an interview with Michael Meacher

Over the last four years Socialism and Health has made a point of interviewing each health spokesperson of the Labour Party to give them a chance to talk about what they see as the priorities in health policy. Our last interview was with Gwyneth Dunwoody who has been succeeded by Michael Meacher. We visited him at the House of Commons in April. This is a summary of that interview.

What do you see as the priorities in health policy for the next Labour government?

Michael Meacher felt it isn’t enough just to talk about how much we spend. In the West we’re getting diminishing returns in terms of age specific mortality and morbidity rates, for increasing expenditure. In such a system there is no point in looking for efficiency by trimming the edges; instead a new approach has to be found. In the area of health the right combination of social and economic policies is crucial. There should be less emphasis on curative technology and more on prevention, health promotion and health education; that is, on changes in our way of life, as the major causes of illness today are all to do with social conditions.

He used the example of an overfed, under exercised person, who smokes and drinks in excess over a prolonged period and is then taken into hospital after a heart attack. Large amounts of money are spent on intensive treatment and care where­upon he or she returns home only to continue the lifestyle which is likely to generate further trouble. “We have got a health service, we’ve got health policies, but we’ve got anti-health social and economic policies.”

Mr. Meacher believed that we will only succeed in producing a significant qualitative improvement in health, and at reducing the incremental costs of doing that, when there is a fundamental change of lifestyle. “It is trying to get across this alternative perspective of health care that I think is our prime task between now and the next election.”

What do you feel the main effects of the last five years of Tory policies have been on the health service, and how do you see it developing in the future?

Michael Meacher focused on two areas. Firstly, the Tories’ claims about their increased  spending on the NHS didn’t stand up when looked at in detail. For example in terms of NHS pay and price increases rather than RPI figures, the increasing numbers of elderly people and the increasing costs of medical technology. He felt that since 1983 there had undoubtedly been a cutback and that this was sure to continue. Secondly, privatisation is going to take a toll. Not only is it ideologically offensive but it also leads to lower standards and lower pay. This is in a service where many people, particularly women, are already paid at exploitative rates. Even discrete medical units may get privatised over the next few years, such as the kidney unit in Wales.

In general Michael Meacher felt that the Tories are using a systematic and comprehensive approach in relation to their objectives and that none of this is good news for patients or the NHS. As a result, the health service is now set for a major fall in standards over the next few years.

How does that tie up with the defensive anti-cuts position that many people are being pushed into?

Michael Meacher felt that these positions weren’t in opposition but rather complementary. While it is essential to oppose the cuts in the context in which they are occurring now — i.e. as part of a general winding down of the NHS — we musn’t assume that what we had in 1979 or 1948 was okay. What is needed is an alternative scenario in which change and renewal of services and hospital stock occurs as part of the development of a better and more appropriate NHS. He reiterated this point by saying “It is not an adequate health policy to simply say that we’re opposed to the cuts and to privatisation and that when we get back in office we’ll restore it all.”

Having mentioned that an alternative perspective is essential in the development of a better health service, what do you see as the ways and means of encouraging prevention and health promotion?

While acknowledging that the opposition of vested interests within industry was fundamentally a power issue, Michael Meacher felt that there was much to be done in arousing public awareness of the issues involved. Dislocation in the food, tobacco and drugs industries would be inevitable if a health perspective was integrated into policies and the immensely powerful capitalist lobbies would indeed be hard to take on. However, if people were aware of the reasons for such a challenge they would be more likely to back policies for change and the chance of success would be much greater.

He felt that people would alter their way of life if they were more informed of the consequences of their lifestyle and knew what changes to make. Taking food as an example, he suggested that the findings of the James Report, which are ex­extremely important but have only really reached health professionals, should be widely advertised to the public on tubes and buses. Effective use of the media and advertising could be useful in spreading such information and keeping people informed about issues which concerned their health.

