24 Sep 2014

Labour’s health policy: eight months to fill in the blanks

The first thing to say about Andy Burnham’s speech to the Labour conference was that he used an autocue.  Given what happened to Ed Miliband yesterday, this is no small thing. No forgotten paragraphs for the shadow health secretary.

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The second point is that although his speech was short on detail, it was impassioned and he had barely got started when he raised the audience to its feet in honour of the “Darlo Mums” and the “People’s (300 mile) March for the NHS”.

It is all in the timing, of course. And this is his time. Health and the NHS, specifically, is very much on the agenda and it is likely to stay there until the next election.

He invoked the A&E crisis, the “dismantling” of the NHS, the broken promise of  “no top-down reorganisation”.  It is all powerful stuff and just what the delegates wanted to hear.

He invoked, too, the spirit of Nye Bevan, although that is compulsory for any Labour health spokesperson.

Although this was not quite 24 hours to save the NHS,  certainly rescuing it from David Cameron was  the theme.  And how is he going to do this? Integration. Not terribly catchy.

This was one paragraph from his speech: “We will ask hospital trusts and other NHS bodies to evolve into NHS integrated care organisations, working from home to hospital co-ordinating all care – physical, mental and social.”   See what I mean?

Yet, as he knows, this is being discussed across the health and social care worlds and is garnering increasing support as a way of dealing with our growing elderly population, the increasing pressure on our hospitals and the shortage of money.

What Mr Burnham did not say is how this integration would be done, who would be in charge of commissioning this care. If there was a single body in charge of buying this care for patients, where would this leave clinical commissioning groups? Would it be put in to the hands of local authorities or trusts or health and wellbeing boards?

Who knows. But that is  the sort of detail that policy wonks and health hacks want. Today was for the public.

So, he promised that the frail and the vulnerable would no longer be “shunted around the system”. Now that is catchy. As is “a national health and care service truly there from cradle to grave”.

In fact, what he was describing was essentially the coalition government’s better care fund plan which is being piloted at a number of places around England.

One team, one point of call, a personal care plan. Teams of home care workers, physios, OTs, nurses, midwives with GPs, mental health nurses and therapists.

It is just he is making a commitment to it, whereas the coalition is still waiting for the results as it were.

There was another catchy phrase, too. And this is despite it being repeated from last year. It was the  promise to repeal the health and social care act.

And again it did not seem to matter to the delegates that there was no detail. They hate it and it is enough to say it is going to go.

Actually, in the past Mr Burnham has said it will not in fact be a wholesale bonfire but rather a repeal of selected sections (not very catchy, so he didn’t say it like that).

One can only suppose that he means the parts dealing with competition and the private patient income cap (the amount of income a trust can make through treating private patients).

Still, there are eight months to the general election so there will be time to fill in the blanks and to work on keeping it catchy.

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4 reader comments

  1. CWH says:

    And what did he say about TTIP and its likely effect on the NHS? I think it was certainly in the minds of those 300-mile marchers.

  2. Richard says:

    Same old Labour rubbish with no details.

  3. anon says:

    a question really, integration would be better than disintegration, and a welfare state relies on a strong economy with all factors of production ie people http://www.businessdictionary.com/definition/factors-of-production.html, balanced budgets etc, is this amount of money the answer? or a faction of what is needed? is something far more radical needed? plus crucially rooting out some bad apples while taking the pressure off the good.

  4. Andrew Dundas says:

    What you’ve omitted from this interesting homily, Victoria, is that Party Conferences are not policy-making events. They are about presenting a political advocacy.
    The other omission is that integrating health-care is about wresting control from local councils and councillors. Those councillors must be persuaded not to kick-up opposition. Just as Nye Bevan had to persuade, cajole and bribe doctors to agree to to a state health service, so too must Andy Burnham have to convert councillors into giving up what they see as their vital prerogatives.
    It’s a myth that we’ve ever had a fully state controlled health service. Most of the suppliers are commercial firms and professionals who’re not directly employed by the NHS: hardly any GPs, dentists, opticians or pharmacists are direct employees. Mostly, they’ve always been contractors. Yet they each have to consent to these changes.
    The Tories forgot that, because the belief of a state controlled NHS is so prevalent. But that has to be changed in a democratic society wherein consent is mandatory. Most of the time.

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