On Thursday Andy Burnham began to describe his vision of the future of the NHS. It is an ambitious and exciting vision for a “whole person”, integrated health service fit for the 21st century. It was an impressive launch of Labour’s health and care policy review.
In a speech that was refreshingly practical, rather than ideological, Burnham focused on the problems families face when relatives are in hospital. He linked this convincingly to the need for the integration of physical, mental and social care services. The requirement to stop the perverse incentives which exist in the NHS and the importance of a health service which enables as many patients as possible to stay out costly hospital beds and in their homes, was the centrepiece of this launch. It is a well thought out vision that both patients and doctors can relate to.
This ambition for the NHS could hardly be more different to the current Tory/Lib-Dem health policy: integration versus segmentation, patient versus profit and, importantly, evolution versus revolution.
Burnham went out of his way to emphasise that the next Labour government would work with the institutions which they inherit. Clinical Commissioning Groups would stay in place, but have their remit changed, and Health and wellbeing Boards will be bolstered. In committing to this Burnham can be seen as actively courting the health professions, who do not want more uncertainty, and gaining their consent for gradual reform.
“Any qualified provider” status will be changed back to the “NHS preferred provider” system and the rules of the market as defined in Health and Social Care act will be repealed. However, in line with the practical nature of his approach, Burnham stopped short of promising to turf out the private providers that will exist in the NHS in 2015. This is sensible and realistic. The refocusing of a system away from profit towards the patient will see many private companies unable to compete against a cheaper and more efficient public alternative. Again, evolution not revolution.
The challenge now is how this will be achieved. The formation of an integrated care service without a top-down reorganisation and through a process of gradual evolution is a very tall order. The health and care policy review will be important not just for fleshing out the detail, but also in making the case for change and gaining the trust of both patients and doctors.
As Burnham said this is the start, not the end of a journey; but the direction is spot on.