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Posts Tagged ‘NHS’

Wes Streeting is right. If Labour is going to save the NHS there needs to be a serious debate about its future

07/01/2023, 10:27:51 PM

by David Talbot

The NHS is so central to British politics that a vague promise to provide it with more funding, festooned across the side of a bus, helped to sway a referendum of vital national importance. Such was the potency of the claim, which spoke to voters’ deepest passions, and indeed fears, about the NHS, that whilst voters believed Brexit would be bad for the economy, they had believed the Leave campaign’s claim of more funds for the health system in a post-Brexit Britain.

The pledge was indisputably incorrect, and horrid – but ultimately effective – politics. Little or no precious national debate was directed towards just what the funding ought to be directed towards, nor whether more long-lasting reform was required beyond the perennial resources argument.

That may be, of course, because ‘the NHS’ and ‘crisis’ has become the white noise of British politics. As an editorial in the BMJ pointedly stated: “The current media frenzy over the latest NHS crisis prompts speculation on how the NHS might end.” The caveat, however, is the editorial was written in 1999.

The Shadow Health Secretary, Wes Streeting, has lamented that the NHS is not “the envy of the world” and that “it is a service, not a shrine”. He has been lambasted from the predictable bastions of conservatism, the far left and the BMA. It did, though, signal a welcome, and long overdue, injection of realism from the Labour Party into the NHS debate.

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We need to have an honest conversation with the public about social care

28/09/2021, 10:07:45 AM

By Joanne Harding

This piece is part of a new book “Labour’s Reset: The Path Back to Power” which is being released today. The book looks at the barriers for voters in picking Labour, what the party can do in opposition to tackle these issues and the type of policy platform that would attract switchers to Labour at the election.

‘If you neglect physical infrastructure, you get roads full of potholes and buckling bridges, which prevent your economy functioning properly. The same is true if you fail to invest in social infrastructure.’ These were the words Liz Kendall used as she addressed a conference of directors of social care back in April this year. I think we can all agree that social care has been neglected by successive governments for years. The question is what could and should Labour do to truly address what I believe to be one of the most difficult policy challenges of our times. One of the fundamental issues with social care is that people do not really understand what it is. It is incredibly difficult to define as it ranges from supporting a person to wash and eat, to administering medication, to safeguarding, protection of liberty and to end-of-life care. It is inextricably linked with health by virtue of some of the elements of personal care, yet it is so much more than health.

However, it does not have the same branding as the National Health Service (NHS) that we all recognise and hold dear to us as a beacon of all that is good. Politicians talk about health and social care, yet they continue to leave it out in the cold when it comes to policy and funding conversations. This lack of focus on social care is reflected in public attitudes – in polling conducted by Yonder for Labour Uncut, when respondents were presented with a list of 11 different policy and just 6% of voters picked social care as the highest priority.

It does not attract the same attention as a hero workforce and life-saving and ground-breaking treatments do. Nevertheless, make no mistake about it, social care encompasses every single one of these things and more.

Labour therefore has a role to play in changing the narrative among its members and the wider public. Maybe then, we can have a more honest conversation about the areas I feel we need to tackle if we are to reform and transform social care.

Funding reform

This will surely be considered the most contentious and difficult element of our policy work. If we truly want a publicly funded social care system in England, we need to establish how we are going to pay for it. Projected growth on spending for social care is simply not in line with predicted growth pressures, which are rising at 3.7% annually in real terms. More than 1 million people aged 65 or over will require varying degrees of social care support by 2035; this is up from 783,000 individuals in 2015. As people live longer and advances in medicine and assistive technology support people to live with chronic and long-term health issues, greater strain will be put on an already creaking system.

We know we cannot simply stand still as we will have a predicted gap of £3.5 billion to fill by 2025 to maintain our existing standards of care, which are frankly failing too many people. Age UK reports that 1.5 million people living in the UK have an unmet care need and if current trends continue, this could grow to 2.1 million. Furthermore , the government have offered short-term bungs over the years to paper over the cracks. Relying on a council tax precept and business rates cannot possibly be a sustainable funding model for an infrastructure that is so vital to a healthy society. It also creates inequity in local authorities that will be living with greater health inequalities and higher levels of poverty. Current provisions are truly a postcode lottery.

