Sadly, Greater Manchester still tops the league table of poor health. High levels of cardiovascular disease and deaths from preventable cancers give people here some of the shortest life expectancies in the country. And, even within GM, there are huge variations in healthy life expectancy with a 15-year difference between our poorest and most affluent areas.
To tackle these health inequalities, we need to link health policy to the broader determinants of health too – housing, planning, leisure and education. I would have a major focus on improving levels of physical activity across Greater Manchester and believe there is a huge amount we can do to improve our cycling network. I will place a new emphasis on building homes with care and support in mind. In the ageing society, we need to follow the lead of Sweden and start building specially-designed ‘dementia-friendly’ homes as part of a plan to make Greater Manchester the country’s most dementia-friendly city-region.
The Greater Manchester Mayor is the first role that brings together the health policy with other key public services. As such, it represents a huge opportunity to reshape services around the person and a Greater Manchester Model of “Whole Person Care” that in time can influence the rest of the NHS.
But there are huge risks too. The concerns I highlighted when the devolution deal was first struck still stand: there is a danger that the Tories are devolving responsibility without sufficient funding to match and sufficient ability to deviate from their misguided competition policies. But I am ready to put all my passion and knowledge for the NHS to work and show that the Party which created the NHS in the 20th century had got the intellectual capacity to update Bevan’s inspiring vision for this.