Labour needs to talk about the NHS

by Renie Anjeh

Lord Warner, the former Labour health minister, hit the headlines earlier this week by calling for a £10-per-month charge for the NHS as part of his report for the think tank Reform.  The reaction from his fellow “comrades” was unsurprising. Some expressed their vehement disdain for the peer by launching a petition calling for his resignation from the party.  Others edited his Wikipedia page so that it included insults and untruths.

Like most party members, I am strong supporter of the NHS and I cherish the principle of free healthcare at the point of use.  However, supporting the NHS is not an excuse for refusing to face up to reality.  The uncomfortable truth, especially for Labour supporters, is that the health service’s finances are not on a sustainable footing.

It is inevitable that due to a rising ageing population and increasing numbers of people suffering from chronic conditions, against the backdrop of tight spending constraint, the funding gap will increase to £54bn by 2020.

As Alan Milburn said in 2012, “the era of big spending is over, fiscal conservatism is order of the day”.  Whoever is in government next year, will undoubtedly have to confront this problem.  Unfortunately, Lord Warner’s report just shows that the Labour party – the party of the NHS – is not sufficiently psychologically prepared for this challenge.  It is important to remember that the monthly NHS charge is one idea amongst many that Warner proposed in his report but the Labour party seemed to reject the report in its entirety.

Rather than braying for his blood, the party should have commended him for thinking seriously about this issue and should have adopted his issues on integrating budgets, investing in community services and efficiency.

This is what Stella Creasy rightly alluded to in her Bright Side Manifesto when she said, “in an era of tight resources, we will do little for those with heart disease, cancer or diabetes by simply fighting for empty hospital beds, when we can be pushing for investment in community services”.

This also speaks to a much wider problem in the Labour party.  On the key issue of the NHS, the party is torn between being a party of protest and a party of government.  Incessantly chanting “the NHS is not safe in the Tories’ hands” or “we love the NHS” will not suffice.  I don’t doubt that it is true for a second but it is not a health policy.

What the public expect from a government-in-waiting is an answer to the awkward questions about NHS rather than just ad hominem attacks on Jeremy Hunt.  It would also be deeply concerning if progress on this issue is being stifled by internal rivalries and political ambitions – the NHS should not be a political game for one or two shadow cabinet ministers.

Now is the time for Labour to demonstrate that it is prepared for government by starting to think seriously about the NHS.  Labour should reject the ring-fence on the NHS budget and instead focus on improving productivity in the NHS which would generate savings.

Also, integration of health and social care budgets cannot be delivered with a ring-fenced health budget.  Labour should be driving forward an innovative reform agenda with ideas such as social prescribing, group consultation with GPs and social impact bonds which conservative estimates say could save up to £4bn per year.

Another thing Labour should be proposing is greater investment in community services and early interventions which could be funded by taxing, rather than banning, fizzy drinks and foods that are high in sugar, salt and fat.  If a £10-per-month charge would be unpalatable, there needs to be a debate about a hypothecated NHS tax or even charges for misusing NHS services and Labour should be leading that debate.

There are some in the party who will not take kindly to these suggestions but the party can ill afford not to have a credible health policy.  It would also be a dereliction of duty seeing as the Labour party are the party that founded the NHS over 66 years ago.  Perhaps Liz Kendall and Stella Creasy are the right people to devise such a policy?

Renie Anjeh is a Labour party activist

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14 Responses to “Labour needs to talk about the NHS”

  1. Julian Ruck says:

    The NHS is unsustainable, full stop.

    Political ideology will not solve the problem but if one were to adopt a ‘strong should look after the weak’ mantra, then I am confident that at the very least, those who are better off would voice no objection to a monthly surcharge.


    PS I know all about Wiki pages being edited with insults and untruths. It is the way of low life cowards.

  2. Tafia says:

    Would this be the same Lord Warner up to his knacker sac in dealings with private medical companies by any chance? Sage Advice, Xansa, Byotrol, Apex Partners?

    How about removing the upper limit on NI payments.

    That said, I would support fining people a small amount for missing appointments

  3. Robert says:

    Yawn! People have been banging on about reforming the NHS as long as I can remember. The reforms cannot have done much good if we need more reforms! The truth is that the NHS model is not perfect but it is better than most at providing healthcare.

