Category Archives: Your Britain

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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Selected health amendments endorsed at Labour’s National Policy Forum in Milton Keynes 18-20 July 2014. This report is not comprehensive. A set of fully amended documents will be available on the Labour Party’s Your Britain website.  Each paragraph is a separate amendment. Only the most significant are included. They will be cobbled together into a coherent narrative, but that is not what we have at the moment.

Labour’s commitment to equality

Labour is the Party of equality. We believe that no person should suffer discrimination or a lack of opportunity because of their gender, gender identity, age, disability, race, religion, socio-economic status or sexual orientation. In government, every decision we take will be taken with that in mind. We will ensure the policies across these eight documents and in our manifesto will be implemented ensuring that they further rather than hinder this cause.

Labour has always led the fight for equality, but our fight is not yet won. We will not rest until everyone can live their lives free from hatred, fear and oppression. In government we will work to remove the structural and social barriers that stand in our way.

Car Parking

We also recognise that car parking charges have an impact on people’s ability to access and work in our health service, excessive charges clash with the founding values of the NHS, that the service should be free at the point of need. A survey by Macmillan Cancer Trust showed that the families of cancer victims could face parking charges of more than £400 per year that places real strain on families. Labour notes recent hikes in hospital car parking charges, which have added to the cost of living crisis facing families. Labour will undertake a review with a view to ensure a fair system of charging.

Carers

Across the UK there are 6.5 million unpaid carers of which many receive no financial support of any kind, and this number is expected to rise to 9 million over the next 25 years.

Labour believes that local authorities must be provided with the support required to ensure that carer’s needs are identified and assessed with appropriate assistance provided. In doing so this will help unpaid carers across the country, providing them with support that will in turn increase their quality of life and that of those they care for.

Commissioning

Health and Wellbeing Boards will have a central role in the commissioning process for people with long-term conditions, disability and frailty – people whose care is often most fragmented and who are heavy users of health and care services. The Health and Wellbeing Board would be responsible for creating a local collective commissioning plan for this group of people – within a nationally defined outcome framework for the development of whole-person care – with a duty of CCGs and Local Authorities to enact the collective commissioning plan.

In caring for those with complex needs, where local partners in communities want to move to a single budget for health and social care, or Joint Ventures, and have the capability to do so, the legislative framework should allow this to happen.

Competition and Markets

The NHS is the most important creation of the Labour movement – free at the point of need to embody our collective identity and the duties we owe to one another. We will ensure it remains rooted in the values that underpinned its creation – cooperation not privatisation and fragmentation. In a planned and collaborative system, Labour will reintroduce the NHS as the preferred provider so that NHS services do not needlessly face the threat of competition and destabilisation.

Repealing the Act will ensure that the Secretary of State has a duty to provide a comprehensive national service which is free at the point of need, that private patients are not put before NHS patients, and that the conflicts of interest the Act created are tackled. We will also ensure that the Secretary of State is able to give directions to the NHS. Labour will break down barriers that prevent or deter co-operation. Labour will take competition law out of the NHS by ending Monitor’s role as an economic competition regulator and by scrapping the Section 75 regulations that force services to be put out to tender.

By contrast, the Government’s free market approach has seen competition used to break up successful NHS services. Some studies have shown that marketised healthcare systems have worse health inequalities and higher costs, and in some situations marketization can lead to poorer quality care, for example higher hospitalisation rates. In a planned and collaborative system Labour will reintroduce the NHS as the preferred provider so that NHS services do not needlessly face the threat of competition and destabilisation. Labour’s commitment to the whole person care agenda will progressively reduce the purchaser provider split across the NHS, enabling local providers to determine how quality services should be delivered within the scope of a national framework. All Trusts – Foundation, NHS and Community Trusts – will need to be accountable to the public and operate within a collaborative and integrated system not a free market free for all. To support this, the mixed economy of Trusts and Foundation Trusts will need to be reviewed so that all service providers are fully integrated to deliver the whole-person care agenda in a collaborative, not competitive, way, and fully accountable to the public. Where additional services funded by the NHS (e.g. from the not for profit sector) they must work in close partnership with the NHS and terms and conditions of staff and public accountability must be prioritised to ensure we achieve high standards in care and terms and conditions. As part of this process we will review the effectiveness of the current TUPE legislation and make improvements where necessary. Labour recognises there is a role for the third sector and a limited role for independent sector organisations in providing health and care services where there are gaps in delivery, or where the NHS is unable to provide a high quality service.

Meaningful choice is about the type of service that is provided and the way that service is delivered not which organisation is delivering it. As a result a Labour Government will abolish the damaging and overwhelming market system of “any qualified providers” that does nothing to provide real choice to patients. Instead of relying on a narrow form of choice, Labour will create a national entitlement, written into the NHS Constitution, to ensure that patients get legal rights to access to the services they need.

In 2003 the previous Labour government established Foundation Trust Hospitals in England with the aim of making hospital services more accountable to local communities by giving Trust members a real say over their running. Ten years on the consensus is that, whilst more than 2 million people are members of Foundation Trusts, the model has not achieved its full potential and there is a need to re-awaken the original ambition behind it. One Nation Labour believes in more ‘people-powered’ public services and so a future Labour Government will consider ways of strengthening the role of members within Foundation Trusts and work to better engage and involve NHS staff in Trust membership.

Health and Care Workforce Conditions

Labour will restore the collection of Race Equality and ethnicity data as part of the specific duty on employment for public authorities bound by the general Public Sector Equality Duty. |Labour will develop a framework of action to tackle discrimination in the workforce of the NHS; measures to eradicate institutional racism in the workforce and to remove the ‘glass ceiling’ for workers from BAME communities.

Labour will continue to support the excellent work carried out by health unions and strengthen and support the collective bargaining structures in the NHS. As part of this Labour will work towards a fairer system of pay setting that allows all parties a fair and informed process on pay determination. Labour would also commit to better supporting the social care workforce and ensuring that the integration of health and social care services never sees terms and conditions being levelled down, instead spreading the good practice in the NHS to social care; and we will investigate and consider the longer term goal of being able to bring care workers within Agenda for Change in line with the Kingsmill Report

Social care workers carry out some of the most important work in society, caring for the sick, elderly and the disabled. Yet the current care crisis is seeing the work they do being increasingly undervalued. As well as the work being physically and emotionally demanding and often undertaken in social hours, there is strong evidence of exploitation in the care sector. This is something which Labour will strive to put right, including by tackling the abuse of zero hours contracts. Labour is committed to strengthening the enforcement of the National Minimum Wage and incentivising employers to pay the Living Wage, because we recognise that care workers are playing an invaluable role in meeting one of the greatest challenges we face as a society, and deserve to earn a decent living and be recognised for their work in caring for our most vulnerable loved ones some councils are already commissioning care providers to pay the living wage and this is a model that should be explored more widely. This is why Baroness Kingsmill has carried out a review of how to better understand and tackle exploitation in the care sector.

