Category Archives: Labour Party

Saving the NHS: Planning our fightback

Few people know that the North West of England can proudly lay claim to be the conception point of our NHS. It was here at the 1934 Labour Party Conference that the party accepted a paper on the creation of a National Health Service by Labour politician, surgeon and founding President of the Socialist Health Association, Somerville Hastings. He was a primary mover in the fight for the NHS from the mid-1930s, and we in the SHA today remain steadfast supporters of the values on which the NHS was founded, the values of the welfare state and the values of Summerville Hastings.

Sommerville Hastings spoke to the Labour programme For Socialism and Peace, at the Labour Party Conference 1934.

This committed the party to the establishment of a State Health Service

To quote the programme:  “Labour proposes to utilise medical discovery to the full in the service of the nation. Labour’s general aim is to provide eventually domiciliary and institutional care to the community as a whole—a State Health Service evolving round a system of up-to-date clinics, with provision for specialist and other forms of treatment. Individual poverty must not be a barrier to the best that medical science can provide.”

70 years on the public are told the NHS is struggling by the Tories and right-leaning think tanks with high media profiles.  We believe that this has nothing to do with our ageing population, nor with the costs of drugs and medical technology as they claim.  A wealthy country like the UK can afford to provide a good health and care service. Like the USA it is increasingly choosing not to. The populace has been trained for decades to think of the economy like children pleading for pocket money for a puppy and being refused as the money is needed (by sensible adults) to put a meal on the table. The evidence shows it is not like that, but far more sophisticated. Money spent on health and care, and on decent terms, training and conditions for staff is money going into, and building, the economy.  It makes more than it spends when looking at the wider picture.

The attack is ideological. Conservatives are using the smokescreen of austerity to form their all-out attack on Labour’s welfare state of which the NHS was the jewel in the crown. Their manoeuvres are, by means of cuts, fragmentation rationing and privatisation. Deficits were artificially engineered, and operations like cataracts, and joint replacements denied. The NHS was split into 44 corporate Integrated Care Systems, and poorer areas have had their funding for health diverted to richer ones – with worse, much worse, to follow.  Watch this space!!!  The NHS is fragmented and no longer national.

And as far as privatisation is concerned, the NHS is now a logo behind which you may unknowingly be using a service contracted out to Virgin or SpecSavers. The whole system is devised and often managed by transnational corporations like McKinsey, Capita and KPMG. As a result of this covert “cultural revolution” billions are wasted on the transaction costs of the Tory NHS market and on the business infrastructure necessary to maintain it. Meanwhile, chronic disease sufferers, older people and maternity patients especially are being enticed to adopt personal health budgets to undermine public sector NHS funding in preparation for linking with health insurance co-payments (for those who can afford them).

Until very recently Labour lacked the political courage to challenge the neoliberal takeover of our NHS. That is until 2017 when the SHA motion to renationalise the NHS was adopted as official Party policy.  The SHA has been at the forefront of the fightback.  We support campaigning organisations in any way we can, but as a think tank, our job is to sweat over the minutiae of the structures by which a socialist government could implement the return of the NHS as a truly world class nationwide system, free at the point of use, according to need, and funded from general taxation. Many of us have a vision that Care also could be nationalised, to fully support our most vulnerable citizens, without milking them of their hard-earned savings and possessions, and with the risks truly spread, like the NHS, via general taxation. It makes financial good sense, as well as being more humane and ethical. Our people deserve no less. It may be a simple sounding vision, but it will need a great deal of thought, hard work and dedication to implement, given the dreadful state of the care system, the increasingly fractured and struggling NHS and the entangled vested interests of privateers and ideologues.

We in the SHA have thousands of people who are experts in their own right as members and supporters, and we encourage them to engage as we work to refine the socialist vision, identify the barriers, and offer detailed and practical solutions to overcome them.  As a long-established part of the Labour movement, we have been meeting regularly with the Shadow Health Team. SHA policies, if they are to be utilised like the vision of Somerville Hastings to build a new and improved NHS which works for the many not the few, will need courage, boldness, hard work from a future labour Shadow Health Team,   and a Secretary of State , who will take full responsibility, and who has the heart to put people, patients and the staff who support them, first. It will also need funding, funding which cannot be allowed to line the pockets of the greedy and unscrupulous.At last year’s Labour conference, we broke through the barrier against NHS renationalisation.

The composite NHS motion, originally drafted by the Socialist Health Association (SHA) and proposed by SHA Chair Alex Scott-Samuel, made it clear that the whole health system is being opened up to corporate interests; This motion committed Labour to actively opposing NHS England’s 5 Year Forward View plan and its accountable (now integrated) care systems. On June 27, Eleanor Smith MP, who has supported our president Professor Allyson Pollock, and Peter Roderick’s NHS Reinstatement Bill, together with Shadow Health secretary Jon Ashworth, signed the NHS Takeback Pledge which is directly derived from the Reinstatement Bill. Labour has aligned itself with the voice of the people.  The SHA has played no small part in this.  We must be vigilant and ensure there is no backtracking or fudging from this commitment.

The SHA believes the fight for the NHS and the soul of our country is between democracy and corporate power. The Socialist Health Association continues to fight for democracy.  We believe that healthcare is a human right, and everyone, regardless of income, class, creed or ethnicity, mental or and physical ability or sexual orientation has a right to access the best quality of healthcare and care. The pooling and sharing of risk on a national basis liberates us from fear of illness. Before the NHS, illness and pregnancy could lead inexorably to poverty, starvation and death. The NHS defined our nation as civilized and caring and has given us 70 years of freedom from fear. We must all work together, as individuals and organisations, to ensure that our children and grandchildren enjoy this same freedom.

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Waiting for Jeremy: Wavertree Chair Alex Scott-Samuel and other invited Merseyside activists on stage awaiting the Leader’s Speech at #Lab18

Note the SHA tee-shirt.

 

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For everyone who couldn’t make the Conference, here is Alison Scouller’s ( Vice Chair ) speech. An audio file is also posted.

Jean Hardiman Smith

Hello Alison Scouller here, sorry I can’t be with you. These are my thoughts to accompany the SHA discussion document before you. We decided to write this policy as part of our wider policy work, as we had no statement of the SHA’s perspective on maternity care.
I’m a retired midwife who worked in hospital, community and latterly as a midwifery lecturer in South Wales. To devise a policy I took inspiration from the Save Liverpool Women’s Hospital campaign’s manifesto for maternity and worked initially with two Welsh members, Billie Hunter, Professor of Midwifery and Gill Boden who is a campaigner for AIMS, and another Midwifery Professor Mavis Kirkham from Sheffield as well as liaising with our secretary Jean Hardiman Smith. Since then we have revised the policy considerably, following suggestions and contributions from Central Council members.
We have taken on board the particular concerns of the Liverpool campaigners in the context of the creeping privatization of the English NHS, but in writing this policy we had to have a policy which is applicable across the UK. Therefore the first paragraph sets this out. .
We decided that the right to access contraception and abortion that should form part of another document about reproductive rights, including fertility treatment, and that here we should focus on care for pregnancy.
As you can see in point 1) we put the importance of addressing poverty centre stage, and the overarching importance of good nutrition from pre to post pregnancy, in fact throughout everyone’s life! We decided not to be too specific on particular public health measures, as our policy has to be applicable in different versions of the NHS and the wider context. We also included the issue of other forms of stress and their detrimental effect on pregnancy outcomes, both in terms of women and babies.
The next 2 points emphasize the importance of those at the centre of maternity care needing to be listened to, whether it’s about their own individual situation or in terms of general observations about how care should be. Planning for care should of course reflect diversity in all communities. In order to address inequalities in society, whilst all should receive the same level of care, extra provision should be there for some, as was recognized by previous Labour Governments in projects such as Sure Start.
We went on to identify issues related to specific stages in pregnancy itself, having covered the pre pregnancy period. In point 6) Antenatal care is clearly crucial to ensure that women are aware of as many aspects of their health as possible, such as family history, normal physiological changes of pregnancy, Body Mass Index , any pathological conditions already present or precipitated by pregnancy, and how these may impact on their pregnancy outcomes. It needs to be accessible as early in pregnancy as needed. It should be as local to women as possible and include at least one home visit, unless the woman does not wish for this, with her named midwife.
When we talk about antenatal education this does not mean in a formal, school type environment but can range from physically meeting in a group setting with a midwife to having education available on CDs, online and via social media. It’s not just about being given information for example about how labour may progress but also learning practical skills to cope with it, such as exercise and relaxation. It’s also about what happens after the birth and coping strategies for parents. The social and support aspects of women and family members meeting with others going through a similar experience are usually the most valued by those enjoying group education. Of course specific needs have to be catered for, so that some women may prefer to attend women only groups and prefer less formal settings.
The evidence for the effects of adverse childhood experiences on people’s ability to be good parents is now quite compelling, hence point 7)
In relation to point 8) We know from research and experience that women’s wishes in relation to place of birth are determined by many factors, and these are very varied. Health care professionals must strive to provide as much evidence based information to enable women and their families to make the right choices for them. All places of birth carry some risks, with home birth and stand alone birth centres there are always concerns about access to ‘back up’ in emergencies. On the other hand there are risks associated with unnecessary intervention (mistimed, inappropriate and even dangerous) in childbirth, both in terms of mortality but also morbidity of mothers and babies I think Lesley page coined the phrase ‘too much too soon, too little too late’ to summarise the problems unfortunately still occurring. The other thing to bear in mind is the importance of antenatal care and education in ensuring safe outcomes. If that care is as it should be, then women at risk of complications are less likely to have poor outcomes because care will have been tailored to mitigate those complications.
Moving on to point 9) we identify the importance of continuity of care. This can be difficult to achieve in cash strapped services but has been consistently shown in research and other feedback to be a key concern for women and promotes positive outcomes.
Finally we put in relation to after birth, points 10) and 11). Physical, emotional and mental health are equally important here. Increasing breastfeeding rates would make a huge difference to children’s health, yet initiation and continuation of breastfeeding rates in the UK remain low. Once again peer support has been shown to be critical to breastfeeding success, as well as support from midwives and health visitors.
In the past, care of women’s mental health has lacked coordination between midwives, health visitors, GPs and community mental health nurses. Equally where babies have been compromised by maternal complications before or during birth and/or being born preterm then neonatal special and intensive care cots should to be available as needed.

