• By Pam 

An overview of the National Health Service

1. Labour’s FinestThe National Health Service was set up by The Labour Party to provide free quality health care to the British population and is greatly valued.  Aneurin Bevan officially started the National Health Service on July 5 1948.  It was born out of a long-held ideal that good healthcare should be available to all, regardless of wealth. (History of NHS)

When health secretary Aneurin Bevan opened Park Hospital in Manchester, it was the climax of a hugely ambitious plan to bring good healthcare to all. For the first time hospitals, doctors, nurses, pharmacists, opticians and dentists were brought together under one umbrella organisation and health provision was free for all at the point of delivery.

The central principles are clear; the health service was to be available to all and financed entirely from taxation, which means that people pay into it according to their means, under national insurance or income tax. These the fairest ways to share to costs of providing for a civilized society……

…..and so it must continue.  

Labour must continue to provide free quality care for all citizens throughout their lives. Labour recognises that the modern world is changing. We must address the challenges, which the NHS faces today, but recognise that the fundamental principles under which the Labour Party was founded should remain and be protected. The NHS is owned by the people, exists for the people, and aims to deliver quality health provision to all of our people regardless of income.

The plans of the current government are without doubt, intended to dismantle the National Health Service and to replace it with a two-tier system.  The coalition government wants the NHS to fail.

Documents obtained by the Guardian (here) under the Freedom of Information Act reveal research by civil servants warning that “markets are susceptible to “failure” and costs could in fact rise unless a true market is created by allowing public services to collapse if they are unsuccessful.”

It opens up the potential for schools, hospitals, social care systems and nurseries to fold without the government stepping in to prop them up.

The Tories want these systems to fail, in order to set up private Health Care Providers from which the profiteers can benefit. Private companies first responsibilities are to their shareholders and the banks rather than to provide the best possible health provision and so the assets paid for by the public will eventually end up in the hands of the very rich.  These mega-rich keep their funds in OFCs (Off-shore financial Centres) or Tax havens and do not fairly contribute into the National Health Service. This is a legalised form of theft.

GPs and consultants have joined with many others in rejecting this. (here) The Liberal Democrats are claiming they have caused the government to make a U Turn on plans. The Guardian  (No U Turn) shows that the privatisation plans are still very much on track and:

“If you had listened carefully while all this was going on, you would have heard Lansley reassuring his backbenchers that the core principles of the bill remained in place and that no red lines had been crossed, and he was quite right. Very little of significance had changed and the bill is still on course to achieve its underlying intention, accelerating the privatisation of the health service, turning the NHS into a kitemark attached to a ragbag of competing and largely private providers.

All the mechanisms to do this are still in place. Private companies can still be involved in commissioning NHS services and these services will still be delivered by any “qualified” provider. Thus the commercial sector can still hold the budget and provide the care. Competition, the aspect of the reforms that most worries doctors, emerges almost intact.”

Furthermore, as health of the nation suffers, this government is hurting even more by cuts to incapacity benefits. The proposed reforms of of the Coalition, where no party has a majority, will remove  the government’s statutory duty to provide universal health care. These policies are based quite simply on right wing ideology, looking to strip assets bought by the public purse and provide a second class service for the vulnerable and needy as they pursue their destructive plans. We can shout at the Tories, but we should not forget that it is the Liberals who seek to keep them there, Liberals who are basking in that little bit of personal glory. Labour must emphasise that the Liberal Democrats share responsibility for damage done to our NHS, and share the blame.

2.   General Practioners Under Labour, GPs should continue to provide free, local surgeries, and confidential consultation for patients. A variety of other services will be located at local Health Centres.

The consultative role of the GP as a first point of contact for patients should be one of trust. The conflict of interest, which would be brought about by GPs managing NHS budgets, is obvious. It is not a career that GPs trained for or wished for. What a waste of the nation’s resources training would-be-doctors to be doctors, and then asking them to be accountants.  This is shameful, and absurd!

3.   Health monitoring Free health monitoring should be extended by a Labour government and should include:

• Regular dental checks and subsequent necessary treatment
• Regular eye tests if advised by GP or other professionals. A patient’s contribution to costs of spectacles may still be necessary, but means testing should apply.
• Breast screening, cervical cancer, bowel cancer screening etc., as advised by GPs
• Regular, general health checks
• Free hearing tests, if recommended by GP.
• Free chiropody as recommended
• Immunization programmes for children, and adults where necessary
• Obesity support and dietary advice
• Contraception advice and sexual health
• Genetic Counselling
• Mental and emotional health and support
• Drug and misuse of substances counselling and support
• Link with other services, including education, social care and housing

4.   Prescription charges
Prescription charges of one shilling (5p) were introduced and a flat rate of a pound for ordinary dental treatment was brought in on June 1 1952 (1).  Prescription charges were abolished in 1965, and prescriptions remained free until June 1968 when the charges were reintroduced.