Integration

Our vision of whole-person care recognises that the integration of services will deepen over time and that through both the restoration of a truly national health service through repealing the Health and Social Care Act and a strengthened national entitlement of services to be provided and patient rights, written into the NHS constitution, the postcode lottery will be minimised. Models of delivery should be developed from a strong evidence base of clinical and social effectiveness. This is about re-shaping the way care is delivered within communities and reducing health inequalities, and not another top-down structural reorganisation.

Local Authority Responsibilities

Greater localism of services should be a priority for future developments of the NHS. The transfer of Public Health responsibilities to Local Authorities has shown that this can have a beneficial impact, helping to deal with local priorities and local problems. There should however be an overarching framework to ensure that issues of post code lotteries do not dominate.

Mental Health and Equalities

Taking part in community activity is a vital way of protecting and improving mental health. The NHS support the growth of local voluntary and community groups as a whole, cooperating with the other services which have a mutual interest in this. We will ensure that health agencies play an active part in community development, with the clear objective of strengthening the role of the community and voluntary sector in relation to health. Labour will ensure all health and social care providers are compliant with the equalities act. It is also important that mental health providers are compliant with the Equalities Act.

NHS agencies and providers will therefore be expected to play their part in ensuring that every locality has a thriving third sector. NHS organisations will be expected to take an active part in neighbourhood partnerships and to encourage users and carers groups to do so. We will encourage firms to involve employees in businesses so that job control is increased. In other countries, such as Germany, workers councils are commons place in businesses.

Labour recognises the link between unemployment and mental illnesses especially depression. Labour will ensure that mental health patients have equal treatment and resources as patients with physical illnesses. To ensure that mental health patient waiting times are reduced and that the distances travelled to access those services should not be excessive, Labour should take steps to introduce waiting time and access standards for mental health services.

Local Authority Health and Wellbeing Boards should be informed by Mental Health and Wellbeing Strategies ensuring preventative as well as curative services and interventions.

The needs of children with mental ill health are currently poorly addressed, with limited services provided. A future Labour Government will ensure that o this area of child health care will be properly resourced and that children needing mental health care will have their needs prioritised at the same level as those suffering from physical conditions.

Labour recognise that failings in the provision of mental health care for BAME communities remain inadequate. Labour will put in place measures to improve the delivery of mental health care for BAME communities and in particular treatment, care and services for patients on psychiatric wards and services for young Black males

NHS Funding

We want to see a community in which power, wealth and opportunity are in the hands of the many not the few and where the rights we enjoy reflect the duties we owe. This will not happen in an unhealthy society where wealth is primarily inherited and the benefits of economic growth go to those who are already rich. Labour’s long-term goal is to break the link between a person’s social class and their health. We will work across government, using the power and influence of all government departments and agencies, to achieve this.

Labour will develop new funding mechanisms for health and social care providers based on delivering quality, equitable and integrated services and incentivising health promotion and preventative care, rather than simply on volumes of episodic treatment. The Government has taken NHS funding away from deprived areas, hitting communities and risking an increase in health inequalities. Labour is committed to investing to improve primary care access, with a particular focus on tackling the health challenges of need and deprivation.

The last Labour Government successfully brought UK health spending in line to that of other comparator economies after nearly two decades of Tory neglect. The Coalition’s ideological cuts agenda is now reversing that trend. This is not acceptable. The next Labour government will guarantee that health care is publicly funded through progressive means at levels that sustain it as a world leading public service. Funding will be redirected into service provision and will build on the last Labour Government’s levels of funding. On social care the starting point is that the status quo, including the government’s version of the Dilnot reforms, is no longer an option. Social care has never benefitted from a universal contributory system of funding and yet is intrinsically linked to health care. Funding within health will be redirected into service provision to ensure that it is spent to maximum effect.

Outsourcing

Alongside changes to protect the NHS from future privatisation, we will ensure all outsourced contracts for services, including under the Health and Social Care Act 2012, are properly managed to ensure they are meeting clinical and financial standards. Where contracted services are failing, we will consider all the options, including bringing them back into the public sector. Future contracting decisions will be based on what contributes to integration through the whole person care agenda.

Labour will also insure that existing and future procurement projects for public infrastructure and services are scrutinised and action taken to ensure they deliver best value for money for the taxpayer and the NHS, learning from past experience, using contractural flexibility to the full and making sure that charges are not at the expense of patient care or appropriate terms and conditions for staff.

PFI

Labour will also ensure that procurement models for public infrastructure and services deliver value for money for the tax payer and the NHS, learning from past experience, using contractual flexibility to the full, and making sure that they are not at the expense of appropriate terms and conditions for staff.

Primary Care

As part of the next Labour Government’s plan to improve services for patients and ease the pressure on hospitals, the next Labour Government will give all NHS patients the right to a same-day consultation with their local GP surgery, the right a GP appointment at their surgery within 48 hours or the right to book an appointment more than 48 hours ahead with the GP of their choice. To help ease pressures and support the delivery of these new standards, we will invest an extra £100 million a year in general practice, funded by savings made from scrapping the Government’s new competition rules which have led to increased costs in the NHS, and from cutting back on the new bureaucracy created in the Government’s NHS reorganisation. The last Labour Government increased GP numbers to record levels, but numbers have fallen since 2009/10 and the Government is far off meeting its stated goal of 3,250 training places a year. So GP recruitment will be a priority for Labour, including through promoting general practice as a career choice, supporting GP returners back to work and encouraging recruitment in under-doctored areas.