Johnson’s statement to the House of Commons last week has done nothing to reassure those of us who live and breathe social care that reform is coming anytime soon. The majority of the income generated by a regressive national insurance rise will not really go towards funding social care. For three years, all of the money will go towards easing the NHS backlog; in fact, only £5.4 billion of the £36 billion will head in the direction of social care. Councils may well be forced to raise council tax yet again in order to meet demand. Social care is in crisis right here, right now. The Tory Party’s talk of funding and reform are actually just warm words.

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Covid has put the NHS front and centre. But Labour needs to beware, 2019 showed that support for the NHS does not equal votes for Labour

12/06/2020, 09:45:56 PM

by David Talbot

On the morning after consigning the Labour Party to a fourth and devastating general election defeat, the Prime Minister addressed the nation from the steps of Downing Street. In the early glow of election victory, Boris Johnson informed the party faithful and, more importantly, the millions of converted Labour voters that the “NHS is this One Nation government’s top priority”.

Jeremy Corbyn and the Labour Party had tried awfully hard during the preceding six weeks to make the NHS the central focus of the election. Chants of “not for sale!” reverberated around campaign rallies as a dossier exposing the “secret agenda” to sell off the NHS to US corporations was thrust into the heart of the campaign.

It was easy to understand Labour’s desire to move the debate from the Conservatives’ favoured ground of Brexit, and its pithy slogan, to the one policy area the party led on. Indeed, at the start of the campaign, the NHS was cited by more (60%) of the population than Brexit (56%) as the most important issue facing the nation. 68% of Labour’s 2017 voters also named the NHS as their number one priority, and Labour retained a lead, albeit small, on the party best placed to protect the health service.

The NHS was not only an important election issue, but it united a party which was allergic about talking about Brexit and acted as a galvanising vehicle for activists to campaign upon, whilst gnawing at the Conservative’s traditional Achilles’ heel.

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By-election Winners and Losers

24/02/2017, 02:18:13 PM

by Kevin Meagher

Winners:

Gareth Snell. Congratulations are due to Snell, having been put the ringer these past few weeks for derogatory remarks he had previously made on Twitter about, inter alia, Loose Women, Janet Street-Porter was why Brexit is ‘a massive pile of shit.’ He withstood the ‘media bomb’ they generated and can now look forward to joining the intra-party tussle for a seat in 2020, as proposed boundary changes scrap Stoke Central.

Jack Dromey. As Snell’s campaign manager, Dromey will take credit for ‘seeing off Ukip’. In reality, Ukip saw off Ukip (see below), but credit where credit’s due: A win is a win in politics and, as captain of the team, Dromey deserves credit.

The Tories. For a government to win a by-election seat from the opposition is a rarity indeed and symptomatic of the state of British politics in 2017, with Labour no longer able to hold what it has. One other point. Like they did in 2015, the Tories are becoming adept at under the surface campaigning. With massively fewer volunteers than Labour, they are plainly making other assets count. Labour needs to be better at reading their game.

The turnout. Despite the noisy intervention of Storm Doris, 51 per cent of Copeland’s voters braved the elements, while 38 per cent of Stokies also made it to the polling station. Both turnouts were better than expected and serve to make the results fairly representative of current opinion. So what’s the message for Labour? The party can hang on in its heartlands (Stoke), but can’t assume it will (Copeland). This will now be interpreted whichever way the high priests of Corbynism and neo-Blairism want it to.

Losers:

Labour’s NHS campaign. ‘It’s the economy stupid’ needs writing on the wall of Jeremy Corbyn’s allotment shed. The Labour campaign team in Copeland played the best card they had and ran a strong campaign on the local NHS. But given the long shadow Sellafield casts over the area, where many of the locals make their living, you can’t expect to prosper when the party leader opposes nuclear energy. Labour’s contract with its voters is that it will look after them economically. (It’s maddening that I need to actually write that).

Paul Nuttall. Ukip has again fluffed the ball over the bar in a by-election it should have won. Worse than that, there was clearly no scenario planning or expectation management in case Nuttall didn’t win. Party spokesmen were left flapping around trying to spin the defeat, while a retreating Nuttall (who didn’t stay for a concession speech) was left surrounded by a media pack when his car wasn’t there to pick him up. Ukip still can’t get out of its amateur hour rut. Until it can, the party is going nowhere.
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Week 4 of the campaign: the good, the bad and the ugly

26/04/2015, 01:27:31 PM

Uncut’s weekly review of the campaign looks at the events of week 4.

