I marched 300 miles recently because I believe in the NHS and which is the best system in the developed world. In the coming few months I hope there will be more clarity from the Labour Party on how they plan to save the NHS. They must not count on the blind faith just because 66 years ago their predecessors created the NHS; the world has changed…writes Prof. Rajan Madhok
At the outset I want to make two things clear. First, I am not party political and that the only reason for supporting Labour would be that the alternative with Tory/Lib Dems would lead to the destruction of the Welfare State and the Britain I chose, but the support to Labour cannot be unconditional.
Second, although I have followed the developments via media and attended a fringe event I have not been to the main Labour party conference – so my knowledge is limited and I will happily be corrected.
I note that two standing ovations to Ed Miliband’s speech were for NHS and that there has been a feeling of some ‘relief’ with the announcement of extra funding and extra staff. Like most commentators I will wait to see the detail and also how to implement such pronouncements, but for now I have three overarching problems with what I have understood about Labour’s stance on health and NHS.
First and foremost is my concern about public’s health – and to paraphrase Tony Blair (although some believe that it was Gordon Brown who had coined the original phrase!) – “we need to be tough on health inequalities and to be tough on causes of health inequalities”.
And the stark reality is that it is the austerity measures which have led to worsening of health, and the proposals to raise minimum wage to £8 by 2020 which means a 25p rise a year will go nowhere near in addressing this root cause. I would like to know more about what is planned to create the civic society and rebalance the gap between the rich and the poor, and how will we challenge and stop developments like TTIP and overall corporate greed which is not just creating income inequality but also affecting the environment and climate.
Second, and to follow on from above, although I am quite clear that 21st century health care for all, given scientific and technological advances, is not affordable (nor desirable) I still do not get why more money can’t be found. £2.5 billion is peanuts compared to what has been given to banks or lost due to tax evasion by the corporates. Without wishing to come across as ungrateful, all I will say is ‘need to do better’ here.
Third, the announcements like increases in workforce do not fill me with confidence, and this is because I cannot see the whole/big picture. Forget the practicalities of how to find such numbers I do not see where they would fit in; there is talk of Integrated/Accountable Care Organisations but what do these things mean apart from yet another ‘new fad’ from America. We need to be clear about what our NHS should look like and then plan the workforce, delivery and governance and management systems. What I have heard/seen so far is ad-hoc and not joined up- and I find it difficult to reconcile with other developments like Allyson Pollock’s Reinstatement Paper. Frankly, the NHS is completely broken now and not fit for purpose, and we need to restart. Andy Burnham’s repeated assertions that there will be no reorganisation make me very uncomfortable because it either shows lack of understanding (which I doubt) or the fact that the Party is not fully committed to doing whatever it will take to get the NHS right – and the latter reinforces the ‘mistrust’ amongst a huge number of supporters who are very aware that it was the Labour Government who created the conditions for the mess we find ourselves in.
I marched 300 miles recently because I believe in the NHS and which is the best system in the developed world. In the coming few months I hope there will be more clarity from the Labour Party on how they plan to save the NHS. They must not count on the blind faith just because 66 years ago their predecessors created the NHS; the world has changed and as the Scottish Referendum shows this will be a tough election. The public has woken and is determined to get accountability into the political system, and the public loves the NHS.
(Prof: Rajan Madhok is a former Medical Director in the NHS and chairman of the British Association of Physicians of the Indian Origin – BAPIO)