Michael Meacher has also set up a food policy group, the membership of which includes Professor James, Jeremy Bray, Bob Hughes (from the agricultural side) and himself and Frank Dobson. The aim is to publish a report, within a year, which will state clearly what a food policy intends to do, the reasons why, and good persuasive arguments to influence other people to support it. Such a policy would look for agreement with agriculture and the Treasury and would then be determined to negotiate for change. A Labour Party policy on food is long overdue; once produced, he felt it would be beneficial to liaise with other socialist groups in Europe in order to influence EEC policies.

In addition to the food policy group. Michael Meacher has himself set up seven other working parties. These include an alternative vision of health care, community care — involving prevention and health promotion, democratisation in the NHS, privatisation, health care for women, dentistry and, through the SHA and Harry Daile, he has recently asked a committee to look into ophthalmic services following the recent moves to privatise the optical services.

The formation of these small working partieis is intended to help overcome some of the problems faced by the previous social policy group of the NEC. With a fluctuating membership of between fifty and seventy people, the group spent much of its time making decisions at one meeting only to reverse them again at the next, depending on who turned up. The overall result was that policies were extremely slow to be developed. The new working parties will not be exclusive; papers and oral evidence from nonmembers will be an integral part of their working. Papers will be circulated in the party for modifi­cation and change but will be developed into policy in a far less amateurish and easy going fashion than has hitherto been used.

Why hasn’t the Labour Party had health as a greater priority recently?

Michael Meacher said there had been a bipartisan concensus about the NHS until Thatcher came into office. From now on he assured us it will have a higher profile in the Labour Party.

While admitting that health should have been given more attention in the past, it does now appear from opinion polls that people not only see the health service as an important issue but also as one on which the Labour Party has overwhel­mingly the best policies. Having stumbled on the jewel in our crown again, the Labour Party is going to support it economically and politically.

What do you feel about the Griffiths Report?

Michael Meacher said he felt sceptical to hostile about the report, but thought it had some good bits in it especially in relation to doctors’ power. The main problem is that it will lead to an increased centralisation of power with a much smaller democratic element. Along with plans for the FPCs in which all their members will be appointed, it is going to be much easier for the government to keep the financial lid on the health service by the simple use of administrative power. On the other hand he felt there is something to be said for re­dressing the balance away from the lack of cost and outcome consciousness that can result from unfettered clinical freedom.

How do you feel about the issue of nurses’ pay?

Apart from any other reasons, Michael Meachers sponsorship by COHSE prompted him into enthusiastic support for a fair wage for nurses! Nurses, along with all women workers in the NHS, were paid appallingly low wages and were clearly used to subsidise the health service. He felt that the Pay Review Body should be used to assess and fix nurses pay at a level which would stop them having to fight each year to increase a sub­standard wage. However, Mr. Meacher was realistic in saying that the key factor was finding sufficient funds to make an appropriate pay award. He felt that much could be gained from reducing the rip-offs by the drug companies and the monopoly suppliers, such as BOC and London Rubber Company. Just as important though, he felt there was no way around putting in more resources. The Labour Party was committed at the last election to 3% extra in real terms, but he would like it to be increased to 5%. If were going to put our money where our mouth is, thats the sort of sum its go to be.

During the interview with Michael Meacher, we were impressed by a number of points. First, his ideas seemed very much in line with current ‘progressive thinking about health and health care. Second, unlike many politicians, he welcomed ideas and discussion and was ready to acknowledge his own lack of expertise in specific areas. Third, his response to that was involvement of a wide range of individuals and groups. We felt he was genuinely concerned with the development of alternative perspectives in health care and was keen to work with all those who shared that concern. It seems that Labour Party health policies might in the future be much more respon­sive to the interests and needs of both the users and providers of health care. Hopefully we may now have the opportunity to start bridging the gap which has all too often separated politicians from those they represent.

Graham Bickler & Alison Hadley

July / August 1984

 

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