The cost of prescriptions in some parts of the UK today prevents many from visiting their GP, or from collecting their prescribed drugs. Elsewhere it is free. People living England near the Welsh border can hop over the border, and get their prescriptions free! If ever there was a postcode lottery, this is surely it!

Essential drugs must be provided free, and prescription charges no longer apply. It is unfair that these are free for some citizens and charged by others simply because of where they live.

There should be an end to post-code lotteries. Labour must ensure prescriptions recommended by medical practitioners are free to all citizens in all parts of the UK. Labour should fund NHS drug research in our universities, and stop the haemorrhaging of NHS funds to privatised drug companies which are profiteering at public’s expense.

5.   Maternity Services

The chronic shortage of midwives needs to be reversed, and there should be consultation with the Royal College of Midwives and trade unions as to what measure professionals find necessary.  More midwife led units in the community should be set up and linked with health visitors monitoring children’s health and development.

Adequate staffing of midwives and specialist obstetricians in hospitals needs to be put in place.  UK is in the middle of a baby boom, with nearly 800,000 babies born last year – one birth every 40 seconds – making it the highest birth rate for 20 years. (Midwife shortages)

BBC One’s Panorama has conducted an investigation *(to be televised on Monday 25^th July 2011) of every maternity unit in the UK to explore the NHS maternity ‘crisis’ linked to the baby boom and how, along with a massive shortage of midwives and a rise in complex births, maternity units are struggling to cope with  ‘relentless’ pressure.

6.   Staffing Adequate staffing of medical professionals and necessary support staff should be a priority of a Labour government, and consultation will be made with nurses, doctors, midwives, speech therapists, physiotherapists, radiographers, psychiatrists and all specialist staff. Training of medical staff needs to be high quality and costs funded by the state for those working in public sector for at least five years. There should be a detailed review of Pay and Conditions. Many highly qualified medical practitioners are being lost because of inadequate staffing, poor working conditions and low pay.

 7. Listening and Monitoring

Opportunities and procedures for evaluation of the NHS from both staff and patients need to be developed. There should be a consultation with all the different professionals involved. Staff morale needs to be boosted.  Users of the service need to feel they are given the very best care possible. Patients’ experiences will be listened to, and invited. Patients are individuals and should feel cared for and their serious suggestions for improvements for their care valued.  There should be a comprehensive review of procedures, systems and working practices throughout the NHS involving staff and patients.

Sue Marsh from her blog  (Diary of a Benefit Scrounger), writes:

“How about patients? How often do you watch Newsnight or SkyNews or the Daily Politics and see a debate over healthcare taking place between two or three patients? Politicians never ask us either. Some hospitals however, make great attempts to involve patients on their boards, or in planning staff training. Many have done endless studies into mental health care or chronic care or elderly care and their expertise and best practices can – and must – be rolled out across every hospital.”

8.   Health Education

The Health Service should maintain a presence in State Schools and ensure children receive health education, including diet, hygiene, sexual health and emotional mental health. The Health Education Service should be redeveloped and there should be a presence in local surgeries.

9.   Science and Research

The NHS should continue to be a major player in clinical science, and in drug development. This will be developed further. The cost to the Service paying for new drugs developed by private pharmaceutical companies could be reduced if NHS scientists are employed and link with universities.

The Independent reports (here):

“A detailed study by Dr Marcia Angell, the former editor of the prestigious New England Journal of Medicine, says that only 14 per cent of their budgets go on developing drugs – usually at the uncreative final part of the drug-trail. The rest goes on marketing and profits. And even with that puny 14 per cent, drug companies squander a fortune developing “me-too” drugs – medicines that do exactly the same job as a drug that already exists, but has one molecule different, so they can take out a new patent, and receive another avalanche of profits.”

10.   Mental Health

Labour must acknowledge that the provision for mental health has been underfunded for many years and requires ring-fenced investment to raise it a suitable level.  There should be access to a range of talking therapies.  Cognitive behaviour therapy is very effective for some but not all users.  Student doctors require greater training in all aspects of mental health.   The economic implications of depression and anxiety disorders alone justify the additional funding.

The Coalition government’s polices are cutting hard and yet reports of closure of mental health hospitals and psychiatric services are  hitting the news with increasingly frequency.