  4. bob says:

    labour and the NHS, what a laugh.

    It gave us:-

    A vastly expanded PFI, to keep expenditure of the Treasury books and leaving NHS Trusts deep in debt, Guys and the London have sunk into so much debt it looks up at the bottom of the Thames. Central Manchester, the old Manchester Royal 5.5 Billion POUNDS, South Manchester, the Old Wythenshawe hospital 1.0 BILLION pounds. SOuth Manchester have discovered a hole in their budget to the tune of 20 MILLION after the last chief exec left. St Helens and Knowsley bailed out, temporarily.

    The scandals of East Kent, Basildon, to name a few where there was an increased number of patient deaths due to poor management and PFI costs introduced by the last Labour government. Stafford, all that epitomised the depths the NHS fell to under Blair and Brown, over 400 deaths, bullying and harassment of staff by managers, unions paralysed and not supporting staff as they were in hock to the Labour government. MPs did not speak out at this slaughter of the innocents. Morcambe Bay, where there is still a criminal investigation ongoing into the Titcombe case and others.

    NHS managers such as Bower and Nicholson, moved and promoted to continue wrecking the NHS by bullying, harassment and subjugation of the TRUTH. Chief executives moved sideways and bringing their cabal into new positions. Chief executives who have a history of bullying being employed by Trusts who have history of such actions and the CQC now marking time on the door step after staff who have fought back.

    And this man is the Chief executive, a friend of Blair, amazing how these men and women are put into these positions.

    Ex Labour MPs and ministers like Milburn and Hewitt, leave politics where they professed their devotion to the NHS, Milburn to Allied Medical who provide scanning services to the NHS and Hewitt to Boots.

    Labour looking after the NHS, I don’t think so, privatisation under Blair and Brown was vastly inflated by them, to have a PFI contract, non medical and nursing services had to contracted out, negotiated by idiots with no concept of the private sector and they were stupid and ripped off. At least the can of worms under Lansley and Hunt has been opened and the worms have crawled out.

  5. Renie says:

    @Julian – Yeah, it’s a shame that people don’t like to debate things in our party but resort to silliness.
    @Tafia – It may well be the same Lord Warner but he has put his finger on an important issue – the NHS needs money. Upper limit for NI is something that could be looked at but I’d prefer a hypothecated NHS tax.
    @Robert – Typical voice of protest. Reason why there are different reforms is because healthcare changes, demographics change, financial circumstances change etc. Do you really think that a £54bn blackhole in 6 years time is a good state of affairs?
    @Bob – Highest patient satisfaction, more nurses, more doctors, waiting times down, new hospitals etc. Of course mistakes were made (every govt makes a mistake on almost every policy area) but Labour made huge improvements. Btw, the private sector has always been involved in the NHS – something called GPs.

  6. John reid says:

    Robert the point of reforms, is that here’s always going to be a ever changing situation, people living longer, more surviving cancer, different ages that woe,n can children, new cures,new diseases, different amount of population, new ways of detecting illness,

    O.K that makes up a small amount of why there are changes outside financial situations, but take the shifts from A and E, to doctors to cottage hospitals, dentistry ,using private Doctors or private dentists foe local work, there’s also treating those with injuries deliberately inflicted, such as rape suites, that have NHS staff in, to schools having a practice nurse, things that weren’t regarded as normal years ago, even now, the inspection of FGM, is being taken serious

  7. Tafia says:

    Truth is, the NHS delivers treatment to UK subjects cheaper than insurance companies in America do to US citizens – and in America less than 50% have comprehensive health cover whereas in the UK 100% do (it’s also probably why infant mortality is higher and life expectancy lower in the US than in Cuba and the UK and a host of other countries.).

    If there were no NHS, private medical insurance would cost an absolute fortune – at the moment it’s ‘cheap’ solely because if you need emergency treatment it’s the NHS that foots the bill. If you need costly treatment (transplants etc) again it;s the NHS that foots the bill. Interestingly, post operative infection rates in private hospitals are higher than NHS hospitals.

    One of the reasons the NHS is costing so much is because it is a victim of it’s own success. The elderly cost a lot – and there ae an awful lot more elderly because the NHS works.