General Practice is under pressure through squeezed budgets, falling recruitment and new commitments from greater involvement in commissioning. It is important that General Practice is able to serve patients, improve access and outcomes. Labour will work with GPs to improve GP registration, including in hard to reach groups. NHS Walk-in Centres have played a vital and successful role in enabling people to access care and reliving pressure on A&E. We have been clear that it is short-sighted to close walk in centres. So it is a huge concern that a quarter of walk-in centres have been closed since 2010. Labour continues to support Walk-in centres. Where they are well used and valued, they should be retained. Labour will review the impact that closures of walk-in centres have had on people’s ability to access primary care services.

Public Health

Given that there is public demand for both high standards of health and social care, and for low taxes, governments should take a strong approach in promoting healthy living to reduce NHS expenditure and increase quality of life and healthy life expectancy. To that end, Labour will introduce initiatives and measures to reduce; smoking and excessive alcohol consumption; excessive sugar, salt and fat in food; food fraud, and air pollution.

The Government’s ‘Responsibility Deal’ has lost credibility as professional bodies have withdrawn from it due to the domination of the agenda by commercial interests. Commercial interests are not necessarily aligned with the aim of improving population health, and excessive consumption of foods high in sugar, salt and fat can have a significant negative impact on the health of citizens and consequently create demands on the Health Service. The growth of chronic illness such as Type 2 Diabetes serves to illustrate this point.

We will make healthy choices easier by encouraging affordable healthy products such as fresh fruit and vegetables while taking action to help people avoid the excessive consumption of unhealthy products high in fat (including trans fats), salt and sugar, including through regulation where appropriate. We will ensure that the quantity of sugar, salt and fat in manufactured food is easily apparent to customers wherever it is sold.

We will also take action to tackle supermarkets selling dangerous quantities of low-cost alcohol that fuel binge drinking and harm health, and further action to help young people not take up smoking.

Labour will work to eliminate inequalities in providing public health information to ensure improvements in service delivery benefit BAME communities.

Reconfigurations

We will reverse the introduction in the care Bill of sweeping powers to force changes to services across an entire region without proper public consultation. We will also extend freedom of information legislation to cover all organisations delivering public service contracts, including the private sector. On coming into office, we will be clear that service changes and reconfigurations should be clinically driven, not financially driven.

Regulation of private care agencies

Labour will ensure more effective regulation of public and private health care providers. We will review progress on the ‘certificate of fundamental care’, recommended by the “Review of healthcare assistants and support workers in NHS and Social Care” to see if further steps should be taken.

Regulation of therapists

Labour strongly believe that being LGBT is not an illness and it should never be treated as something which is curable, which is why we believe public money should never be spent on ‘conversion or cure’ therapies. Labour will ensure that existing safeguards are strengthened to prevent this from happening and will examine the effectiveness of the current system of regulation. Labour will work with the professional bodies to ensure that publically funded services enforce the Equalities Act 2010.

Social Care

The current eligibility criteria for social care are often interpreted according to available resources locally, often rendering them meaningless. National minimum eligibility criteria must be used to set a baseline giving everyone the right to be kept safe and well. Beyond this, Labour will work with key interests to agree the standard of wellbeing and independent living for older and disabled people, in line with the UN convention (on the rights of persons with disabilities) that our society should aspire to, and to help inform future spending priorities.

A One Nation Labour government will seek to ensure that no on fears their old age or struggles to cope with the care of a loved orv&.21st century care service that is integrated with the NHS and focused on the person being cared for must be underpinned by professional standards, regulation enshrined in law and a trained and valued workforce on fair pay, terms and conditions, and represented through a sectoral body. We cannott ask our system and workforce to do more for less as our elderly population increases and demand for care rises. Such a system would be as transformative as the introduction if the NHS for those who need care, their families and care workers across the country – that majority of whom are women.

…operating from the starting point that the status quo, including the government’s version of the Dilnot reforms, is no longer an option. Various ways of supporting and funding improved care must be considered. Bureaucratic and misleading Resource Allocation Systems used by councils should be reformed, with personal budgets becoming optional as part of a new focus on making personalisation meaningful

Transatlantic Trade and Investment Partners

Labour share the concerns that have been raised about the impact that TTIP could have on public services. Labour believes that the NHS and all public services need to be more, not less, integrated and we are concerned that including public services in the final TTIP could increase the fragmentation of health services that is already taking place under this Government, That is why we believe that the NHS and public services should not be included in any TTIP agreement.

Labour believes that key to an EU US trade deal that we would encourage the rest of Europe to support, which avoids a race to the bottom and promotes decent jobs and growth would be safeguards and progress on labour, environmental and health and safety standards.

Labour has raised concerns over the inclusion of an ISDS mechanism in TTIP. Labour believes that the right of governments to legislate for legitimate public policy objectives should be protected effectively in any dispute resolution mechanisms.

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These are the amendments submitted by the Labour Party Disabled Members Group to the Labour Party policy process

Work and Business:

Page 7 line 45 add at end:

“Disability harassment is a particular problem for disabled people at work, and we will legislate to outlaw bullying and harassment in the workplace, introduce a Dignity at Work Act, and reinstate the third party harassment aspects of the Equality Act 2010 to protect people who are harassed by members of the public while at work.”

“Labour will introduce:

  • A statutory right to disability leave to challenge abuse of sickness absence to get rid of disabled workers; extension of the employment provisions of the Equality Act 2010 to protect volunteers to assist disabled people gain experience;
  • restoration of the third party harassment and multiple identity provisions of the Equality Act 2010 and the power of tribunals to make recommendations in order to require employers to change their policies;
  • a review of the operation of the Equality Act 2010 with a view to strengthening it to prevent employer avoidance; a strengthened public sector equality duty and its extension to cover all employers;
  • enshrine the status and rights of workplace equalities representatives in law;
  • a further significant increase in funding for Access to Work and far greater publicity of its availability, to be combined with a programme of promotion to employers and broadening the criteria of what it can fund.

Programmes for disabled people are working to a one-size-fits-all approach to disability. A flexible approach is needed individually tailored to the needs of the disabled person.”

Page 11 delete lines 34-37, insert:

The majority of disabled people who are able to work want to do so. There are a number of disabled people whose impairments militate against them carrying out paid employment. This must be recognised. A new test is needed to replace the Work Capability Assessment. This should be based on the social model of disability. It needs to ensure that only suitably qualified persons carry out the assessments. It needs to be able to reflect fluctuating conditions, especially but not only mental health, and other “invisible” impairments. It must also respect evidence from GPs, consultants and other healthcare professionals. The replacement for the work capability assessment should be designed in collaboration with representatives of disabled people’s organisations, and disabled people.