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For those who were unable to attend Conference, here is Dr Coral Jones speaking at the conference.

https://www.youtube.com/watch?v=q7oiIeuQfqk&feature=share

Jean Hardiman Smith

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To all members, comrades and friends on behalf of the Officers and Executive:

First, I would like to thank Judith Varley for the tremendous support she gave me at the Conference as a disabled companion. It was extra good having an active and interested SHA member as a plus to our usual allocation of 2. Judith was invaluable in discussions, and in looking around the wider fringes and events at conference. I hope she will have her own tale to tell. Thanks also to my SHA fellow delegate, Coral, who was just great to work with. Missing her already.
SHA had a wonderful presence at the Labour Party Conference this year (2018). There was a slight disappointment from the perspective of the Socialist Health Association in that the Conference focus was on Brexit. In the Women’s Conference our own delegate, Coral Jones, spoke well and persuasively on our motion on the issue of abortion, and how it is still technically a criminal matter. Coral will tell us more about this in her own words. Although the motion was not chosen to go forward, one on Women and the economy being favoured, all was not lost. Coral managed to speak to it eloquently, persuasively, and at some length, at the end of the main Conference, after Central Council member Norma Dudley proposed a reference back to our SHA motion on NHS renationalisation. Norma was speaking on behalf of her CLP, but she mentioned us warmly, and was speaking for us too. I cannot praise her ability highly enough, she is a real asset, like Coral.
I discovered, if I didn’t already know, that there is a wealth of talent amongst SHA women. Even when they were not speaking on the platform, or chairing sessions, they were showing their understanding and passion on health and care issues from the floor. I will try to remember some names, but everyone I heard was amazing, so if is an oversight if you are not mentioned:
Saturday/Sunday: Myself and fellow SHA member Felicity Dowling were speaking at The World transformed on the way forward for the NHS on Sunday. I hope I did us proud, Felicity certainly did. I am hoping she will let us have a copy of what she said to put on our website. Jessica Ormerod, and Nicholas Csergo were present to support us, as were other members and friends. If you read this, please add to the debate, and add your name to the people present. As speakers we didn’t get to take part in the round table discussions, and it would be good to hear about them.
Other members were speaking at, and supporting the Conference fringes and events on Sunday, and I hope Felicity will also let us know about the Women’s March to save the Royal women’s Hospital in Liverpool on Saturday.

Monday: Our first Fringe event was on Women’s Health and was very ably chaired by Central Council member and Chair of Liverpool SHA, Irene Leonard. It was attended by Alex, me, and Andy Thompson and a lot of other members and supporters. It was great to see Andy, Alex, and Nicholas supporting the session on Women’s Health. Of course, it is not just a women’s issue, and their support and friendship is very much appreciated. Our members Jessica Ormerod, Felicity Dowling and another local activist with a great depth of knowledge (Alex can tell us more about her, and I hope we meet up with her again – and recruit her), spoke so eloquently and passionately on the subject, and members of the audience were able to make very knowledgeable and worthwhile contributions. I hope Irene will say a few more words on this session.
Tuesday: Coral, myself and Judith mostly stayed in the Conference, but in the afternoon, Brian Fisher our Vice President arranged a meet up to talk about Care in the Community. Judith and I attended, while Coral and Norma both covered the Conference.
Tuesday Evening: Our second Fringe meeting on care and the renationalisation of the NHS Bill. We were very lucky with this, as MP Emma Dent Coad, who is the MP who ensured Grenfell did not pass unnoticed, and Eleanor Smith, the MP who is supporting the Renationalisation Bill through Parliament were both able to be present for almost the whole of the session. We also had our SHA member Judy Downey, possibly the foremost expert in the country from SHA perspective, and who is honest, and passionate. Last, but not least, Brian Fisher our Vice President spoke well and passionately about the issues, and a truly Socialist solution. I had the honour of chairing, but with a whole roomful of energised, knowledgeable and passionate people, both speakers and audience, it chaired itself. Again, Nicholas and Alex were there to support, as were Norma, Corrie Lowry, another Central council member, and great speaker, and Felicity. Our own Kathrin Thomas was also there in support. We all agreed that we could not let care be relegated to the long grass, as it seems to be in great danger of doing, and I hope we will get the opportunity to work with the MPs again. Gilda Petersen, from HCT, with whom we (SHA via Brian and me) are working on a Conference in November (details to follow) brought leaflets to the meeting room. I hope everyone will support this. It is in Birmingham on the 17th November and will be another chance to hear some wonderful speakers again, meet with new ones, and spend a whole day thinking about these complex issues.

Judy spoke about the privatisation of Liberty and will do so again in November.

Today I collected our material from the stall, and listened to a great speech from Jonathan Ashworth, and, to come full circle, the debates to which Coral and Norma made such a great SHA contribution.

To all members and friends, I won’t know what everyone did, and your contributions are all important. Please send me your information and opinions, so that all voices are heard

Jean Hardiman Smith Secretary and proud SHA delegate

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FINAL DETAILS – PLEASE COME VERY EARLY

Saving the NHS: Planning Our Fightback
Sunday 23rd September, 10.45 – 12.45
organised by Health Campaigns Together and NEON.

Venue: Black E (sometimes described as Liverpool’s third cathedral) at
1 Great George St, Liverpool L1 5EW
http://www.theblack-e.co.uk/content/location

This is part of a series of events, alongside the Labour Party Conference,
organised by The World Transformed.

We plan a lively session that asks participants to think forward and think strategically.
Speakers include John Lister from HCT, Public Matters, National Nurses United, Save Liverpool
Women’s Hospital, Wigan Outsourcing Campaign, Socialist Health Association, Just Treatment.

See you there!

Keith Venables, HCT and George Woods, NEON.

Lastly, ahead of the event we’d really appreciate you helping us promote it and get the word out.

You could retweet the @TWT_NOW tweet here
You could add something like this to the tweet:

‘We’re going to be at the session on a mass movement to save the NHS at @TWT_NOW this year!

Join us to help build a practical plan to defeat privatisation and cuts https://www.facebook.com/event s/289263841860031/

Join and share the Facebook event page here https://www.facebook.com/event s/289263841860031/

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Since the last Labour Party conference, the NHS has remained under immense financial and performance pressure, CCG boardrooms are still thick with talk of transformation and integration, and opinion polling indicates that healthcare remains a top priority for the public. Health is at the core of the Labour promise, so it is no surprise that this year’s conference is teeming with fringe events on health. This article previews the opportunities to hear the latest thinking on health and care, from inside and outside the movement. Main conference fringe listings can be found here, while listings for The World Transformed are here.

Voices from within the system

Both NHS Providers, which represents hospital and ambulance trusts, and the NHS Confederation, which represents both provider and commissioner organisations, are holding fringe events. NHS Providers’ event is intriguingly titled “Targets And The 10 Year NHS Plan – Meet, Reform Or Scrap?”, perhaps reflecting the themes of their recently published blog on the key questions facing the system (Mon 8am, Concourse Room 2, ACC, invitation only).

The Confed, meanwhile, will be asking the somewhat leading question “Does The Labour Party Need Another Nye Bevan Leadership Moment To Plug The Funding Gap In The NHS?” with a top-quality line-up including Jonathan Ashworth, Unison’s Sara Gorton, the co-chair of NHS Clinical Commissioners (the trade body for CCGs), and representatives from the Institute for Fiscal Studies and the Association of the British Pharmaceutical Industry (Mon 10am, Hilton Hotel).

Later the same day, the Confed brings together a panel including the RCN and Health Foundation to discuss NHS workforce planning (Mon 12pm, Novotel), and discusses mental health and local government with Luciana Berger MP, Mind and Mersey Care (Mon 3pm, Novotel). The Confederation’s Chief Executive also speaks alongside the Social Market Foundation and Simplyhealth on health outcomes (Tue 8:30am, Pullman Hotel).