The good

Chuka Umunna’s interview in the Guardian

One of Labour’s most visible performers this campaign has been the shadow business secretary, Chuka Umunna. His polished media performances have ensured that he is on the Labour press office’s speed-dial when the toughest interview bids arrive.

Inevitably in an election campaign, interviews are about the issues of the day. It’s hard to see the person rather than the political position. Chuka’s interview in the Guardian probed a little deeper and offered a glimpse of what makes the man tick.

It revealed a personal biography which is a story of struggle, success, loss and revival. One which shines a light on who he is and the type of politician that he is maturing into.

Chuka’s father’s rise, from penniless migrant to running a thriving business, is clearly enormously influential.

Most immediately, it explains why Chuka is instinctively comfortable with business and able to put businessmen and women at ease with Labour, in a way that other Labour front-benchers cannot.

Yet there is more to Chuka than just being Labour’s business-whisperer.

The duality of being the child of an immigrant and a successful businessman creates a rare perspective. Most politicians lead their lives in a straight line – they are born into a class and remain in that class.

Chuka’s world was one simultaneously of disadvantage and privilege.

It’s why the rhetorical cadences from Ukip on race and identity are familiar to Chuka from his youth, as they are to anyone from a minority who grew up in the 1970s and 1980s.

What Ukip say today about Eastern European migrants was said about Asian and African migrants from the 1950s through to the 1990s.

The manner in which his father faced this and overcame it, informs the direct and robust way that Chuka addresses Ukip.

Chuka’s father’s achievements and Chuka’s upbringing have given him the self-confidence to challenge Ukip in a way that his party colleagues seem to lack.

The subsequent loss of his father when he was 13 was evidently and understandably a pivotal moment in Chuka’s life.

It also places him in a rather unique category of politicians.

The Phaeton complex describes the behaviour and development of children who experience the loss of (or separation from) one or both of their parents. It seems more than a coincidence that this group is so over-represented among political leaders –Winston Churchill, Richard Nixon, Bill Clinton and Tony Blair to name just a few.

Whether Chuka’s future will be as starry as some of the other political Phaetons is unclear yet, but in an election of dry photo-opportunities and endlessly rehearsed lines, the Guardian interview with Chuka offered something more than the standard, and increasingly stale, fayre.

Progress in righting some of the wrongs of the past (more…)

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Labour needs to be straight about its plans for the NHS

24/10/2014, 01:38:13 PM

by David Talbot

“The NHS is on the ballot paper in May” declared the Labour leader at Prime Minister’s Questions as he sought to solidify his party’s clear advantage on this most important, and emotive, of issues. That the NHS is set to be centre stage at the forthcoming general election is partly due to naked politicking, and partly due to the dire forecasts for our health service. Both main combatants are well aware of the financial and demographic peril the NHS is in, but both continue to besmirch the debate with clichéd attacks on how the Tories can’t be trusted on the NHS or, a new variant of the same line, Labour are ruining the NHS in Wales.

It is essential that politicians are honest with the public about the scale of the challenges facing the NHS. This is particularly true of the Labour party who are prone to nostalgia and playing on sentiment, invoking the spirit of Nye Bevan and having a nonagenarian address party conference, for instance, but specifically because the party is making pledges which, deep down, it must know will be difficult or nigh on impossible to deliver. The NHS matters too much for short term electoral considerations; it is better that the party is frank, and dare say unpopular, with the public now rather than risk alienation, anger and a disintegrating NHS later.

Ed Miliband’s flagship announcement at the party conference last month was an eye-catching commitment to establish a new £2.5 billion ‘Time to Care Fund’. This unravelled not long after some fairly rudimentary scrutiny; it will be not be implemented in full until 2017/18 and Labour would need to first pass a Budget and then enact legislation before the mansion tax, levy on tobacco firms and tax avoidance levies would yield any income. And even then there are serious doubts the revenue raised would come anywhere near the £2.5 billion quoted.