Page 11 line 6 add at end:

Labour will ensure there is a non means tested benefit to meet the additional costs faced by disabled people, and place them on a level playing field with non-disabled people but pending the design of the new benefit Labour will immediately revert to the 50-metre distance test in respect of the higher rate mobility component of PIP. In designing the new benefit Labour will replace DLA/PIP with a Disability Costs Allowance and will consider introducing a third element to assist people to meet the general costs of disability.  Disabled people and organisations representing disabled people will have a role in the process of assessment for the benefit and in evaluating the assessment process. There should be a disabled person on each tribunal considering appeals where award of the benefit has been refused. Atos should not be given any right to carry out the assessment, and should be removed from the existing contract to carry out assessments for the personal independence payment without compensation. The assessment must be accessible, fair and transparent, carried out by NHS workers, must use evidence obtained from GPs, consultants and other healthcare professionals, use existing assessment data held for people’s entitlement to disability living allowance where held, entitle a recipient of DLA automatically to PIP and be carried out once to result in a lifetime award unless the impact of a condition worsens. There should be no cap on the budget for the benefit, so that all disabled people who meet the criteria receive the benefit. Savings from introducing a universal set of assessment criteria to standardise and eliminate continuous and often conflicting assessments and from carrying out once-in-a-lifetime assessments must be reinvested in personal independence payment or in a replacement for PIP.  Designing a replacement for DLA/PIP is one way of reducing the poverty faced by disabled people who have faced a disproportionate share of the cuts from the Tory Government.  We therefore welcome the report of the Disability and Poverty Taskforce produced in April 2014 and an incoming Labour Government will work with disabled people and their organisations to examine how its recommendations can be taken forward.”

Better Politics

Page 8 line 22 add at end

Add at the end: “as well as promoting positive attitudes on equality issues amongst people of all ages.  During the lifetime of a Labour Government elected in 2015 we will carry out a review of the effectiveness of the Equality Act 2010 and pass legislation to implement the results of the review and make any necessary improvements to the Equality Act 2010 before the 2020 General Election.”

Page 9 line 40 insert at end:

“We will ensure that Levenson’s Recommendations 11 and 38 are fully implemented to ensure that false or inaccurate portrayal of disabled people in the media is challengeable and prevented. We will also introduce a new criminal offence of incitement to disability hatred and implement the recommendations of the Equality and Human Rights Commission’s Report ‘Out in the Open.”
“Many British people use British Sign Language as a first language and recognition is a key issue for inclusion and equality for deaf people. Achieving legal status for British Sign Language as a minority language in the UK is essential to achieving this, as is the right of deaf children to be educated in a bilingual and bicultural environment, ensuring access for deaf people to information and services via video relay services, promoting learning and high quality of British Sign language in all schools, and ensuring staff working with deaf people can communicate effectively in BSL. The Labour party will consult with the deaf community on a regular basis.”

“Disabled people are forced to undergo an array of tests and assessments to determine qualification for benefits, services and credits. Labour will introduce a universal set of criteria to standardise and eliminate continuous and often conflicting assessments. Such a scheme will include qualification for ESA, PIP, Access to Work, tax credits, council care and support packages, Blue Badges, Freedom Passes, Taxi cards etc. There should be a once-only test leading to a lifetime award unless the impact of a condition worsens.”

“Labour would fully apply rights to which disabled people are entitled under the UN Convention on the Rights of Persons with Disabilities, which to date have been applied partially and which have been undermined by benefit cuts.  The first formal review of the UK’s compliance by the UN is due to be completed in spring 2015 and a Labour Government would take on board the recommendations of the review.”

Education and Children

(also supported by the Socialist Educational Association)

Page 11, line 3 after the sentence ending “Children and Families Bill.” insert:

“Under a Labour Government there would be a strong presumption in favor of inclusion in mainstream education for disabled children with special educational needs with the necessary support and safeguards. The previous Labour Government committed under Article 24 of the UN Convention on the Rights of Persons with Disabilities to “continuing to develop an inclusive education system” and Labour will therefore repeal Section 39 of the Children and Families Act 2014 which allows children to be placed in a special academy or special free school without an education, health and care plan and a national minimum standard would be set for the “local offer” introduced by the Act.   To make this a reality disabled learners would receive the necessary individualised support by reinstating individual education plans removed by the latest revised draft of the SEN Code of Practice and maintaining well trained and qualified headteachers, teachers and teaching assistants. SENCOS would hold an appropriate SENCO qualification and be members of the school’s senior management team. Reasonable adjustments would be made to all mainstream course curricula, examinations (including the reinstatement of continuous assessment) and assessments to make them accessible for disabled learners.  There would also be a requirement for all new, upgraded and rebuilt education establishments to be fully accessible for disabled people and Labour would look to find ways of improving disabled access to existing school buildings. Disabled headteachers, teachers and teaching assistants are positive role models in schools and would be supported in qualifying for, entering and staying in the profession.  All education professionals and staff would receive disability equality training as part of initial training and continues professional development. Equality training would become a compulsory part of the national curriculum and cover all “protected characteristics” under the Equality Act 2010 and there would be compulsory reports on discriminatory bullying incidents also covering “all protected characteristics” to school governing bodies.”

Health and Care

Social Care: Page 8  line 18 In Section entitled – The future of social care.

After second paragraph add:-

“Labour believes that it is time to accept that social care should be placed on the same basis as health care; cover for all, contributed to by all and free at the point of need. The case for all care being free is the same as the original case for free health care.   Labour will work towards delivering on the aspiration of free care, building on the Care Bill provisions, which extend social free care to some.

Policies which take away the independence of the disabled and cause deteriorating health as a consequence are costly and cruel.  An incoming Labour Government will not implement the current Government’s proposals to end the Independent Living Fund (ILF) in June 2015 and will instead initiate a full review of disabled people’s independent living. As part of that review Labour will look to use National and local government purchasing power to drive down prices of disability related equipment and services, including insurance. Labour will also look at ways of reducing the cost of social care for disabled people and their local authorities without reducing the quality of services delivered.”