The Academy of Medical Royal Colleges also pulls together a high-profile panel to discuss priorities for health and care investment, again featuring Ashworth, alongside GP leader Prof. Helen Stokes-Lampard and other leading physicians (Mon 2:30pm, Hilton Hotel). The Royal College of GPs is also hosting an evening event, “The Health Debate” (Tue 7:45pm, Meeting Room 7, ACC). The Royal Colleges of Nursing and Midwifery are represented at the Fabian Society’s Health fringe event, titled “Achieving a Better Health and Care Service” (Sun 1pm, Merseyside Maritime Museum)

Social care is well-represented in this year’s fringe. The Socialist Health Association’s own fringe addresses the future of social care and the NHS Renationalisation Bill (Tue 6pm, Quaker Meeting House). Age UK and the British Red Cross are similarly forward-looking, hosting an event titled “Health And Social Care For The Future: Transforming The System Through Person-Centred Care” (Mon 8:30am, Pullman Hotel, invitation only), and Carers UK joined by Barbara Keeley MP for a session examining the role of the family and the state in care (Mon 10am, Concourse Room 2, ACC). Keeley also joins the panel for a fringe organised by the IPPR think-tank and Future Care Capital, a charity and investor in health and social care startups (Mon 12:30pm, Meeting Room 14, ACC), as well as an Age UK and Fabian Society fringe discussing Labour’s wider agenda for older people (Tue 1pm, Merseyside Maritime Museum).

Party Priorities

The conference presents a number of opportunities to hear from the Shadow Health team, starting with Jonathan Ashworth in conversation with the Huffington Post (Sunday, 12:45pm, Concourse Room 2, ACC), and at the Health and Care Forum reception, where he will be joined by the Welsh Government minister for Children, Huw Irranca-Davies (Sunday 7:45pm, Meeting Room 4a). Ashworth joins the RCN and Health Foundation the following day to consider the killer question “How Do You Fix Health And Social Care Without Losing The Next Election?” (Mon 8am, Hall 2 Room 4, ACC), and also features at events arranged by the Confed and the royal colleges, above.

Given Simon Stevens’ recent comments on gambling as a public health issue, the Labour Campaign for Gambling Reform’s event, “Lessons From The Fight Against Fixed Odds Betting Terminals” is very timely (Mon 12:30pm, Hall 2 Room 5). Gambling reform has been a hot topic across the party this year, with prominent campaigners including Tom Watson and Matt Zarb-Cousin putting the pressure on the government over fixed-odds betting terminals.

The Socialist Health Association will be bringing together women’s health experts and campaigners to discuss maternity and the campaign to save Liverpool Women’s Hospital – a vital campaign to preserve a unique hospital (Mon 12:30pm, Quaker Meeting House)

Backbench MPs Luciana Berger and Paul Williams join Progress’ health fringe (Mon 12:45pm, International Slavery Museum), while MPs Julie Cooper and Ben Bradshaw participate in the Fabian Society’s discussion on the future shape of primary care (Mon 1pm, Merseyside Maritime Museum). Berger also sits alongside Shadow Minister for Public Health Sharon Hodgson and representatives from the Northern Health Science Alliance and University of Manchester to discuss regional health inequalities (Tue 12:45pm, Concourse Room 5). Thangam Debbonaire MP and Jeff Smith MP convene a fringe on drug law reform (Tue 5:30pm, Pullman Hotel).

The Labour Campaign for Mental Health have teamed up with the charity YoungMinds (Sunday, 5pm, Hall 2 Room 4, ACC) to discuss the crisis in young people’s mental health, while at the same time Alzheimer’s Research UK and Age UK host Barbara Keeley MP, the shadow minister for mental health and social care, in discussion about dementia (Sunday, 5pm, Concourse Room 2, ACC).

The World Transformed

Now entering its third year, Momentum’s fringe festival is relatively light on health topics, with only three of the sessions centred on health and care. A separate ticket is required for TWT sessions.

The New Economy Organisers Network is increasingly well-known for its systematic and highly-effective approach to campaigning for progressive causes. This year NEON has increased its focus on the NHS, hiring a full-time NHS organiser, so their TWT session planning the fightback won’t be one to miss, especially since it will also feature one of our own members! (Sun 11am, Black-E main space).

Jonathan Ashworth pops up again alongside the New Economics Foundation and Plan C, the anti-authoritarian communist group, talking mental health and capitalism (Mon 5:30pm, Black-E Theatre).

Finally, Global Justice Now and Health Poverty Action take an international tack on health, discussing prospects for a global NHS (Tue 11am, Black-E Theatre).

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The association has been affiliated to the Labour Party nationally since at least 1934, when our President, Somerville Hastings, the first doctor to appear at a Labour Party Conference, proposed the resolution which committed the Party to establish a free National Health Service.

We are one of 20 affiliated socialist societies. We are entitled to send two delegates to the Labour Party national conference, and one delegate to the Women’s and Youth conference. Although we do not require all our members to be in the Labour Party any delegates to any party bodies must be party members, and live in the relevant constituency.

For most purposes the party puts the societies in the same category as the affiliated unions. So at conference our card votes are generally counted with theirs – and are therefore negligible.  The societies meet regularly together, and we have 3 delegates elected by societies to the National Policy Forum and a representative, James Asser, on the National Executive Committee.   Because most of the societies are very small we have for many years agreed to jointly nominate people chosen on the basis of one society one vote.  We are entitled to send an observer to the NPF if we are not among the 3 delegates.

We pay a national affiliation fee of £1.25 per member, £945 last year, which covers the whole UK.

We are entitled to affiliate to regional Labour parties, but they expect us to pay affiliation fees to them which vary between £200 and £50 calculated on a formula which often is based on an assumption that we have a minimum of 1000 members in the region.  That entitles us to attend their conference and there is a place on the regional executive for a socialist society representative. Wales and Scotland operate in a manner analogous to the English regions, and we have to pay additionally to affiliate there. They have their own conferences and policy making structures for devolved matters.  The socialist societies have two gender balanced seats on the Welsh Executive.

Local Campaign Forums exist at what were once called county level and at city level. In principle socialist societies could have a place on these forums.  These cover areas which, more or less, map to NHS health economies in England, so are potentially of interest to us, but their composition does not appear to be nationally mandated.

We are entitled to send up to 5 delegates to each Constituency Labour Party, so long as we have that many members in the constituency unless there is a different basis of representation agreed by the NEC in that constituency.  We have to pay an affiliation fee of £6.  This is significant in constituencies which operate on a delegate structure, but less so in those which operate on all member meetings.

The Association does not have any rights in respect of ward branch Labour parties.

These arrangements may be altered as a result of the party’s Democracy Review.

Labour party constituencies, Labour groups or any other organisations can affiliate to the Association.  The affiliation fee for local organisations  is £25 and for small national organisations £125.  Larger organisations pay a larger fee by agreement.  The benefits of membership, in particular, reduced rates for our events, and inclusion on our mailing lists are extended to any member of an affiliated organisation who wants them.  This currently includes Unison, Unite, GMB, and a number of Constituency Labour Parties and union branches.

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The Labour National Policy Forum was held in Leeds 18- 20th February

Alex Scott Samuel and myself attended the Labour Policy Forum as observers for the SHA.

The commencement of the proceedings was on an internal matter, which meant that an excellent speech by Jeremy Corbyn was delayed, and there was no Q&A session.  As it turned out we had lost so much time we worked through the coffee breaks in our breakout sessions, listening to some excellent ideas, and some which had been in circulation for decades.   Alex and I were particularly interested in local communities and health inequalities, and other health and care related subjects.

Altogether there were 8 headings for the breakout sessions, and a plenary session on health with speakers Jonathan Ashworth, MP Shadow Health Secretary, and Sharon Hodgson MP, Shadow Minister for Public Health.  On Sunday afternoon there was a panel on Brexit.

I have a copy of each of the briefing papers as follows and could send it as a Document if anyone would like to see what the present thinking is. I understand a report will be issued, which I will circulate when received.

International

Health and Social care

Work Pensions and Equality

Housing, Local Government and Transport

Justice and Home Affairs

Environment Energy and Culture

Economy, Business and Trade

Early Years, Education and Skills

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“It’s about including people – as simple as that. Let’s be a shining example of equality in action – it’s what we’re all about isn’t it?!”

The Equality Act 2010 places statutory duties on political parties. It covers:

  • Branches, constituencies, regional and national structures,
  • Staff, officers, candidates, representatives and volunteers,
  • Services to members including meetings, events and campaigns,
  • Political activities, and
  • Positive action.

The duties under the Act are continuing. They are not about doing something once. The duty to make reasonable adjustments for disabled people is anticipatory. It is not about waiting for a disabled person to ask for changes to be made. It’s very important that officers, representatives, volunteers and staff fully understand how they need to function under the Equality Act.

When this document mentions the Party, it means all Party structures, officers, staff, candidates, representatives and volunteers.

All information in the first section of this handbook is taken from guidance provided by the Human Rights and Equalities Commission.

We are indebted to barrister Catherine Casserley of Cloisters Chambers (cloisters, com) for her pro bono work on this document.

Disability Equality ACT Labour (DEAL), formerly the Party Participation and Disabled People Group, is the campaign for Labour Party compliance with the disability elements of the Equality Act 2010.

The Equality Act 2010 and the Labour Party.

The Equality Act makes it unlawful for anyone acting on behalf of the Labour Party (or any political party) to discriminate against people with protected characteristics. Being a disabled person is a protected characteristic. The other characteristics are age, gender reassignment, marriage and civil partnership, race, religion or belief, sex and sexual orientation.

The purposes of the Equality Act can be summarised using the acronym FEAT:

  • Fostering good relations between those with protected characteristics and others.
  • Eliminating discrimination.
  • Advancing equality of opportunities.
  • Tackling prejudice.