There are cuts to mental health across the nation including Northern Ireland (here),  Brentford (here) and Camden (here)…

“ Where 95 mental health beds, resulting in the loss of the Grove Centre and Queen Mary’s House, are closing imminently. This will save nearly £5m.A hasty “discussion” is currently being held about the future of St Luke’s Hospital, which has been in use for mental health treatment since 1930. This historic site, which the trust owns, and which is a green and pleasant environment for users of mental health services, is to be flogged off to the highest bidder as soon as possible”.

 

11.   Living Conditions and Public Health

Thedeteriorating effects of external factors on public health, for example lack of affordable housing and on the cost of keeping warm, of the cutting of health education have direct effect on the NHS, and this is something, which the government are aware of.  The Coalition government’s nudge policy was criticised by  (Grahame Morris MP).

“The savings resulting from existing Public Health measures are likely to be reversed under the current government’s cuts’ programme, and will load extra costs across many facets of people’s lives. For example, there is solid evidence that good housing leads to good health, to better education and to well being. The consequences of cold homes are estimated to cost £2 billion per year. Yet this is the first time since 1945, that there has not been a policy on fuel poverty.  50% cuts to social housing budgets, will also lead to increased levels of fuel poverty. 

Other public health consequences resulting from the election of the Tory-led government include such diverse concerns as the fact that the school meal standard will not apply to the new Academies; the rising unemployment figures will be associated with rising mental heath issues, stopping or inadequate food labeling will prevent people making healthier dietary choices, and it is clear that there will be ‘knock-on’ effects from the cuts to the health service budget, to welfare, to Sure Start, to housing and to the benefit system.   Public health measures are very significant across the board, and the cuts will evidence their importance both in costs and quality of life.”

These cuts will not save money, and will have profound effects on the nation’s health and such demands on the NHS, which the government hopes will mean that the service will ultimately fail.

Privatisation and commercialisation of the NHS must be avoided. Any assets stripped by the coalition government should be brought back into our National Health Service by a re-elected Labour government. Furthermore, there needs to be a National Care Service set up to provide for the elderly and vulnerable.Labour must protect, care for and ensure good health of every citizen. That is Labour’s duty, and those are our citizen’s rights.

Without Health there can be no Wealth,

Without Learning there can be no Earning

Without Sharing there can be no Caring

 

Without Labour looking and leading leftwards, we are lost!

The NHS has been Labour’s finest to date. But with socialist policies, I believe Labour’s finest is yet to come.  Let’s move forward.

References and Further Reading

1. History of the NHS http://www.nhs.uk/Tools/Documents/The%20history%20of%20the%20NHS.htm

2. NHS U Turn A Fake:  http://www.guardian.co.uk/commentisfree/2011/jul/06/andrew-lansley-health-bill

3. Fuel poverty

http://www.guardian.co.uk/money/blog/2011/jul/15/fuel-poverty-killer-too-little

4. Health and Housing  Research site http://www.healthyhousing.org.nz/

5.  Grahame Morris MP, on Public Health  in June 2011-07-17 A report by Pam Field, and Dr Sue Davies 

6. Sue Marsh’s Blog on NHS, including  Patients’ influence on NHS decisions

http://diaryofabenefitscrounger.blogspot.com/2011/02/do-you-really-want-to-save-nhs.html

7. Drug companies http://www.independent.co.uk/opinion/commentators/johann-hari/johann-hari-the-hidden-truth-behind-drug-company-profits-1767257.html

8. Midwife shortage, http://community.rcm.org.uk/groups/midwives/conversations/one-born-every-40-seconds

 *9. http://www.bbc.co.uk/pressoffice/proginfo/tv/2011/wk30/mon.shtml#mon_panorama

10 BBC Mental Health Cuts , Northern Ireland

http://www.bbc.co.uk/news/uk-northern-ireland-13755974

11 Camden and Islington Cuts 

http://www.camdennewjournal.com/letters/2011/jun/cuts-will-leave-us-warehouse-mentally-ill

12 .Brentford Cuts, Mental health

http://www.romfordrecorder.co.uk/news/cuts_to_beds_in_mental_health_wards_in_brentwood_1_965340

13 Report from Guardian, Ministers urged to let hospitals fail

http://www.guardian.co.uk/society/2011/jul/11/nhs-health

14. Providing a quality standard of living for a civilized nation

15 Doctors reject coalition’s health care plans

http://www.guardian.co.uk/society/2011/jun/28/doctors-reject-health-bill-changes