Living Standards and Sustainability

Transport (also supported by SERA) Page 6. Line 40:

Many disabled people are dependent on public transport to meet their mobility needs. The privatisation of most public transport, coupled with the local authority cuts, leading to reduced subsidies to public transport services, has worsened an already unacceptable situation for disabled people. Provision of services is now, frequently, both wholly inadequate and prohibitively expensive. Labour will move towards public ownership of the public transport system, its expansion, full integration and rational planning.

Labour was disappointed in the failure of the Government to accept the recommendations from the Transport Select Committee on making public transport accessible for disabled people.  Labour will work in partnership with disabled people’s organisations, including “the Disabled Persons Transport Advisory Committee”, which Labour is proud to have saved from Government proposals to shut it down, to make public transport more accessible for disabled people.  Priorities will include making sure that pedestrian environment is accessible to disabled people, a phased introduction of a requirement for all buses to have audio and visual announcements and finding innovative ways of increasing the pace at which national rail stations are made accessible. It is shameful that the Government cut the Access for All Fund designed to improve disabled access to railway stations by 42% despite the fact that less than 20% of national rail stations have step free access.

All public transport should be free to disabled people and their accompanying carers without time of day restrictions. Until that is achieved train operating companies will be encouraged to offer Disabled Persons Railcard discounts to holders of disabled persons concessionary fare passes.

Labour will introduce a specific legal duty on all providers of public transport to provide a service that meets the needs of disabled people, not just through physical accessibility of the various modes of public transport but also by timetabling that ensures adequate mobility opportunities for disabled people.

Energy (also supported by SERA) Page 7, line 29: after the sentence ending with the words “to compare prices” insert:

“As disabled people spend more time at home a social and /or disability tariff is needed.  A Labour Government will give the same help to disabled people as they give to pensioners with the costs of fuel.”

Stronger Safer Communities:

Crime Page 11, line 22 after mental health problems insert

“those with neuro diverse impairments, dyslexia, autism, Asperger’s syndrome dyspraxia etc.”

Amendments Submitted by Other Organisations following Agreements Reached with Labour Party Disabled Members Group:

Stronger Safer Communities (Submitted by SERA):

 Page 5 line 15 after the sentence ending with the words “for the next generation” inset  ” All the new homes built by the Labour Government will be built to be as energy and water efficient as possible, with generating capacity were appropriate and built to lifetime homes standard with a proportion built to wheelchair accessible standard.”

Health and Care Submitted by Bournemouth East and West CLPS and Mid Norfolk CLP on behalf of Labour Party Disabled Members Group and the Socialist Health Association:

Page 10, line 38:  Insert the following “Britain’s mental health is at its worst since 1997 with increasing morbidity and a worsening suicide rate, because of recession and savage cuts to public services which disproportionately affect the most vulnerable. A clear focus on enhanced well- being and the promotion of mental health within schools, workplaces and general hospitals is needed to reduce the economic and social burden of mental ill health. Labour will instruct the Care Quality Commission to make sure that all providers of mental health and social care services comply with the Equalities Act meeting the access needs of disabled people and the cultural needs of the BAME community. In addition, Labour will demand that all relevant authorities play an active part in improving the integration between physical and mental

Health services and deploy community development resources with the clear objective of strengthening the community and voluntary sector to deliver on our aspiration for better mental health and spiritual well-being for all local populations.”

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Amendments submitted to the Labour Party’s Health Policy proposals

 

Health Policy Amendments

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The Association is entitled to propose 10 amendments to the Labour Party’s proposed policies.  These are the amendments we are planning to propose after discussion at our Central Council last week. (there are 12 listed as we hope to cooperate with another affiliated society).  Suggestions for improvements are welcome, but each amendment is limited to 200 words, and they have to be submitted by 13th June.

Amendments to Health and Care

1. Social Care

Page 8  line 18  In Section entitled – The future of social care.
After second paragraph add:-
“Labour believes that it is time to accept that social care should be placed on the same basis as health care; cover for all, contributed to by all and free at the point of need. The case for all care being free is the same as the original case for free health care.   Labour will work towards delivering on the aspiration of free care building on the Care Bill provisions which extend social free care to some.

Policies which take away the independence of the disabled and cause deteriorating health as a consequence are costly and cruel.  An incoming of Labour Government will not implement the current Government’s proposals to end the Independent Living Fund (ILF) in June 2015 and will instead initiate a full review of disabled people’s independent living. As part of that review Labour will look to use National and local government purchasing power to drive down prices of disability related equipment and services, including insurance. Labour will also look at ways of reducing the cost of social care for disabled people and their local authorities without reducing the quality of services delivered.”

2. Mental Health

page 10 line 38 add: “ Britain’s mental health is at its worst since 1997 with increasing morbidity and a worsening suicide rate, because of  recession and savage cuts to public services which disproportionately affect the most vulnerable. A clear focus on enhanced well- being and the promotion of mental health within schools, workplaces and general hospitals is needed to reduce the economic and social burden of mental ill health. A new National Service Framework, with a robust set of clinical and social outcomes based on a model of early identification recovery and optimism, delivered in partnership with service users and carers will be established. Labour will instruct the Care Quality Commission to make sure that all providers of mental health and social care services comply with the Equalities Act meeting the access needs of disabled people and the cultural needs of  BAME communities. In addition, Labour will demand that all relevant authorities play an active part in improving the integration between physical and mental health services and deploy community development resources with the clear objective of strengthening the community and voluntary sector to deliver on our aspiration for better mental health and spiritual well-being for all local populations.
Children’s mental health is paramount if psychomorbidity in the adult population is to decrease. CAMH services need to be adequate for the speedy identification and treatment of mental disorders in children in the least stigmatising way.”

3. NHS

Page 4 line 7 Delete second paragraph and replace with:-

“Labour will restore the duty of the Secretary of State to deliver a comprehensive, universal NHS overwhelmingly publicly provided and entirely publicly managed and will give the Secretary of State the power to give directions to any part of the NHS.
Labour will deliver an NHS that values and promotes collaboration and cooperation. Labour will remove any legal or other barriers which prevent or deter cooperation including any which seek to require NHS services to be competitively tendered.   Labour will replace the system of procurement through commissioning with a system where publicly funded care services are planned and decisions about services and funding are made through open and transparent democratically accountable processes drawing on experiences in Scotland (and Wales, where health outcomes on a par with England are delivered for about 10% less cash than comparable English regions).