The Act preserved the principle of “more favourable treatment” even when it means treating others less favourably. This is unique to disabled people and does not apply to other protected characteristics.

The Party has an obligation to provide reasonable adjustments. If it fails to do so, it is guilty of unlawful discrimination.

It also means the Party must create a comfortable, dignified environment for disabled people. If it fails to do so, it is guilty of harassment. If it fails to do so even when a disabled person isn’t present, it could be guilty of harassment by association.

In addition to the main body of the Act  the following sections apply:

Actions or inactions that result in discrimination against physically disabled people may sometimes be obvious, but that is far from always the case. That is why it’s important to ask people what adjustments they need rather than making assumptions.

Actions or inactions that result in discrimination against people with mental health related impairments or neurological disorders is often about assumed norms within the Party or in wider society. For example, if a branch said that someone could not join, or be a prospective candidate, because they were always late to meetings; and the reason they were late was because their medication made them sluggish in the evenings; and their medication was for a mental health issue, this would be discrimination because of something arising in consequence of disability. This would be discrimination unless the treatment could be justified on other grounds, or the branch did not know that they were disabled.

The Equality Act applies even when Party services, events, campaigns, membership or associate membership are free.

Everyone who is carrying out a function for the Party, including staff, officers, candidates, representatives and volunteer activists, are subject to the Equality Act.

Members of branches, constituencies, regions or national structures cannot override their duties under the Equality Act by voting to act in a way that would put the Party in breach of the Act, or by omitting to do something that would put them in breach of the Act. Chairs of Party structures must rule any such vote results null and void.

Diagram shows a red circle with the Party logo inside. Text in the circle reads: the problems are Party rules, norms and perceptions. Around the outside of the circle are arrows pointing outwards to the issues faced by disabled members in the Party. The issues surround the circle. They are grouped as follows: Rules include: systems, structures, processes, strategies, services, and communication. Perceptions include: assumptions, discrimination, attitudes, disbelief, harassment, stereotyping, prejudice and apathy. Norms include: venues, transport, language, immediacy, the outside, the unknown. At the bottom is a text box that reads: using the Social Model of Disability we see the exclusion disabled members face is caused by the way the Party is run and organised

Discrimination

There are four different types of unlawful discrimination that apply to disability:

Unlawful discrimination can take a number of different forms:

  • The Labour Party must ensure all activities open to members, officers, candidates, councillors or MPs are accessible to disabled members, officers, candidates, councillors or MPs. If they do not, it is direct discrimination.
  • It must not do something to a disabled member in a way that has a worse impact on them and other disabled people than it has on other people. Unless the Party can show that what they have done is objectively justified, this is indirect discrimination. Doing something can include making a decision, or applying a rule or way of doing things.
  • The Labour Party must not treat disabled members in an inferior way because they incorrectly think they are a disabled person.
  • It must not treat disabled members badly or victimise them because they have complained about discrimination or helped someone else complain or done anything to uphold their own or someone else’s equality law rights.

Unlawful discrimination is based on treatment that is meted out because of or related to disability. It is not limited to behaviour, rules or ways of doing things that only impact only on a disabled person. For example, if a non-disabled person, perhaps a personal assistant, carer, family member or supporter, is treated badly because of their association with a disabled person, or because it had been assumed they were a disabled person, they will have been unlawfully discriminated against.

Harassment

Harassment is not only about bullying. Harassment is any conduct that violates a disabled person’s dignity or creates an intimidating, hostile, degrading, humiliating or offensive environment for any disabled person.

Harassment is focussed on the environment the Party creates in branches, constituencies or any Party structure, activity, campaign or meeting. It doesn’t just cover verbal abuse, but it could be, for example, the atmosphere created at a meeting when someone is asking for adjustments.

Harassment is based on treatment that is meted out because of or related to disability. It is not limited to behaviour or conduct directed to any disabled person. For example, if a non-disabled person is in a room and hears such conduct they will have witnessed harassment and ideally, will put in a formal complaint about the incident.

Reasonable adjustments

The duty to make reasonable adjustments is an anticipatory duty. The Labour Party must not wait until a disabled person wants to join or participate in meetings, activities, events or campaigns or stand as a branch or CLP officer or as a candidate. The Party is required to think in advance about what people with a range of impairments might reasonably need, such as people who have a reading impairment, a mental health impairment, a sensory impairment, a neurological impairment, a mobility impairment or a learning disability.

The Party must think about reasonable adjustments for disabled members, associate members, guests, and disabled people who are:

  • seeking or might seek to become members, or
  • likely to become guests.

A continuing duty

The duty to make reasonable adjustments is a continuing duty. It is not something to be considered once and then forgotten.

If a disabled person wants to participate in Party activities, events, campaigns or meetings or stand for office but finds barriers not previously identified, then the Party needs to think about reasonable adjustments. This applies whether or not it has already made any adjustments.

If the Party changes what it does, the way that it does it or where, then it needs to review the adjustments it has made. What was originally a reasonable step to take might no longer be enough.

The Equality Act duty contains three requirements that apply in situations where disabled people would otherwise be placed at a substantial disadvantage compared with people who are not disabled. These are called reasonable adjustments.

Changing the way things are done.

The Party has rules and ways of doing things, both written and unwritten, that can present barriers to disabled people. These barriers put disabled people at substantial disadvantage and even stop some people participating in events, activities, campaigns or meetings altogether.

Making changes to premises.

Where a physical feature puts disabled people at substantial disadvantage, the Party must take reasonable steps to:

  • remove the feature;
  • alter it so that it no longer has that effect;
  • provide a reasonable means of avoiding the feature; or
  • provide a reasonable alternative way of making the service available to disabled people.

It is better for the Party to look at removing or altering the physical feature or finding a way of avoiding it (such as replacing steps with a ramp or, if it is reasonable for it to do this, a lift) before it looks at providing an alternative service. An alternative service may not give disabled people a similar level of service.

Providing aids and services.

These might include:

  • providing equipment like hearing loops,
  • allowing personal assistants or other support staff or volunteers to attend meetings, events and activities with individual disabled people,
  • online meetings,
  • online voting,
  • giving people additional time to think about decisions at meetings,
  • delaying decisions for later online votes,
  • papers in different formats,
  • papers sent out further in advance than usual, or
  • job sharing by elected officers.

The Party must take reasonable steps to provide aids or services if they would enable or make it easier for disabled people to participate in events, activities campaigns or meetings or to stand for election.

Are disabled people at a substantial disadvantage?

The Equality Act defines disabled people as having a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on their ability to do normal daily activities.

The Act covers conditions like dyslexia, sensory impairments, neurological conditions, personality disorders, severe disfigurements, HIV, cancer, multiple sclerosis, depression and anxiety and many more.

What is meant by ‘reasonable’?

When deciding whether an adjustment is reasonable the Labour Party can consider:

  • how effective the change will be in assisting disabled people in general or a particular member;
  • whether it can actually be done;
  • the cost; and
  • the Party’s resources and size.

The Party can consider whether an adjustment is practical. The easier an adjustment is, the more likely it is to be reasonable. However, just because something is difficult doesn’t mean it can’t also be reasonable. If an adjustment costs little or nothing and is not disruptive, it would be reasonable. In deciding if cost is a factor, the Party’s resources must be looked at across the whole organisation. This means, if a branch, constituency or other individual structure can’t afford an adjustment, that cannot be used as a reason not to provide it. It is only if the Party as a whole could not afford an adjustment that cost would come into it.

Who pays for an adjustment?

If an adjustment is reasonable, the Party must pay for it. Disabled people must not be asked to pay for it.

Where councillors, MPs and other elected individuals or staff receive remuneration from the Party to cover administrative and campaigning expenses, the cost of any reasonable adjustments must not form part of that remuneration. This would place disabled representatives or staff at a disadvantage when compared to other representatives or staff and would therefore be discriminatory.

Political activities

The law applies to parties at a national, regional, constituency and local level and to people working for them or making decisions about the party’s membership and activities, whether paid or unpaid.

The Labour Party must not:

  • refuse membership to disabled prospective members or grant membership on less favourable terms because of impairments; or
  • offer membership terms, benefits or services that are discriminatory, whether that is direct or indirect discrimination.

This includes activities that are directly related to political activity, such as meetings, events, activities and campaigns. Conditions put on membership or participation, such as door knocking as a requirement for becoming a candidate, are likely to be discriminatory.

Reasonable adjustments for political activities may include provision of an online option at meetings or allowing extra time for decisions to be taken rather than taking decisions solely at meetings.

Membership

The Labour Party must make reasonable adjustments for disabled people in selection processes, elections to branch and Constituency office and in how members, associate members and guests (and prospective members and guests) access services and enjoy membership benefits and facilities.

The aim of reasonable adjustments is to make sure that disabled people are able to join the Party and participate as far as is reasonably possible to the same standard offered to non-disabled people.

Positive action.

Equality law enables the Labour Party to take positive action for any of the protected characteristics. This means the Party could, for example, have physical or online meetings or ongoing forums specifically for disabled members, specify that Disability Officers become voting members on Executive Committees, employ disabled staff to provide support for disabled members at regional and national level, and require all information and publicity materials be approved by disabled members.

