Miliband evading the big questions on the NHS ------------------------------------------------------ Ed Miliband has written about the NHS in today’s Daily Telegraph, saying people should be given more power to help themselves and the importance of organising services around the needs of people, instead of organising people around the needs of services. The full piece can be read here: telegraph.co.uk/news/politics/ed-miliband/10673978/Ed-Miliband-treat-yourself-and-save-the-NHS.html. But John Lister, NHA policy advisor, says Miliband’s short article has succeeded merely in raising more questions than answers about Labour’s plans for the NHS: What Ed Miliband says in this article is basically what he said at last weekend’s Labour conference. We have seen similar ideas from Shadow Health Secretary Andy Burnham, but with more concrete proposals for putting councils (via Health & Wellbeing Boards) in charge of commissioning local services, along with GPs. There’s nothing wrong with many of these ideas as such: but when this is all that Ed Miliband says, it seems to evade all the big questions: 1. To do as he suggests means reversing the fragmentation of health care and the split between health & social care. This means repealing at least the core of the Health and Social Care Act. Unlike Andy Burnham, who has repeatedly promised to do so, Miliband does not mention this. In fact he rejects the idea of any “top down reorganisation” — which might mean leaving the Act in place. 2. To develop services on the level Ed Miliband suggests is quite impossible with the tightening budget for the NHS, and even less possible with Osborne’s planned further squeeze to 2021. To fulfil this ambition, Labour has to break from Osborne’s policy and spend more money. He says nothing about this. 3. To develop mental health care on the level Miliband suggests means tackling the historic and now widening disparity between the resources of physical health and mental health. Mental health is 24% of the disease burden, but receives just 13% of NHS Budgets. Mental Health spending has been falling in the last 2 years, and Mental Health tariffs are to be cut next year by 20% more than acute tariffs. We are already desperately short of acute Mental Health beds, secure Mental Health beds and Child & Adolescent beds – and are sending patients miles from their homes to remote, costly and poor value private facilities. Labour has to stop this waste and resource starvation in services to those with the greatest mental health needs before it makes any sense to pump extra resources into the services for people with less serious needs, such as “talking therapies” and the type of mental health care Miliband is talking about. 4. The community health, primary care and social care resources have to be put in place before it’s possible to get people to look after themselves better, empty hospital beds and rationalise hospitals. All this requires investment. Services were admitted by Prof Keith Willett, director for acute care for NHS England on the BBC’s Today programme this morning to be “at full stretch”. So it will mean more money to do more. Will Ed tell the other Ed to get real and promise increased NHS, council and public sector funding? Integrated services of the type Miliband proposes here need to be planned and controlled, and the best use needs to be made of resources: there is no room for wasteful competition and the profit margins of private sector providers. Only 2 weeks ago Miliband was echoing Blairite commitment to “choice, contestability and competition” and insisting that the private sector “has a role”. He was wrong then. Has he changed his mind already? Labour needs to be clear on restoring a publicly-funded, publicly provided NHS. Any choices should be within that framework.
Posted on: Tue, 04 Mar 2014 12:46:41 +0000
Trending Topics
Recently Viewed Topics
© 2015