The NHS will no longer operate as a market or pretend that Foundation Trusts are free-standing competitive corporations.  The private sector will only be allowed to offer patient services as an alternative to the NHS by exception, where it evidences enhanced care and innovation.. ”

4. Accountability

Page 4 line 30 delete sentence beginning “Instead, we need…”  Insert “The health service must ensure collective and individual accountability throughout. Care must be delivered with as much participation in shared decision-making as the patient wishes at the time. Planning functions must be democratically accountable.  We will ensure the engagement of patients and family / carers in the care process as co-producers of health outcomes and the provision of good information to patients to enable them to be actively engaged. Values important to patients like dignity and respect should be demonstrated in every service provided.  This should be informed by widely available and meaningful information about the performance of and outcomes from health care services.
Nationally, UK comparative performance in terms of health inputs, care processes and patient outcomes (both patient and clinician reported) will be used to ensure the NHS matches the performance of the best European systems. The average length of life both attained and forecast at national and sub national levels, the number of life years lost, and the quality of life in key respects (especially for the last decade of life) will inform these measures. The Chief Medical Officer (England) will be required to submit an annual report directly to Parliament charting progress in these areas.”

5.  Public Health

Page 10 Line 15 insert “We will make healthy choices easier by ensuring that the financial incentives and taxation system supports affordable healthy products such as fresh fruit and vegetables while making unhealthy products high in fat, salt and sugar better regulated and relatively more expensive.
We will remove the VAT exemption from sugar, which has little nutritional value.  We will ensure that the quantity of sugar, salt and fat in manufactured food is easily apparent to customers wherever it is sold. We will ban the use of trans fats in food products (as done in Denmark) – and push for the ban to be extended throughout the EU.We will introduce minimum unit pricing and encourage lower alcohol products.  We will reduce the hours during which supermarkets are permitted to sell alcohol and make it more difficult to buy dangerous quantities of alcohol following the successful example of reducing damage caused by paracetamol poisoning. We will progressively raise the age below which it is unlawful to supply tobacco to young people.  We will bring forward proposals to reform the law on misuse of drugs to balance the penalties against the harm done by different drugs including alcohol and tobacco.”

Amendment to  Stability and Prosperity

6. A healthy society

Page 4 line 8 insert “We want to see a community in which power, wealth and opportunity are in the hands of the many not the few and where the rights we enjoy reflect the duties we owe. This will not happen in an unhealthy society where wealth is primarily inherited and the benefits of economic growth go to those who are already rich.  Labour’s long-term goal is to break the link between a person’s social class and their health. We will work across government, using the power and influence of all government departments and agencies, to achieve this. All Labour’s policies in government will be subject to an assessment of their impact on the public’s health.

We will use a new tax on wealth to finance the NHS and social care system to achieve a level of spend as a percentage of GDP on a par with the best in Europe, aided by the removal of tax rules that currently allow tax avoidance by international companies earning  untaxed profits in the UK. We will safeguard the NHS from the TTIP which will otherwise act as a means of a commercial takeover of our healthcare provision. ”

Amendments to Work and Business

7. Health and work

Page 6 line 25 insert: “Employees of all grades with higher levels of control over their work (in terms of content, pacing of tasks, decision-making, etc.) have better health. Low control at work is associated with higher rates of heart disease, musculoskeletal pain, mental ill health and mortality – even when other risk factors (such as smoking) are accounted for. Interventions to improve control at work (for example rotating tasks, flexible working, employee participation in making company decisions, employee ownership/shares) have been found to improve health – with no detrimental effects on productivity. We will introduce measures to ensure that firms are  involving employees in the business so that job control is increased. In other European countries, such as Germany, “workers’ councils” are common place in businesses and they could be introduced here.”

8. Benefits for disabled people

Page 11  line  6 add at end “Labour will ensure there is a non means tested benefit to meet the additional costs faced by disabled people, and place them on a level playing field with non disabled people.  Pending the benefit redesign Labour will immediately revert to the 50-metre distance test in respect of the higher rate mobility component of PIP. There should be a disabled person on each tribunal considering appeals where award of the benefit has been refused.  The assessment must be accessible, fair and transparent, carried out by NHS workers, must use evidence obtained from Occupational Therapists,  doctors and other healthcare professionals, use existing assessment data held for people’s entitlement to disability living allowance where held, entitle a recipient of DLA automatically to PIP and be carried out once to result in a lifetime award unless the impact of a condition can be expected to change. There should be no cap on the budget for the benefit, so that all disabled people who meet the criteria receive the benefit.  We welcome the report of the Disability and Poverty Taskforce and will work with disabled people and their organisations to examine how its recommendations can be taken forward.”

Amendment to Living Standards and Sustainability

9 Transport and health

Page 3  Line 48  Insert new heading “Transport and health ”
Insert “Traffic accidents are higher in more disadvantaged and urban areas (particularly amongst children and outside schools), and are the leading cause of death in children over 5. We will encourage widespread introduction of 20 mph limits in urban areas to encourage the reclaiming of our streets by pedestrians.
The Active Travel (Wales) Act 2013 will be extended to England so every local authority will be required to publish details of expenditure on transport measures divided between walking, cycling, public transport and motor vehicles.   We will rebalance the transport budget so that 10% is spent consistently over the length of the parliament on the needs of pedestrians and cyclists with the aim of building networks of segregated cycle tracks in every major city.  We will remove VAT from bicycles.
We will take urgent steps to reduce the air pollution caused by road traffic, and in particular by diesel engines. We will reconsider the taxation of vehicles and motor fuel in the light of the evidence of damage to health caused by particulates.
We will reduce the level of alcohol which is permitted for motorists”

Amendment to Education and Children

10. Healthy Children

Page 10  Line 4 insert “In 2013 the UK had worse rates than nearly every other Western European nation for early neonatal deaths especially among socially disadvantaged groups. More investment in employing trained midwives to provide one to one care is crucial and shown to be effective in reducing still birth. We will ensure that sufficient support from midwives and health visitors is available for women and babies to tackle the appalling level of death among young children. We will increase benefit rates for pregnant women so that they can afford a healthy diet. All children are vulnerable and schools need to do much more to promote both physical and mental health. Every school must have a school nurse and a school counsellor. Childrens mental health services need to be adequate for the speedy identification and treatment of mental disorders in children in the least stigmatising way.”