Changes to selection arrangements could include steps the Party takes to:

  • encourage prospective disabled candidates to come forward, for example, by holding an event just for them or writing just to disabled members;
  • increase disabled candidates’ prospects of being selected, for example, by giving public speaking training only to disabled members;
  • identify suitable disabled candidates, for example, by reducing the time disabled people have to have been Party members to be allowed to stand for election;
  • Reserving places on electoral candidates shortlist for disabled members; or
  • having disabled members only electoral candidates shortlists.

Standards of behaviour

Sometimes, how someone behaves is linked to the impairment they have. For example, the behaviour of people with Tourette’s Syndrome or those with Asperger’s, Autism, Borderline Personality Disorder or other mental health or neurological disorders can seem unacceptable or disturbing to those who do not understand these impairments.

Standards of behaviour that have a worse impact on people with a particular impairment than on people who do not have that impairment, must be objectively justified. Otherwise, it is indirect discrimination.

The Party must make reasonable adjustments for standards of behaviour to avoid discrimination arising from a specific impairment.

Monitoring

The Party can decide to monitor the number of disabled members it has, but if the Party asks you about your disability, you do not have to answer if you prefer not to.

When monitoring the number of disabled members the Party has, and the reasonable adjustments that may be required, the Party should include people with physical or learning impairments, chronic illnesses and mental health conditions.

Impairments can be acquired at any stage of a person’s life. The continuing duty means that cyclical disability and reasonable adjustment requirements monitoring is appropriate.

Authors:

  • Kathy Bole
  • Emily Brothers
  • Sarah-Jane Brownlie
  • Catherine Casserley
  • Lesley Farrington
  • Henry Foulds
  • Marta Gave
  • Rory Heap
  • Lorraine Harding
  •  Matthew Luke
  • David R S Martin
  • Craig Potter
  • Nikki Ratcliffe
  • Rachel Salmon
  • Fran Springfield
  • Sophie Talbot
  • Sarah Taylor
  • Rona Lisa Topaz
  • Dave Townsend
  • Ruth White

For Disability Equality ACT Labour.

Campaigning document: It’s our Party – Let us in!

This is our campaigning document proposing ways the Party can improve its disability equality performance.

A circle with a map of the world contains the text: The problem is the disabling world. Arrows point outwards from the circle to the barriers put in the way of people with impairments. The Barriers are: Badly design buildings. Stairs not ramps. No lifts. Special schools. Few sign language interpreters. Discrimination. Inaccessible transport. No parking places. Isolated families. Poor job prospects. A text box at the bottom reads: The Social Model of Disability states that the oppression and exclusion people with impairments face is caused by the way society is run and managed

The Equality Act covers each Labour Party branch and CLP as well as every other Party structure. Party structures must not directly or indirectly discriminate; they must ensure all disabled members are able to participate in decision-making, meetings, events, campaigns, standing for office and other activities.

To comply with the Act, Party structures need to identify their disabled members, ask what reasonable adjustments they require and make those adjustments.

Many disabled members are excluded from Party activities, events and decision ­making processes. Some have experienced branches refusing direct requests to make reasonable adjustments. Further, elected officers of Party structures have argued against making reasonable adjustments such as online participation at meetings, or being accompanied to meetings by a carer or personal assistant who may or may not be a Party member, because they require changes to internal custom and practice.

Party structures are not routinely asking what reasonable adjustments disabled members require. When discussing what comprises a reasonable adjustment, many elected officers of Party structures do not understand the issue beyond basic physical changes like ramps for wheelchair users. Little, if any, attempt is being made to use technology and the internet to enable people to access their right to participate.

Many CLPs do not have a Disability Co-ordinator/Officer and there is no equivalent of Party Women’s and BAME Forums or Youth Labour.

Previous Party guidance has attempted to address the Equality Act duties, but this guidance is not being followed. Previous attempts to correct this situation have not succeeded.

Disability equality training for elected officers in Party structures is not currently a requirement.

To comply with the Act elected officers of all Party structures need to be aware of the legal requirements placed on them, and have a good enough working understanding of the ramifications of those requirements.

In order to tackle stigma, The Labour Party should hold itself to more inclusive standards than current practice in wider society, rather than lagging behind. The authors of this document aim to ensure Labour Party compliance with Equality Act duties, informed by current good practice and past Party guidance, is firmly built into Party rules, guidance, systems and structures. We recognise that the Labour Party, as the party of equality, must take the lead in enabling full participation by disabled members.

Monitoring

The only way to identify what reasonable adjustments we need to make is to ask disabled members what they require. Existing disabled members need to be asked in a one off survey, whilst new disabled members need to be asked as they join. Elected officers of Party structures can find contact details of their disabled members from the Party membership database.

If a request is made to make an adjustment to custom or practice that elected officers do not understand, they will need to go back to the individual making the request to discuss their exact requirements and how they can best be provided. Debating whether these adjustments should be made is inappropriate. Consultation is vital, and no elected officer should act on an assumption that they know what is best for anyone.

Party structures should use the following questionnaire which will be made available in print and online in a format suitable for screen reading software, in plain English and Easy English with images suitable for people with dyslexia or learning difficulties, and as an audio described file:

Your response to this questionnaire will enable us to meet our duties under in the Equality Act 2010. Please complete and return to …

  • Name:
  • Membership number:
  • Do you identify as disabled? Yes/No.
  • Do you have an impairment &/or a long term (physical or mental health) concern which impacts on your day-to-day life? Yes/No.
  • Do you have a disabled family member or friend who you live with or provide some assistance to? Yes/No.
  • Are you satisfied with the way we notify you about meetings, events and other activities?
  • If no, how should we change this?
  • Are you satisfied with the way we provide print and online materials?
  • If no, how would you prefer us to do this?
  • Are you able to understand and participate in meetings, events and other activities?
  • If no, what should we do to change this?
  • Are there any other ways we can enable to you participate?
  • If you would like to make any other comments, please add them here:

Any personal information gathered on an individual will be covered by the General Data Protection Regulations which come into effect in May 2018 or before then, the Data Protection Act, and should be treated as confidential unless otherwise agreed with the individual.

CLP development plans should set specific goals towards achieving equality for disabled people. For example monitoring the number of disabled candidates, venues where access audits have been undertaken or meetings where full online participation has been made available. These goals are quantifiable and can be used to monitor progress periodically.

Disability equality training for elected officers of Party structures.

On being put forward for election all potential elected officers of Party structures should be supplied with Party guidance on compliance with the Equality Act, including these proposals.

After election, all disability officers, chairs, secretaries and delegates to conference should be required to attend disability equality training provided by appropriately experienced disabled members so that they can avoid discriminatory actions, omissions or statements.

An inclusion day, open to all members, should be held each year to provide training and opportunities for debate.

Funding

A National Inclusion Fund to which all CLPs can apply for funding equipment which will enable all members with a disability to be able to access all CLP activities. This may include items such as; hearing loops, paying fora BSL signer to be present at meetings, equipment to privately video-cast meetings. (This list is not exhaustive and is to be used to provide guidance only.)

The Fund to be overseen in each Region by Disability Officers and/or disabled people acting as Disability Ambassadors who will be able to advise constituencies on their duties under the Equality Act 2010.

Disability officers

All CLPs should elect a Disability Officer. CLP Disability Officers should automatically become CLP Executive members. Disability Officers should be respresented regionally, at the National Policy Forum, the NEC and all regional and national party structures.

Service Audits

Elected officers of Party structures to be required to carry out an annual audit of the events, meetings and activities to see how disabled people have been enabled to participate.

Elected officers should use the results of the audits to make legally required reasonable adjustments.

Each Party structure to produce an annual report detailing results of Accessibility Questionnaires, audits and reasonable adjustments that have been, or are planned to be, made. These reports to be made available to all members in print and online in a format suitable for screen reading software, in plain English and Easy English with images suitable for people with dyslexia or learning difficulties, and as an audio described file.

Accountability and transparency

Constituencies to produce annual reports compiled from their branches. These reports to be made available to all members in print and online in a format suitable for screen reading software, in plain English and Easy English with images suitable for people with dyslexia or learning difficulties, and as an audio described file.

The NEC to produce an annual report compiled from CLP reports and reports of all other structures. This report to be made available to all members in print and online in a format suitable for screen reading software, in plain English and Easy English with images suitable for people with dyslexia or learning difficulties, and as an audio described file.

Campaigning

Disability Equality ACT Labour is campaigning internally-within the Labour Party- for change. It is vital that all Party structures comply with their legal obligations at the very least, and quickly.

Campaigning is a key activity of CLPs and the Party as a whole. All campaigning activities must be made inclusive and accessible. A model of inclusive and accessible campaigning needs to be produced and used by all Party structures. There is the resource, talent and skill set within our movement to be innovative in our approach.

Electoral slates

Electoral slates are potentially disciminatory because of the danger of not including openly disabled candidates. Slates can be barriers to disabled members standing, substantially weakening the possibility of disabled members being elected to key positions. Careful thought needs to be given to the equality ramifications of slates.

Complaints

Members’ health and impairments should be taken into account when a member has a complaint about the behaviour of other members. Disabled members are often vulnerable and their health can be severely affected by the complaints process to a greater extent than for other members. Complaints from disabled members should be vigorously investigated and pastoral support be given throughout.

Unacceptable language

Comments like “playing the disabled card” made by members against disabled members should be as unacceptable as “playing the female, racist or LGBTQ+ cards” are.

