This is a discussion document.  It hasn’t been agreed by anyone.  It is part of an attempt to organise our policies and principles.  It isn’t intended to change the policies we have agreed over the last 86 years, but to find a way of describing them concisely and effectively.  Constructive comments are welcome.

Our statement of principles reflects our beliefs. They are not based on evidence. We believe that all human beings are of equal worth and should be treated equally. Others might not agree.

  1. The claims of the individual should be subordinate to social codes that have collective well-being for their aim, irrespective of the extent to which this frustrates individual greed.

  2. Medical treatment and care is a communal responsibility that should be made available to rich and poor alike in accordance with medical need and by no other criteria.

  3. People should be engaged in their own care, and communities should be engaged in the well being of their locality and in democratic control over services.

  4. We want to see a society that recognises the economic and wider determinants of good health and well being and which acts proactively to promote health and well being and eliminate health inequalities with equality of opportunity, affirmative action, and progressive taxation.

  5. Comprehensive and universal health and social care should meet people’s needs. It should be free at the point of use and funded through taxation to meet the physical, mental health and well-being requirements of the community.

  6. Services should prioritise and focus on patient’s clinical and personal needs including prevention, social action and participation in their own care.

From these principles flow some fundamental policies which are based on evidence and experience. They might play out differently in time and space, but they should be the basis of operational policies.

  1. A free Health Service is a triumphant example of the superiority of collective action and public initiative applied to a segment of society where commercial principles are seen at their worst. Competitive consumer markets in health and care do not generally deliver better quality or reduced cost. Individual payment at the time of need leads to over treatment of the rich and under treatment of the poor. Means testing does not get round this problem. Payment systems need to be designed to incentivise benefits to the users of the service, not the delivery of more treatments or services to the benefit of providers.
  2. Health and social care is rationed everywhere and at all times. We want a system where resources are used to their best effect, based on evidence of cost effectiveness. The National Institute for Health and Care Excellence and the sharing of data across the NHS gives us excellent opportunities to assess evidence of effectiveness and to base the direction of services on robust evidence. We need a clinical and allied workforce that fully meets clinical and patients’ needs, with national pay and conditions, engaged, as far as possible, in research and professional development so that the latest evidence and technology is implemented rapidly and threats to health are assessed and dealt with appropriately. Research should be an integral part of service delivery.

  3. The level of resource, both money and staffing, is the responsibility of national government and should be delivered from general taxation. When services are restricted because of lack of resources decisions about the way in which restrictions should be applied are the responsibility of national government and must take into account evidence about different levels of need and different costs in different communities.

  4. The National Health Service has national standards for service delivery quality and outcomes measurement and information about the delivery of these standards should always be freely and transparently available.

  5. Planning and managing the delivery of services should be the responsibility of local communities with democratic involvement. Different services have different catchment areas and different arrangements must be made as a result.

  6. Services for the poor tend to be poor services. We want to see rich and powerful people using the same services as those who are not, so that we all have an incentive to ensure that the services are as good as they can be.

  7. Health and social care systems should be integrated around the people who need them with continuity between different providers linked by shared records. Competition between different service providers is usually an obstacle to this. Prevention should be incentivised above treatment and co-operation above competition.

  8. Danger of abuse in the Health Service is always at the point where private commercialism impinges. We recognise that the NHS has always been a mixture of public and private provision and that this balance generates conflicts of interest which needs to be managed carefully and transparently. Commercial providers may sometimes be able to offer new or better services, or to meet service pressures when there is pressure on capacity, but use of private services should be a local decision made democratically. We oppose any general requirement for the tendering of services. We are happy to see local community based organisations supported to provide services where they are best able to do so. Any provider of services which are publicly funded should be obliged to provide information about the delivery and costs just as public providers have to. Commercial confidentiality has no place in a publicly funded service.

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  1. This is an excellent summary – concise and clear. Its difficult to disagree with any of it – and difficult not to get angry about the fact that successive governments move us further and further away from it.

  2. Paragraph 8 is a reiteration of the neo-liberal agenda of acceptance to more private intervention.

    Quite clearly the idea and as one example; because dental treatment is organised on a private practice system of delivery doesn’t mean that they provide a better service or that it is even economic, that is a political choice not to provide adequate dental services and should be reversed.

    It does seem to me that Martin neither understands the meaning of a comprehensive national health service or is not committed to defend it from the inherent flaws of private sector provision. Martin has consistently peddled the idea that because right wing politicians chose to involve the private sector…. due to the deliberate underfunding policies that create the conditions to enable the private sector to be seen as the great white nights coming to our rescue, instead of the actual reality as the Trojan Horses for more privatisation.

    We are living in the 21st century and as someone born a month after the second world war ended, meaning my parents paid the hospital £7 per week to have me. I have since 1948 grown up with the NHS seen it expand as it should have, to give care from the cradle to the grave, only to be latterly (from 1970 onwards) subverted by Neo-Liberal dogma that only serves the interests of the very rich. That said even Superman couldn’t afford the American private hospital care necessary to keep him alive and fell back on the help of rich acting friends that paid for some of his medical bills.
    In the USA it would cost my parents in the region of £15,000 to have me if I were born today.

    We are now living in a world of rapidly diminishing natural resources, which is not able to sustain the growth of China and India along with all the other developing nations, it should therefore be self explanatory for any thinking person to understand that we must change, but not as the Neo-Liberals want to put all control into the hands of the few, but look at sustainable options to employ people in way that is beneficial to society, our public services can meet and fulfil that objective.

    In short market philosophy never was but even more today, relevant, to meeting the needs of people. We can and should plan a sustainable economy that looks after the needs of people, and quite frankly this is not rocket science and was always the objective of socialists.

    We need to rebuild our NHS and care services, in doing so create real jobs with real wages that will of itself maintain the economy, the same can be said of all our public services.

    I will not repeat the evidence I have previously provided showing that money is not a problem, only Neo-Liberal politicians are, they are dismantling the state and handing our assets over to the private sector, selling the ground from beneath our feet. We have all the money we need to properly fund our public services including the NHS, what we don’t have in power yet is a government with the will to do what the Labour Party achieved after the war ended. Their problems were infinitely greater then than those we have today.

    If people doubt that we have the money to achieve what I say, then ask yourself where did we find £375, 000, 000, 000, to bail out the banks when the whole world banking system had collapsed.

    Or David Cameron when it came to bribing his voters in the Somerset Levels during those floods, where he said “money was no object, they would do whatever was necessary”, (noting that prior to the floods he sacked half the environment agency workers in that area to so say, save money).

    Even our dear Tony Blair said we could not afford to renationalise our railways, then due to the death toll on the rail networks, turned on a sixpence and found the money to nationalise Rail Track.

    So lets stop thinking we need to wait for the mega rich to make up their minds to exploit our talents to make even more money, and start thinking how we use our own money (this country does not need to borrow its own money, that which only the Bank of England can create) to create a civilised society.

    It is possible, but we do have to think about it.

  3. Martin Rathfelder says:

    These principles have not been concocted by me, so don’t blame me for anything you don’t like. But paragraph 8 is largely taken from Bevan’s article, In Place of Fear

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