Amendments to Better Politics

11. Community Development

Page 4. line 24 insert. “Taking part in community activity is a vital way of protecting and improving mental health. Health providers will be directed to support the growth of local voluntary and community groups as a whole, cooperating with the other services which have a mutual interest in this. We will ensure that health agencies play an active part in deploying community development, with the clear objective of strengthening the constructive role of the community and voluntary sector in relation to health.  NHS agencies and providers will therefore be expected to play their part in ensuring that every locality has a thriving third sector largely funded by grants rather than contracts. NHS organisations will be expected to take an active part in neighbourhood partnerships and to encourage users and carers groups to do so. There needs to be a shift so that we look at the most disadvantaged people regaining a sense of hope control and optimism over their lives, working on the strengths, (assets), of people, their families and the communities in which they live – this will impact positively on mental health and well-being and is evidence based from the recovery framework that is gaining credence in mental health”.

12. Age discrimination

Page 8  line 46  insert new section “Age”…”We will ensure that there is parity of treatment in health and social care services in respect of both youth and  age.  This implies

  • equal access to effective, safe care
  • equal efforts to improve the quality of care
  • the allocation of resources on a basis commensurate with need
  • equal status within healthcare education and practice
  • equally high aspirations for service users
  • equal status to the measurement of health outcomes”
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Proposed amendments to Your Britain for consideration 7th June 2014

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Promoting patient choice at the end of life

 Labour’s health and care policy recognises that “users, their families and the public are at the heart of local health and care services”. To that end the policy stresses the importance of respecting a person’s choice of care setting at the end of life, with the ambition of making it possible for people to die at home surrounded by their family.

This is a welcome commitment; but it is important to recognise that personal control at the end of life extends beyond choice of care setting and includes choice and control over how and when we die.

Who has the Right to Choose?

 Historically policy on end-of-life care and decision making has developed in a piecemeal way. This is partly because of the ethical dimension. On some issues Government can set out policy (like dying at home) but others are issues of conscience and are for Parliament to decide (like assisted dying for the terminally ill). At times Government can get caught between the two (like the right to refuse life-sustaining treatment and the debate around the Liverpool Care Pathway).

 A failure to look holistically at patient choice at the end of life means that some significant issues remain unresolved. End-of-life care has been included as a priority in the most recent NHS Mandate, but NHS England has stated that it will not be refreshing the End of Life Care Strategy, instead publishing a set of actions and ambitions – leading the National Council for Palliative Care to express concerns that momentum will be lost in delivering improved access to end-of-life care. On the ground the Liverpool Care Pathway, following an independent review, is being phased out, but with no firm replacement in terms of national guidelines for healthcare professionals. Concerns have also been raised about the lack of a national policy on do not attempt resuscitation (DNAR) orders, and more widely a failure to promote patients’ existing rights through Advance Decisions and Lasting Powers of Attorney to refuse medical treatment in advance of a loss of capacity. And of course there is the ongoing public and parliamentary debate on assisted dying for the terminally ill, with a Private Members’ Bill tabled by Lord Falconer set to be debated shortly in the House of Lords.

Medical advances mean that thankfully many of us will now live longer, but also that many more of us will face prolonged suffering at the end of life. Patients who now rightly expect their wishes and autonomy to be respected in all other areas of healthcare will no longer accept limited choice at the end of life and/or having to watch loved ones suffer against their wishes. Acknowledging the ethical dimension in end-of-life care, there is a real need for leadership from a future Labour Government in creating the framework and making parliamentary time available to consider these issues in the round.

In short, the Labour Manifesto should provide a broader commitment to promoting patient choice at the end of life. Specifically, we hope that a future Labour Government would, in addition to promoting choice over care setting at the end of life, ensure:

Access to good quality end-of-life care across all care settings including hospitals and care homes.

  • Sufficient training in end-of-life care for relevant healthcare professionals, including good communication with patients, and clear guidance on removing or withholding life-sustaining treatment.
  • Promotion of advance care planning, and the ability for patients to set out through Advance Decisions and Lasting Powers of Attorney their treatment wishes in advance of a loss of capacity.
  • Sufficient parliamentary time to debate the issue of assisted dying for terminally ill people.
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These amendments relate to the Stability and Prosperity consultation document.   They are merely ideas at present.  Nobody has agreed them.

Page 4

line 8 insert “We want to see a community in which power, wealth and opportunity are in the hands of the many not the few and where the rights we enjoy reflect the duties we owe. This will not happen in an unhealthy society where wealth is primarily inherited and the benefits of economic growth go to those who are already rich.  Reducing economic inequality will be a central concern of the Labour Government”

Page 5

Insert  at line 44 after ‘future success.’ “Key to building an economy which creates sustainable economic growth in every region of the country will be supporting micro, small and medium sized businesses. A growing sector that has the potential to increase employment opportunities at the same time as demonstrating that there is a more ethical model of doing business is the social enterprise, co-operative and not-for-profit economy. These models have also proved themselves to be remarkably effective and resilient.”

Page  7

Insert at  line 45: “Widening access to the UK Payments system to allow a greater number of financial services providers – including credit unions – to provide current accounts will increase competition in the market and offer a better deal for consumers.”

Page 8

Line 17 insert:  “As the major banks have closed branches on our high streets the payday lenders have moved in. More than 1 million people take out payday loans every year totalling almost £2bn. One Nation Labour will cap the overall cost of credit to prevent these high cost lenders from charging the most exorbitant rates. We will also introduce a new levy on payday lenders and use the resources to support the expansion of credit unions. With the right support credit unions can play a growing role in the provision of financial services – as they do in other developed countries including in Ireland and Canada. Key to supporting this growth would be increasing the number of employers who offer payroll deduction of savings and loan repayments. A Labour Government will look to public sector employers to lead the way.”

Line 31 insert “We will use a new tax on wealth to finance the NHS and social care system”

Page 10

Line 22 insert “We will rebalance the social security system to offer more support to pregnant women, parents and children in the early years.”

 

2 Comments

The document to which these amendments relate  is on the Your Britain website.  At present these are merely proposals the Association is considering.  They are not yet agreed.