Loss of income

Disabled members in receipt of benefits put themselves at risk of losing income should they stand for office or as a candidate. The Party needs to address this as a matter of urgency.

A Disabled Members Section.

The Party should actively encourage disabled members to set up a section in the same format as the Women and BAME members.

A firm footing.

When these proposals are bedded into the Party, we will be in a position to use our experience of implementing good practice to strengthen our position on equalities and campaign on a firmer footing.

A circle contains the text: The problem is the disabled person. Arrows point inwards towards the circle from the problems presented by the disabled person. The problems are: Is housebound. Confined to a wheelchair. Can't walk. Can't get up steps. Can't see or hear. Is sick. Is looking for a cure. Has fits. Needs help and carers. A text box at the bottom reads: This is a diagram of the Traditional Medical Model of Disability which the Social Model was developed to challenge

 

© Disability Equality ACT Labour 2018.

Download the full version of the document and  alternative formats from disabilityequalityactlabour.org

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The NHS Accountable Care System contracts announced on 7 August impose a basis for 44+ local health services to replace England’s NHS. This has bypassed Parliamentary debate and due legislative process.

On 9 August, the House of Commons Library revealed a doubling of the number of NHS sites being sold off. 117 of these currently provide clinical services. Like their US templates, Accountable Care Systems will provide limited services on restricted budgets, replacing NHS hospitals with deskilled community units. This will worsen health indicators like the long term increase in life expectancy, stalled since 2010.The Accountable Care Systems and asset sell-off result directly from the 5 Year Forward View  currently being implemented via Sustainability and Transformation Partnerships. The 5 Year Forward View precisely reflects healthcare multinationals’ global policy aims.

Labour opposes Accountable Care Systems. New legal opinion finds Sustainability and Transformation Partnerships lack any legal powers or status under the 2012 Act: yet they seek through bureaucratic means to eliminate or override the already minimal remaining level of local accountability and democratic control over NHS commissioning and provision. They could eliminate remaining statutory powers and rights of local authorities, commissioners and providers. Many of these also outline plans to establish ‘Accountable Care Systems’.

Conference condemns the current Tory NHS pay cap for all staff and the scrapping of the university training bursary for health Students as significant contributors to the current staffing crisis.

Conference welcomes the commitments made in the Labour manifesto to scrap the pay cap for NHS staff.This Conference Calls on our Party to restore our NHS by reversing All privatisation and permanently halting Sustainability and Transformation Partnerships and Accountable Care Systems. Labour is committed to an NHS which is publicly funded, publicly provided and publicly accountable. We therefore call on the Party to oppose and reverse funding cuts meeting Western European levels.

Conference opposes 5 Year Forward View policy:

  • downskilling clinical staff;
  • Tory cuts to the NHS including the Capped Expenditure Process;
  • the sell-off of NHS sites;
  • reclassifying NHS services as means-tested social care;
  • cementing the private sector role as Accountable Care Systems partners and as combined health/social care service providers.
  • replacing 7500 GP surgeries with 1500 “superhubs”.

Conference recognises that reversing this process demands more than amending the 2012 Health & Social Care Act and calls for our next manifesto to include existing Party policy to restore our fully-funded, comprehensive, universal, publicly-provided and owned NHS without user charges, as per the NHS Bill (2016-17).

Conference opposes the Naylor Reports call for a fire-sale of NHS assets and instead resolves that the next Labour government will invest at least £10 billion in the capital needs of the NHS.

Conference therefore calls on all sections of the Party to join with patients, health-workers, trade unions and all other NHS supporters to campaign for:

  • increasing recruitment and training
  • an NHS that is publicly owned, funded, provided and accountable;
  • urgent reductions in waiting-times;
  • adequate funding for all services, including mental health services
  • tackling the causes of ill-health, e.g. austerity, poverty and poor housing, via a properly funded public health programme,
  • reversing privatisation, PFIs and the debts which they entail;
  • reversing private involvement in NHS management and provision;
  • recognition of the continuing vital NHS role of EU nationals;
  • Constructive engagement with NHS staff-organisations
  • rejecting the Tories Sustainability & Transformation Plans as vehicles for cuts in services;
  • urgent reductions in waiting-times;
  • scrapping the Tories’ austerity cap on pay-levels;
  • restoration of NHS student bursaries;
  • excluding NHS from free trade agreements and repeal and reverse the 2012 Act, to reinstate and reintegrate the NHS as a public service, publicly provided, and strengthen democratic accountability.

Conference welcomes Labour’s commitment to making child health a national priority, including investment in children’s and adolescents’ mental health services.

Labour created our NHS. Labour must now defend it

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Membership list

HM Opposition

  • Jonathan Ashworth MP
  • Barbara Keeley MP
  • Justin Madders MP
  • Sharon Hodgson MP

NEC

  • Keith Birch
  • Paddy Lillis
  • Pauline McCarthy
  • Darren Williams

CLPs and Regions

  • Tony Beddow
  • Mark Dempsey
  • Joanne Harding
  • Linda Hobson
  • Donna Hutton
  • Mariam Khan
  • Rory Palmer
  • Karen Reay
  • Joanne Rust
  • Joyce Still
  • Jacqueline Taylor

Affiliates

  • Cheryl Barrott
  • Gail Cartmail
  • Jennifer Elliott
  • Mary Hutchinson
  • Eleanor Smith

Elected Reps

  • Luciana Berger MP
  • Huw David
  • Catherine McKinnell MP

Policy Development

The Health and Care Policy Commission is responsible for developing policy in a number of areas which include the future of the NHS, social care, mental health and public health. The Commission looked at a number of issues this year, including NHS performance and finances, social care and public health. The  NHS workforce, Brexit and the Conservatives’ Sustainability and Transformation Plans were also discussed. Concerns were raised about damaging Government policies relating to the NHS and social care and the negative impact this Government is having on performance, patients and NHS staff.

At Annual Conference 2016, a policy seminar was held with delegates in order to talk about a variety of issues with the Health and Care Policy Commission and members of the shadow health team. Keith Birch (NEC co-convener) chaired the session and gave an update of the work of the policy commission. He also gave a short summary of the work which had been carried out by the Commission over the previous months on their priority issue document, which focussed on
mental health.

Then Shadow Health Secretary, Diane Abbott and Justin Madders, Shadow Health Minister updated delegates on the work of the Health team. Diane shared delegates’ concerns about funding for mental health and high treatment thresholds resulting in people missing out on the care they need. Justin updated delegates about  NHS performance, stressing that Tory failure has led to NHS Trusts struggling to meet some key targets, such as ambulance response times and A&E waiting times. He addressed the challenges facing the NHS workforce, including the Tories’ decision to scrap nurse bursaries, and GP recruitment and retention with delegates.

At the seminar, there was a lively exchange between delegates which encompassed wide ranging topics and views. A number of issues were raised including carers and their pay. Delegates talked about NHS funding and agreed that the NHS cannot be a low-cost service, but needs to be funded adequately in order to meet growing
needs. Other issues examined were the NHS workforce, including concerns about the level of money being spent on agency nurses. Justin Madders agreed with delegates that this is not an effective way of paying for the workforce, that staff should be recruited directly and that the NHS should not be forced to rely on agency nurses to fill gaps. It was clear that many delegates were worried about conditions for NHS staff and were concerned about the status of EU workers in our health and social care system amid concerns that without these workers, the system would be on the verge of collapse.

Delegates were keen to talk about social care and the high levels of delayed discharges from hospital. Another key issue which was raised was the Sustainability and Transformation Plans (STPs), with some delegates concerned that these plans are being decided under the radar and could lead to cuts to services in certain areas. The use of Private Finance Initiatives (PFI) was also raised, as well as how to deal with existing debt. It was noted that regarding the issue of PFI, it is critical to get
things right, and that lessons need to be learnt. Neuroscience, childhood obesity and equality and diversity in the NHS workforce were also raised.

National Policy Forum representatives met in Loughborough on the weekend of 19 and 20 November 2016 to discuss the challenges facing Britain. They attended a number of sessions over the course of the weekend to consider priorities for the consultation process for the coming year and to share views from members received on a wide range of issues. Key issues raised were NHS funding and growing financial deficits in NHS Trusts. Representatives underlined that the sustainability of our NHS depends on adequate funding, and addressing drivers of healthcare spending, especially the crisis in social care and poor public health. Representatives also discussed the social care system, the demands on which they felt had dramatically changed since the system was developed and how the funding system must change to adapt to it. There were also calls for a focus on improving standards in social care for both recipients and staff. Public health was also identified as a key challenge, particularly in the face of cuts to services. There was a general agreement that the prevention agenda should be prioritised and that action should be taken to tackle health inequalities. Mental health, an issue which members have highlighted as a priority through submissions and discussions, was also examined, in particular the funding of services and the lack of services for young people. Following the meeting in November, a document was produced summarising the priorities outlined at the NPF meeting. These priorities formed the basis of the consultation document produced by the Commission and published in March.

