Name of organisation: Socialist Health Associatio, Type of Organisation: Affiliate

Date of meeting agreeing response: Central Council, 25th March 2000, Number of members present: 20

Contact name: Martin Rathfelder, Position held: Acting Director


  1. Do you agree with the four areas chosen for development? Generally yes. We particularly welcome the emphasis on eliminating poverty
  1. Are there areas not covered in the document that you would like the Economic Policy Commission to develop? Please specify and rank in order of preference.

The SHA sees that many of the developments in healthcare in coming decades will involve the patenting of treatments and diagnostic tests deriving from human genetic research and other bio-technologies. There are already issues where first world drugs are too expensive for developing countries. We would have wished to see a section on trade and the WTO which addressed biotechnology and patenting issues. We have reservations about the patenting of life-forms, but more specifically feel the Commission should consider the role of the NHS in research and development. The MRC General Practice Research Framework now covers 12% of the UK population. No other country possesses any comparable facility for population based research, an increasingly essential step in the development of new treatments. Access to this could become an important source of NHS income, and the facility could become a powerful tool for education of both staff and public in the new culture needed for effective mass application of medical science. Clearly Britain’s future as a knowledge based economy means UK companies making reasonable returns on investment in developing new treatments, but these should be made readily available and not based on denying countries, healthcare systems or individuals effective therapies. Nor should our NHS be held to ransom by multinationals. The ready availability of new technology to promote health should be seen as a global objective through the WTO and reflected in policy. The development of the NHS and MRC as an international force in this market could give this strategy a material foundation, independent of multinational corporate interests. (Rank = 1)

The SHA welcomes the recent comments of Alan Milburn at the LSE which recognised the role of the NHS in promoting economic prosperity. We have published the work of Allison Quick and Richard Wilkinson (“Income and Health”, SHA, 1991) on income distribution and health which went beyond this and indicated that the degree of inequality of income in developed societies is a strong determinant of overall health. Those societies experiencing more equal distribution of income have significantly better health than those with less equal distribution. This goes beyond just the effects of poverty and social exclusion. (We are happy to supply copies of both the book and papers from a conference we organised on this to Commission). (Rank = 2)

  1. Are there any areas covered in the document that you would like the Economic Policy Commission to consider for further development? Please specify and rank in order of preference.The SHA continues to have reservations about Public Private Partnerships. While we welcome the removal of the requirement to transfer staff in NHS schemes and the general rule that assets should now revert to the public sector we are still concerned that such schemes do not represent good value for public money in the longer term. The long term contacts involved can also commit commissioning public sector bodies to patterns of service delivery from a providing consortium which restrict the ability of the commissioners to change how services are delivered. We feel the impact of this future inflexibility has not yet been fully recognised. (Rank = 1)The SHA welcomes the attention given to eliminating poverty generally. We do however feel the National Minimum Wage needs to be increased at a rate ahead of inflation rather than – even after the recent increase – falling in real value. We feel linking it to increases in average earnings is modest and sensible way ahead, meaning the low paid share in growing national wealth rather than falling behind. We also feel pensions should be increased in the same way, rather than relying on the means tested approach of a Minimum Income Guarantee – annual increases for pensioners of less than £1/week are not popular! (Rank = 2)The SHA notes the considerable attention given under ‘making work pay’ to avoiding the high marginal rates of tax experienced when people move from benefits to lower paid work. One aspect which is not addressed, apart from the reference to the welcome removal of charges for eye tests for over 60’s, is that of NHS charges. While prescription charges in particular may not be a difficulty for higher income groups, for those in lower paid work – who are also more likely to be ill than the better off – we feel they can represent an excessive burden. We would wish to see charges abolished. As an interim they should at least be cut rather than allowed to increase. (Rank = 3)The SHA welcomes the references to encouraging saving and promoting the role of credit unions. We do however wish more had been said about promoting cooperative and mutual enterprises generally (particularly given how much de-mutualisation has taken place in the last 6-7 years). We also feel the capital limit for means tested benefits for non-pensioners being retained at the £3000 it was 15 years ago does not encourage saving. If the Party is to have joined up policy it this area we feel it should be increased to a common level for everyone. (Rank = 4)

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