Page 10

Line 15 insert “We will make healthy choices easier by ensuring that the financial incentives and taxation system supports affordable healthy products such as fresh fruit and vegetables while making unhealthy products high in fat, salt and sugar better regulated and relatively more expensive.  We will tax alcohol progressively by unit of alcohol, introduce minimum unit pricing and encourage low alcohol products.  We will reduce the hours during which supermarkets are permitted to sell alcohol and make it more difficult to buy dangerous quantities of alcohol following the successful example of reducing damage caused by paracetamol poisoning.”

Line 33 insert “We will progressively raise the age below which it is unlawful to supply tobacco to young people.  We will bring forward proposals to reform the law on misuse of drugs to balance the penalties against the harm done by different drugs including alcohol and tobacco.”

“We will take forward the programme of fluoridation of the water supply to reduce the damage to children’s teeth”

 

See also proposals relating to the documents on Stability and Prosperity, Work and Business, Living Standards and Sustainability, Stronger Safer Communities, Education and Children and Better Politics.

 

 

1 Comment

These amendments relate to the Stronger, Safer Communities consultation document.   They are merely ideas at present.  Nobody has agreed them.

Page 4

line 16 insert “Labour will tackle the problem of under-occupation by taxing empty property and removing the tax incentives which encourage investment in property for rent”.

Page 5

Line 3 insert “Inequality in the UK is mediated by housing. While many have no adequate home others have several homes, all steadily appreciating in value because of scarcity. Rich people are increasingly  and unhealthily segregated from the poor in gated communities. Selection for the best schools is conducted by estate agents.”

line 7 Delete sentence beginning “As a last resort…” Insert “We will introduce a tax on land”

Line 33 Delete paragraph  beginning “Labour believes that…”  Insert “Labour will alter the law to give private tenants more protection from eviction, exploitation and unjustified rent increases. Landlords who benefit from the provision of Housing Benefit will be expected to bring their properties up to reasonable standards.”

Page 6

Insert on  at line 22
“Tenant Voice
Labour recognises the importance of tenants and leaseholders having a stake and a voice in their housing – whether their homes are owned or managed by local authorities, housing associations or arms-length management organisations (ALMOs). Rochdale Borough Housing and Phoenix Community Housing in Lewisham are examples of real tenant empowerment.”

Line 30 insert “Returning Public Health to Local Authorities is a logical step which we support, but it needs to be accompanied by a development of more powers for local authorities to protect the health of their communities. We will change the law to make it clear that public health should be taken into account in all planning and licensing decisions and to ensure that public authorities at all levels must undertake Health Impact Assessments of their decisions.”

Page 7

Line 10 insert ” The NHS will harness community building/development approaches, ensuring that local communities work with statutory agencies to set the agenda for change that meets their needs. This, within a national framework of entitlements set by government.  ”

Line 32 Insert “We will review the complex and ineffective mechanisms for involving local communities in the running of the NHS”.

 

 

 

 

 

2 Comments

These amendments relate to the Work and Business Policy Consultation. They are merely ideas at present.  Nobody has agreed them.

We may wish to support the Labour Party Disabled Members Group policy proposals

Page 3

Line 45 Insert : “One Nation Labour will build an economy which creates sustainable economic growth in every region of the country. We know that key to this will be supporting micro, small and medium sized businesses. A growing sector that has the potential to increase employment opportunities at the same time as demonstrating that there is a more ethical model of doing business is the social enterprise, co-operative and not-for-profit economy.

Page 6

line 25 insert: “Employees of all grades with higher levels of control over their work (in terms of content, pacing of tasks, decision-making, etc.) have better health. Low control at work is associated with higher rates of heart disease, musculoskeletal pain, mental ill health and mortality – even when other risk factors (such as smoking) are accounted for. Interventions to improve control at work (for example rotating tasks, flexible working, employee participation in making company decisions, employee ownership/shares) have been found to improve health – with no detrimental effects on productivity. We will introduce measures to ensure that firms are  involving employees in the business so that job control is increased. In other European countries, such as Germany, “worker’s councils” are common place in businesses and they could be introduced here.”

Page 7

Line 12 delete “ratio of” insert “hourly”.

Line 14 insert “Companies and public bodies will be obliged to publish details of the hourly rates of pay of all employees, showing the number employed on each rate”.

Line 40 insert “In contrast One Nation Labour recognises the value of genuine employee ownership. Companies where employees own a significant stake in the company they work for now account for combined annual turnover in excess of £25 billion, more than 2% of GDP and growing. Evidence shows that employee owned businesses are more resilient and more successful than other more traditional models. One Nation Labour will support the growing employee owned sector but will never couple this with slashing employment rights. Which we believe is contradictory and counterproductive.”

Page 11

Line 37 insert “Demonising people on benefits has a detrimental effect on mental health and well-being, and emerging evidence shows that the governments “reforms” have negative consequences in relation to increasing suicide, self-harm and depression, for the existing population of people with mental illness but also possibly for the general population previously not having mental health problems.  The evidence also suggests that the reforms are having a negative impact on people in that they are reluctant to be discharged from mental health services, fearing that this will negatively impact on work capacity assessments.”

1 Comment

These amendments relate to the Education and Children consultation document. They are just ideas. They haven’t been agreed by anyone.

Page 7

Line 21 insert “Good health education should be strengthened as part of the curriculum, with parents and families encouraged to participate.”

Line 41 insert “Schools will be incentivised to ensure that all pupils who are able to do walk or cycle to school.”

Page 9

Line 21 insert “The health care sector relies heavily upon publicly funded research  and upon publicly supported students. In terms of research, Labour should operate a strategic health research programme concentrating upon selected areas where the UK  has good existing infrastructure. ”

Line 42 insert “Research for UNICEF has shown that children in the UK feel trapped in a “materialistic culture” and don’t have enough time with their families. The UK is in 16th position – below Slovenia, the Czech Republic and Portugal – in a league table of child well-being in the world’s richest countries. We will ensure that the well being of children and particularly the provision of public facilities for children and young people will be a high priority. New standards for children’s play facilities will be developed.”

Page 10

Line 4 insert “In 2013 the UK had worse rates than nearly every other western European nation for early neonatal deaths, due to risky behaviours during pregnancy especially smoking, which is more common among women who are socially disadvantaged. We will ensure that sufficient support from midwives and health visitors is available for women and babies to tackle the appalling level of death among young children. We will increase benefit rates for pregnant women so that they can afford a healthy diet.”

Line 36 insert “All children are vulnerable and schools need to do much more to promote both physical and mental health. Every school must have a school nurse.””

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