The newly constituted Health and Care Commission met for the first time in January. Jonathan Ashworth, Shadow Health Secretary, spoke about the crisis in the NHS, the Government’s failure to meet key performance targets, the pay cap on NHS workers and the impact Brexit could have on the health and social care workforce. Sharon Hodgson, Shadow Public Health Minister focussed her update on three issues: funding, prevention and services. She also spoke about the Government’s childhood obesity plan and the 62 day cancer target. Barbara Keeley, Shadow Cabinet Member for Social Care and Mental Health updated policy commission members on the situation facing social care, including cuts to funding and high levels of delayed transfers of care. She also touched on challenges for the social care system with regard to workforce. She also spoke about mental health, and members of the commission were concerned that Clinical Commissioning Groups (CCGs) are not using funding correctly to support Children and Young Persons mental health. Justin Madders, Shadow Health Minister, gave an update on patient safety, A&E and Sustainability and Transformation Plans (STPs). Workforce issues were also underlined as being key to the challenges faced by services, including the uncertainty of Brexit. Commission members believed that there was a need for a proactive approach to be taken in the run up to winter, rather than waiting for a crisis to happen in our NHS. There were concerns that there is a general lack of transparency when it comes to Sustainability and Transformation Plans and that these need to be scrutinised closely. Pressures in the NHS, including in maternity services, and rationing were also raised as concerns, as well as the risk of losing funding streams from the EU which currently provide funding for health research.

Commission members were keen to stress how NHS and social care are key priorities for the Party and held a dedicated discussion on NHS finances. This had been identified by the NPF and commission members as a key issue for discussion this year. Members considered the fact that the NHS is facing its biggest financial squeeze in history and that that head for head NHS funding will be cut next year. Jonathan Ashworth talked about the Government’s aim to find £22 billion of savings
in the NHS, and also made reference to the £8 billion pledged by the Government, explaining that this figure has been widely discredited and is a misrepresentation of the funding actually going into the NHS in England. There was acknowledgement from Commission members that NHS funding is a key issue which would need to be further explored over the course of meetings and evidence sessions. Over the course of the meeting, some clear themes for further consideration emerged, which included social care, funding of services and public health. The NHS composite adopted at Annual Conference 2016 was tabled at the meeting and members examined
the wide range of issues included in the composite. These included the reversal of NHS bursaries, stopping creeping privatisation in the health service and Labour’s commitment to a publicly owned NHS, free at the point of use.

At the Commission meeting in February, Barbara Keeley led a dedicated session specifically focussing on social care, an issue which has been a priority for the Commission throughout the year and which many submissions have reflected upon. She raised concerns relating to social care funding detailing how the current level of funding is not allowing local government to meet their legal duties in relation to care. There was a general discussion regarding the social care precept and how money is raised for social care as well as carers pay and EU nationals working in the care sector. There was a general agreement that health and social care cannot be looked at separately and that a wider discussion needs to be had on future funding of both. Commission members also raised concerns about the closures of residential and care homes, which are handing contracts back to local authorities.

The meeting also considered the first draft of the consultation paper which focussed on the priority areas of funding, social care and public health, as informed by the National Policy Forum at their meeting in November. Specifically discussed was the importance of recognising differences in health and social care policy in the devolved nations, and members felt that this was something which should be addressed in the consultation document.

The group discussed a number of submissions received including on the NHS Reinstatement Bill and access the NHS for migrants. TTIP and future possible trade deals were also raised, as were issues relating to Brexit and the health and social care workforce.

Shadow Secretary of State Jonathan Ashworth explained that the shadow health team is working hard to keep the NHS and social care prominent on the agenda, including fighting to save NHS bursaries. He also spoke about the work he has been doing to raise awareness of issues faced by children of alcoholics.

In March the Commission held a session with the leading Health charity the King’s Fund, to take evidence about the state of NHS funding and finances. During the meeting representatives tackled a wide range of issues which included deficits, NHS performance, workforce and future  funding of the health service. Commission
members were interested to examine detail about the levels of funding required in the NHS, waste in the system and privatisation. They also asked questions about the internal market in the health system and PFI, and discussed the internal market in the NHS, with particular reference to Wales. During the session, the issue of social care and its funding was discussed in depth and discussions touched on the issue of the Living Wage, which has previously been discussed by the Commission.
The Department of Health budget and workforce issues, such as the fall in GP numbers as well as in applications for nursing, formed part of the discussion. Other topical issues looked at during the course of the meeting were delayed transfers of care, social care in the community and intergenerational fairness. It was also recognised that while the focus on social care is often on older people, we should not forget that it is also important for others, for example those who suffer
from learning disabilities or autism. They also discussed Sustainability and Transformation Plans and agency staff. NHS workforce, pay for NHS workers and Brexit in the context of the NHS and its impact on workforce issues were all raised by Representatives, as was rationing. Sharon Hodgson spoke about the importance of prevention to reduce problems with alcohol, smoking and obesity. The Commission also discussed the Pre-exposure prophylaxis (PrEP) trial, a drug which can protect against HIV infection, which is due to come to an end shortly. Sharon stressed that there was a lack of Government action when it came to the childhood obesity plan.

Barbara Keeley highlighted cuts to social care and that there are 1.2 million people living with unmet care needs. She also said that there is a shortage of mental health beds, meaning that younger people often end up being treated on adult wards. Justin Madders highlighted concerns on NHS pay, and raised questions about the Five Year Forward View refresh being deliverable. The Commission considered a number of submissions which had been received including on charging for GP services.

Labour’s Manifesto

Following the announcement that a snap General Election was to be held, a teleconference meeting of the Health and Care Commission took place to discuss priorities for the manifesto. A number of key issues were outlined during the phone call including on workforce, primary care, prevention of mental health problems and child health. In the run up to the Clause V meeting to agree the manifesto, members were asked to submit their policy priorities to feed into the manifesto process.

Issues of importance outlined were the integration of health and social care systems, increased funding for the NHS and social care, boosting the training and recruitment of health professionals. Members of the Policy Commission also stressed that those health professionals in training should receive the support they need, and supported the view that Labour should pledge to reinstate the NHS bursary which the Tories have scrapped. Ideas and proposals were also received from a wide
range of stakeholders, including charities and third sector organisations. Issues ranged from improving research and development for cancer, investing in general practice and its workforce, tackling obesity and smoking, improving end of life care, and taking action to tackle loneliness.

There were a number of issues relating to the recent work of the Health and Care Commission reflected in the final manifesto. Health has always been, and will remain to be, a key issue for the Labour Party, and the content of the manifesto clearly demonstrated this.

Throughout the year, a key issue which was discussed at meetings and reflected in submissions was the Government’s Sustainability and Transformation Plans (STPs). Members of the Commission were instrumental in raising this issue and key to ensuring that the manifesto committed to halting and reviewing the STPs. They were keen to make sure that local people should be asked to participate in the redrawing of plans with a focus on patient need rather than available finances.

The Commission were keen for the manifesto to tackle issues relating to NHS and social care staff. The document did this, pledging to scrap the NHS pay cap, guarantee the rights of EU staff working in our health and care services, to legislate for safe staffing levels in the NHS and to ensure a proper living wage for care workers – all issues on which the Commission had taken a strong view on over the course of the year. Commission members also highlighted the importance of investing in health visitors and school nurses, and this was reflected in the manifesto with a pledge to increase the number of health visitors and school nurses as
part of a preventative healthcare drive.

Throughout the work of the Commission, NHS and social care funding had been a key area of discussion. We saw these views reflected in the manifesto, through the pledge to provide and extra £8 billion for social care over the course of the Parliament and to provide the NHS with £37 billion in extra investment for the NHS, including £10 billion for infrastructure. Members of the Commission also stressed that public health should be a priority. The manifesto particularly focussed on the health of children, a priority for the Commission, and also pledged to publish a new childhood obesity strategy. The manifesto also committed to improving sexual health services, particularly HIV services. A key issue for the Commission, which was looked at in detail by the Commission both last year and this year, was mental health. Following this the manifesto put forward a number of measures to improve those with mental health problems, promising to reverse damage done by the Tories,
which is particularly hitting services for LGBT and BAME communities, and committing to the ringfencing of mental health budgets.

During the manifesto development process, the Commission also received submissions from a number of specialist organisations and charities about health and social care. For example, working to reduce loneliness in our society, an issue championed by the Jo Cox Foundation.

Commission members were keen for the manifesto to highlight their opposition to the privatisation of the NHS. The manifesto pledged to reverse privatisation and return the health service into expert public control, a key issue for members, pledged to repeal the Health and Social Care Act, make the NHS the preferred provider and to reinstate the powers of the Secretary of State for Health to have overall responsibility for the NHS.

Current Issues

State of the NHS

Since the Tories came to power in 2010, we have seen a marked deterioration in NHS performance across key areas in England. There are now almost four million people in England waiting for treatment, such as hip and knee operations, and 2.5 million people had to wait more than four hours to be seen in A&E departments last year. The Tories have failed to grasp the severity of the situation facing our NHS. They have effectively abandoned both the A&E and waiting time targets, conceding that waiting lists are likely to grow and that hospital Trusts will not be required to meet the four hour A&E target until March 2018.

The financial situation facing the NHS is extremely concerning. Hospital trusts ended the year £800 million in deficit, Clinical Commissioning Groups are being forced to ration services and treatments because they simply do not have sufficient funding and alarmingly, recent reports show that some areas of the country will be forced to make draconian cuts to services over the next year. In addition to this, the Tories have made cuts to infrastructure budgets, leaving our hospitals to crumble. These measures will undoubtedly have an impact on patient care.

