Like many people in the UK, I am proud of the NHS and anxious about its future. My own family has had excellent healthcare, but news headlines emphasise failure and huge strain on the system, both from insufficient funding and from staff leaving due to Brexit. My prior knowledge is limited but I have read 1) that we are spending less on our healthcare than comparable European countries, and 2) that the American privatised system results in far greater spending overall for poorer or similar outcomes. However, it seems that our Government is turning towards American style privatisation rather than to Europe.
The NHS is so large and complex that it is very hard for an outsider to understand what is going on. Which reforms should we be opposing? Which are dangerous and which simply modernisation? Might we lose services without realising the danger?
The one-day conference organised by Stroud Labour Party with Unite and Unison support was very informative about the local and national situation. There were several workshops and strands so I can only report on the ones I attended.
The talks started with David Drew MP and two Union officials talking about the local and national situation. The phrase ‘A deliberate and malicious fragmentation of the NHS’ was used, and the implications of the plan to put 750 local NHS workers into a new company was put into context. The lack of transparency and public consultation was highlighted. Apparently this is happening in many areas as well as Gloucestershire, though some places have ruled it out. It seems to be partly a way of reducing tax (odd for a tax-funded body) and partly for staffing and pensions savings later on. Documents also refer to ‘greater operational efficiency’ but offer no convincing detail on why. It also seemed to be against civil service advice.
A campaigner for healthcare in rural areas said that people’s health is hugely affected by lack of access. With small community hospitals targeted for closure, A&E departments being consolidated further away from many, and public transport appallingly reduced, the people who need the care most are the least likely to be able to get to hospital and follow-up clinics quickly. As a consequence, asthma, diabetes and heart attacks all have worse outcomes in rural areas. We should not accept this on the grounds that not many people are affected: we are a prosperous enough country to be providing good care everywhere and we should be addressing these issues.
A Health Visitor said that while people do generally try to take responsibility for their family’s health, many children are living in poverty and under stress, in substandard or temporary accommodation, with increasing rents and reduced state support. All this makes providing a stable nurturing environment very hard. There is research to show that early support and intervention has the best effect on children’s health and achievements, but 350 Sure Start Children's Centres had closed by last January.
This all implied that the whole system is under huge stress and it will be hard to lessen the burden by focussing on the NHS alone: improvements to housing and transport are vital considerations.
A local NHS consultant spoke, showing the difference in funding under Labour and Conservative governments, she said that there have been many headlines about A&E failures but in her experience it is working pretty well. However, it is often at A&E that other stresses become apparent. She compared the situation with a plumbing crisis, saying “where the water sprays out is not always where the original problem is”. She also said that she didn’t think people were using A&E inappropriately (as the papers allege), as she rarely sees someone who shouldn’t be there. She says the NHS does need to adapt to stay effective and not every reform is bad. Attempts to blame the ageing population for overuse of resources is ridiculous, given that we’ve done censuses since 1911 and this should have been planned for.
Several people said that we need a positive approach. Too much gloom makes people give up and feel they have no chance of changing anything. It’s important not simply to oppose but to show what we can achieve.
The afternoon keynote speaker was Professor Wendy Savage, the president of ‘Keep Our NHS Public’ https://keepournhspublic.com/ which looks like a very useful resource for information on the implications of current plans.
Another speaker, Caroline Molloy from OurNHS, https://www.opendemocracy.net/author/caroline-molloy talked about attempts to blame groups for overusing the NHS, including migrants, smokers, and people who are overweight or elderly – and showed statistics undermining these deliberately divisive claims.
For the last workshop of the day, I chose the Unions one, ‘Engaging Health Workers in the Unions to save the NHS’ and found it very interesting. Someone said that a report on Union membership was titled ‘Smaller and Older’ and what can be done? When I started work, joining the union was a matter of course, union reps spoke as part of the induction process, but when younger people I know started work, unions were not mentioned at all. (Material for a different blog post there!)
Overall it was an excellent, informative day and I really congratulate Stroud CLP for organising it.
(I’ve written up summaries of the talks I attended as I understood them, please do get in touch if you spot any inaccuracy.)