It is not to say that the party is not coming up with a better vision for the NHS. Labour’s plan for a combined health and care service is unquestionably the right direction of travel, but it is not a cost or pain-free option. Andy Burnham may deny that there will be large-scale reorganisation, but unavoidably, and undoubtedly, there would be heavy financial and structural costs. A messy structural reorganisation of the administration of healthcare would clearly get in the way of healthcare delivery. What is important, what the public should not be fed, is the idea that it is not a reorganisation. It is exactly that.

The King’s Fund Barker report estimated that even after introducing a combined health and care service, spending would need to rise to around 11% of GDP to meet demand. This would still leave our health spending trailing the highest European spenders – but it would require double the spending increase that Labour is currently proposing.

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Unite leverage squads turn attention to private sector providers in the NHS

19/08/2014, 05:54:39 PM

Last year, Unite’s leverage department generated a storm of publicity with its actions during the Grangemouth dispute. Directors of the employer, Ineos, were targeted in their homes, with one executive calling the police after a leverage squad of 25 protesters arrived on his road, complete with banners and a giant, inflatable rat.

Now, word reaches Uncut that the union’s leverage squads will be turning their attention to private sector involvement in the NHS.

In a letter sent to union members, Unite leader Len McCluskey states,

“Our Leverage Department has now turned its efforts towards protecting our NHS…Unite will not stand by as the vested interest groups carve up the NHS for private gain and our Leverage Department has begun work to protect accident and emergency wards in your community, to protect hospitals and GP centres under threat in your community, and to expose and prevent the vested interest groups who tender for NHS work, those groups who have profit before patient care.”

On the Unite website, the work of the leverage department is described as,

“…a process whereby the Union commits resources and time to making all interested parties aware of the treatment received by Unite members at the hands of an employer. Those interested parties may include shareholders of the employer; competitors of the employer; communities within which the employer operates; customers of the employer and the market place of the employer…”

This latest move seems to represent an escalation of leverage activities. While in previous cases, leverage squads were deployed in industrial disputes like Grangemouth, it appears that ideological battles – such as the role of the private sector in delivering health services – will now be fought using these same tactics.

While many on the left in the Labour movement would support Unite’s expansion in the use of leverage, it is likely to cause the Labour leadership a headache in the run up to the general election.

The inevitable question that will be asked of Ed Miliband and Andy Burnham will be whether they back Unite’s decision to deploy leverage squads over the NHS.

If they condemn it, the story will be about another Labour-Unite spat. If they do not, then the old headlines about Labour being in the pocket of Unite and trade union militancy, will be recycled.

Either way, Labour is about to be put on the defensive.

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If we can’t access GPs, do we really have a health service at all?

11/08/2014, 10:54:08 AM

by Kevin Meagher

As I sit here nursing a nasty chest infection that I can’t seem to shake off, the crisis in the NHS is brought home to me all too clearly. I can’t get an appointment to see my GP before the end of next week, begging the question that if I cannot access basic healthcare at the point of need, do we in fact have a National Health Service in any meaningful sense at all?

As Shadow Health Secretary Andy Burnham has pointed out, the slump in service standards “is more marked in general practice than anywhere else in the NHS: in 2009/10, four out of five people said they saw a GP within 48 hours; now it is just two in five.”

And it’s set to get worse. A recent poll of GPs suggests average waiting times for a basic appointment are going to stretch to 13 days by next April. Apparently, I should have had the forethought to make an appointment after the first cough.

In response, the government’s NHS Choices website (“Your health, your choices”) suggests that people like me should “consider the alternatives” before bothering their GP. Thankfully, this is just a range of staggeringly inane and nannying ‘advice’ rather than an invitation to seek out a consultation with the village wise woman or medicine man.

Instead of seeing the doctor, “[t]he pharmacist behind the counter at your local chemist may be able to give you the help you need, so you won’t have to spend time waiting for an appointment.” Discussing your medical history within earshot of the queue in Boots certainly offers an interesting approach to patient confidentiality.

If, however, you feel compelled to seek out the kind of informed medical support that we pay our taxes to access when we are ill, the advice is not to forget your manners, especially to the support staff. “Be polite to receptionists. They are busy people who often have to deal with unhappy patients. Being polite to them will encourage them to help you.”

What is the corollary of this extraordinary statement? Patients are not busy people and if some receptionist does not consider a patient to be sufficiently ‘polite’ they will not help them?

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Labour needs to talk about the NHS

04/04/2014, 03:28:17 PM

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.

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