At the General Election, Labour put forward a substantial funding package for the NHS in England, pledging to invest £37 billion over the course of the Parliament. The Tories once again failed to recognise the challenges facing our health service, and pledged far less over the course of the next five years. Commission members have
discussed future funding for the NHS on several occasions, and a number of submissions were received on future funding of the health service, including different ways to pay for the NHS in years to come. The Commission will continue to keep the vital issue of funding for health and social care under review going forward.

Workforce

Concerns about the NHS and social care workforce have increased over the last twelve months. Under the Tories, staffing shortages have become the norm. We don’t have enough nurses or midwives, leaving hospital wards dangerously understaffed and patients are struggling to get an appointment with a GP due to a shortfall in general practitioners. The Government’s decision to scrap the NHS bursary has resulted in a 23 per cent fall in the number of applications to become a nurse this year. We have a serious shortage of nurses in the UK, with an estimated 24,000 nurse vacancies. Throughout the course of the Commission’s work, shortages in the non-acute sector were also discussed, as were the impact of public health cuts to the workforce. It was clear from submissions and evidence that this decision will have
damaging consequences for the NHS workforce. Overwhelmingly, people supported reintroducing NHS bursaries, and this policy was included in Labour’s manifesto. Another key issue discussed throughout the course of the Commission’s work was the NHS pay cap. It was felt that this policy, which has been in place since the Tories came to power, is unfair and completely fails to recognise the work carried out by health professionals every day. In the manifesto, Labour pledged to scrap the NHS pay cap and to put pay decisions back into the hands of an independent pay review body. In addition, Labour’s manifesto made a commitment to legislate for safe staffing levels in our NHS in order to protect both patients and staff.

Another factor, which will require ongoing discussion and debate, is the potential impact of Brexit on the NHS and social care workforce. An estimated 130,000 people from other EU countries work in our NHS and social care systems, and the Tories have failed to guarantee their rights following the Brexit vote. Concerns about EU workforce numbers are likely to continue over the coming years, putting yet more strain on our overstretched workforce. Labour has made clear that on day one of a Labour government we will immediately guarantee that all EU nationals currently living in the UK will see no change in their legal status as a result of Brexit, and we will seek reciprocal rights for UK citizens in the EU. The Commission will continue to examine this complex issue over the coming months and years.

Social Care

Under the Tories, we have seen deep cuts to local authority budgets that pay for adult social care; between 2010 and 2015 £4.6 billion was cut from social care, there are now around 1.2 miliion people living with unmet care needs and 400,000 fewer people are receiving state funded social care.

The Commission received a number of submissions about integration of health and social care systems, as well as suggestions about how the system should be funded. Commission members underlined that the social care system had changed dramatically and stressed that there must be changes to the way in which it is funded in order to adapt to an ageing population and changes in the system. Conservative policies on social care announced during the course of the General Election were heavily criticised by politicians and experts across the board, so much so that the Prime Minister was forced to drop her damaging ‘dementia tax’, and explain to the
electorate why she had not chosen to include a cap on care costs in the manifesto.

Labour’s manifesto committed to £8 billion of additional funding for social care over the next Parliament, as well as working towards the establishment of a National Care Service, which would put a maximum limit on lifetime costs, raise the asset threshold at which people would start paying for care and offer free social care at end of life. Recognising the importance of the workforce and unpaid carers in the delivery of social care, the manifesto also committed to increasing the Carer’s
Allowance and to working with councils to end 15 minute care visits and provide care workers with paid travel time, access to training and an option to choose regular hours. Given the complex nature of social care and the ongoing challenges in the sector, the Health and Care Policy Commission will continue to keep this topic under continuous discussion in the future.

The future of our NHS and an end to privatisation

Throughout the course of the Commission’s work this year, it was clear that the future of our National Health Service and its structures is an issue of concern. Labour have repeatedly warned that Tory cuts have left our hospitals crumbling and infrastructure systems dismally insecure. It’s why at the election Labour pledged substantial investment into the NHS. Labour will always fight to keep the NHS free at the point of need and to argue for NHS services to be run by public sector NHS providers.

It was evident from submissions and discussions that people are particularly concerned about privatisation of services, and believe that the NHS should continue to be a universal service, free at the point of need. Submissions were received about the NHS Reinstatement Bill, as well as Private Finance Initiative debt. The manifesto has made the position of the Labour party on NHS privatisation clear: privatisation under a Labour Government would be reversed and we would repeal the Health and Social Care Act, making the NHS the preferred provider. In addition to this, a future Labour Government will reinstate the powers of the Secretary of State for Health to have overall responsibility for the NHS and will introduce a new legal duty to ensure that excess private profits are not made out of the NHS at the expense of
patient care.

The role of privatisation in our health and social care systems will continue to be a key issue for the Commission, particularly when looking at the Government’s ongoing Sustainability and Transformation Plans (STPs). Under the Conservatives’ plans, some local NHS services are at risk of downgrading or closure, and there
are real concerns that these plans are being pushed through without proper scrutiny by local communities. The Commission will also scrutinise the Tory response the Naylor Review of NHS estates which proposes selling NHS land and buildings.

Commission members also stressed the importance of considering how priorities vary in the devolved nations. For example, in Wales integration of health and social care is a key ongoing issue, which the Commission will continue to discuss in future. A priority for Commission members going forward is to ensure that policy differences between England and the devolved nations are discussed fully and to see what can be learnt from different approaches and policies to health and care issues.

Mental Health

The past twelve months have seen rising concerns about mental health services for adults and children alike. Under the Tories mental health funding has been cut, the number of mental health nurses has fallen by 6,600 and mental health budgets have been raided to backfill financial holes elsewhere in the NHS. Child and Adolescent Mental Health Services have shown particular signs of strain with referrals rising, but resources failing to keep pace. Labour’s manifesto promised to ring-fence mental health budgets in order to protect services and ensure that funding makes it to the front line. The manifesto also pledged to invest in early intervention by increasing the proportion of mental health budgets spent on support for children and young people, ending the scandal of children being treated on adult wards and providing
additional funding to ensure every secondary school in England is able to offer counselling services to their pupils. The Health and Care Policy Commission will continue to consider developments in mental health in its future discussions.

Public Health

Public health has been discussed throughout the course of the year at meetings and via submissions received by the Commission. At the National Policy Forum meeting in November, representatives were keen to make public health a priority for further discussion and policy development. The consultation document launched in March looked specifically at future challenges in public health, including prevention of ill health, workforce and funding. Current issues which Labour has successfully influenced over recent weeks and months, such as the such as the inquiry into contaminated blood, the PrEP impact trial and the publication of a Tobacco Control Plan, will continue to be looked at and monitored in future work of the Commission.

Submissions

All submissions received by the Policy Commission are circulated to members ahead of the next meeting for consideration as part of our discussions on policy development. In 2016-17 the Health and Care Policy Commission received and considered submissions on the following topics:

  • A&E services
  • Abortion
  • Abolishing car parking fees
  • Additional voluntary tax for the NHS
  • Agency Staff
  • Attendance allowance
  • Attracting and retaining medical staff
  • Autism
  • Bed shortages and overcrowding
  • Career progression in nursing
  • Computerised Medical Records
  • Coroners
  • Diabetes
  • Diet and Health
  • District nurses
  • Drug free prescriptions
  • End of life care
  • Electroconvulsive therapy
  • Electronic monitoring of NHS stock
  • Free dental treatment, eye care and psychotherapy
  • Funding PrEP on the NHS
  • Gender Identity Clinics
  • Governing Boards representation
  • Government Department for Disabled and Young people
  • Health and Social Care Act 2012
  • Health and social care for the elderly
  • Health insurance for overseas visitors
  • Hospital car parking fees
  • Hospital closures
  • Hospital meals standards
  • Insolvency proceedings
  • Independent NHS funding watchdog
  • Integrating Health and Social Care
  • Junior doctors
  • Loneliness
  • Long term planning in the NHS
  • Markets in the NHS
  • Medical coroners
  • Mental health funding
  • Mental health professionals recruitment
  • Merge health care and social care
  • Merge hospital numbers and national insurance numbers
  • Minimum number of registered nurses per set number of patients
  • National Health Service Transparency Code
  • National NHS holiday
  • National Social Care Service
  • NHS Autonomy
  • NHS Employee Representation
  • NHS Lottery
  • NHS Management Improvement Programme
  • NHS Reinstatement Bill
  • NHS tax funding
  • NHS temporary staff
  • NHS’s ‘ordinarily resident’ tests
  • No bonuses
  • Nutrition and preventative healthcare
  • Parity of esteem
  • Paying for GP appointments
  • PFI debts in NHS budgets
  • Pharmaceuticals
  • Privatisation
  • Publicly owned pharmaceutical and biomedical companies
  • Recruiting more nurses and doctors
  • Research funding
  • Return scheme for former medical professionals
  • Senior managers and directors
  • Sheltered housing
  • Staff recruitment from the EU
  • Standardised, non-intrusive testing for vitamin and autoimmune deficiencies
  • State care homes
  • Sugar Tax
  • Support for care at home
  • Sustainability and Transformation Plans
  • Time limits on drug copyright
  • Top-down targets
  • Transparency
  • Training in mental health first aid
  • Treatment of myalgic encephalomyelitis (ME)
  • Two-tier fertility treatment
  • VAT on private medical costs
  • Vulnerable adults protections
  • Whistle blowing protection policy
  • Work experience for Chief Executives in the NHS
  • Zero-hours contracts
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