  8. Mark Webster says:

    Er… I must have misunderstood something.

    I thought the idea was to raise funds via taxes and spend them in a socially useful manner, such as on the NHS.

    problem : NHS short of funds.

    solution : raise taxes.


  9. bob says:

    John reid: The schools had a school health service provided by the local authority, sexual assault was dealt with by the police doctor.

    Renie, I work in the NHS and see it far differently, too many managers who will not make decisions and when they do it is as a collective so that no one person can be adjudged at fault for any decision, were are all stakeholders. Surgery has changed in the last 40 years I have been in the NHS, surgery which would have taken as a two week admission is now done as a day case or not at all. Medical patients have changed, used to be if you had a heart attack again a two week stay with slow mobilisation, now if your stable after coronar,y angiogram and stenting out in 72 hours.

    More surgery, done by the private sector either in private hospitals on contract or through ISTCs, backdoor privatisation of the NHS.

    New hospitals costing not just an arm and a leg but the family silver as well. More nurses are not going to replace those emigrating or retiring, more doctors due to the Working Time Directive.

    Your flippant, mistakes were made sickens me to the core, the needless deaths of patients is not just an error in your sickening words but acts of manslaughter which the Labour government were through policies and political interference are responsible.

  10. Tafia says:

    Renie Reason why there are different reforms is because healthcare changes, demographics change, financial circumstances change etc.

    That is pure unadulterated drivel. My daughter is a surgeon in Wales, my sister is a senior manager (ex-nurse) in Merseyside and my ex-wife is a senior nurse in Yorkshire. Over the last 2 decades there has not been a single year where there have not been major reforms thrust on them without consultation and more tellingly, not once have they even finished one set of reforms before the next set reforms were put on them, with no reference at all to the previous incomplete ones. It is purely politically driven as opposed to clinically driven.

  11. Robert says:

    Exactly Tafia. You have just described the last 20 years of public service reform. The next government should correct anything that needs correcting but otherwise allow public sector workers to do their job. Most reforms are just politicians trying to justify their existence.

  12. BenM says:

    “problem : NHS short of funds.

    solution : raise taxes.”

    Not necessarily as binary as that.

    You’re right, no one wants to pay ANOTHER charge on top of the tax we already pay to use the NHS. That idea is so idiotic I can’t believe anyone pays it lipservice.

    You can prioritise spending choices.

    But the biggest one of all is getting the economy right so it continues to provide the tax revenue it needs.

    The Biritsh economy is failing palpably in that regard, and Osborne’s stuff up has made the situation almost irreversible.

    The economy needs a healthy workforce free from the fear of illness. Therefore the eocnomy needs to pay for a universal health system to support itself.

    It is as simlpe as that. The Tories – blineded by haven’t got a clue.

  13. Mark Webster says:

    BenM, yes I agree that the solution is far from simple. But given the ageing population and increasing range of treatments that we wish to provide, costs are going to increase, which is not in itself a bad thing as it just shows that we are providing a greater population with more extensive healthcare.

    There seems to be a popular Cinderella notion that this greater service provision can be funded from those savings released by being “smarter”. So far being “smarter” has consisted of PFI , privatisation, re-organisations and corporatism which has probably not freed up funds. It could be argued that the flow of funds to investors has in fact added to costs rather than reduced them.

    I suppose it is just in utter desperation with this endless issue that I just turn to the naive solution. Stop trying to improve things by being “smart” and revert to the simple positiion of raising taxes to cover costs. In fact i would gladly pay an extra 5% on the base rate , if this issue of underfunding and endless grief would just go away.

    But then again I’m an engineer and not a politician.

  14. Renie says:

    @Robert and Tafia – Governments are elected to pursue their agenda. If a Government wants to improve the NHS that is a good thing. We should always be trying to make improvements. Also it is a folly to deny that changing demographics, more demand, fewer resources etc. triggers reform. I’m afraid that inaction and no reform is not an option with a £54bn bill in less than 6 years. Not surprised that Rob’s response is a “yawn” then again it is mildly better than his claim that we should leave Putin alone or that another Tory Coalition is a success for Labour.

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