Bravo Andy Burnham

27th January, 2013 12:07 pm

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to the “NHS preferred provider” system and the rules of the market as defined in Health and Social Care act will be repealed.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.

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  • JoeDM

    All about structure and organisation. Nothing about people and the quality of personal care provided at the bedside !!!

    Labour did nothing to improve the failed NHS during the 13 years of power. Where did all that money go? As spending doubled the general level of care declined in increasingly filthy hospitals.

    • Alexwilliamz

      Have you really forgotten where the NHs was 15 years ago and more importantly where it was heading?

      • Yes, in some respects Labour saved the NHS. There are significant differences between Labour’s approach and that of the Tories, but also, some similarities.

        New Labour snuggled up to the private sector with religious passion (though probably didn’t expect to wait until the afterlife for their reward). Even the Auditor-General had to admit that, in order to make PFI contracts look better value than the publicly financed option, “pseudo-scientific mumbo jumbo” was used, requiring civil servants to “unlearn some long-established principles of objectivity and honesty in order to sign off on PFI contracts.” *

        *For more see Profs. Leys and Player in The Plot Against the NHS.

      • JoeDM

        That is not the point. The point is the quality of patient care at the bedside.

        Endless discussion of organisational structures etc. will do nothing to improve the attitude of the staff towards those they are supposed to care for.

        Just read about the years of failure (under a Labour Government that was doubling the amount spent on the NHS) at Mid-Staffordshire NHS and you wonder how many other local NHS organisations are getting away with similar poor patient care.

        • “The point is the quality of patient care at the bedside.”

          Which hasn’t been at all improved by the loss of 7000 nurses since 2010*, without any reduction in demand. What we are seeing is the running down of NHS to enable the arguments for privatisation to become all the more compelling. Yet there is no evidence showing that the private sector can deliver a more effective or cheaper service than the publicly funded alternative. The Tories (along with some New Labour MPs – Burham himself is not unblemished) have launched is an ideological assault on the NHS.

          Be prepared: In the coming months there will be a storm of NHS related horror events in the Tory media. This won’t be part of a campaign to re-employ more nurses, it will be part of a campaign to open up the NHS to corporate health providers and insurance companies – or to put it another way, it will be a campaign to commodify any illness you are unfortunate enough to have.

          While on the topic, folks might like to study this list of MPs with financial links to companies involved in healthcare**.

          * http://www.mirror.co.uk/news/uk-news/staff-shortages-at-17-hospitals-could-153207

          ** http://socialinvestigations.blogspot.co.uk/p/mps-with-or-had-financial-links-to.html

        • Patient satisfaction soared under the last Labour government. The reason is that quality of patient care improved considerably.

          I have a long term condition, so I have used the NHS regularly for 40 years (by regularly, I mean at least 4 hospital clinics a year and at least 2 GP visits, but some years I have used the NHS more). I can categorically assure you that care improved vastly from the beginning of the century. I remember the bad old Tory days when I would arrive at a hospital clinic at 2pm and not be seen until 6. I remember the days walking down the hospital corridor avoiding the buckets placed under leaks in the roof. I remember the demoralised staff overworked to breaking point.

          That changed under Labour. In 2010 hospitals were in the best state they have ever been in, staff were motivated and waits at clinics were no more than 15 minutes. I am now seeing the return of the bad old Tory days, in fact it is worse because now we are seeing hospitals made bankrupt by a government who is more concerned with money than patient care.

          Mid Staffs is not representative of the NHS under Labour. In fact, it is exactly what the government’s reforms are designed to produce. This government has cut hospital funding by 1.5% for two years (and it intends to cut more). The NHS is expected to behave like a market, you know, a market like electrical retailers like Comet and Currys are part of, and this means that the government wants trusts to fail, go bankrupt and close. Just like Mid Staffs. I do not want this.

  • Brumanuensis

    Burnham has always ranked highly in my estimation – he was my second choice in the leadership election – and the changes he’s proposed recently, particularly on integrating the NHS and social care. In my experience, the weakest element of the NHS has been co-ordinating these two branches, which generates waste and also hurts vulnerable patients. Needless to say, if he commits to repealing the stupid limitations that the government have placed on NICE, one of the finest bodies working in the public sector, he’ll have crafted a near-perfect alternate health-care policy for Labour.

  • I attend my local HWB as a member of the public. The board needs considerable “bolstering”, in particular, the elected members need to realise that they are there to represent their communities and to challenge the decisions of the commissioners. This is not happening. In fact, I would go as far as to say that I think some of the councillors on the HWB haven’t a clue about the commissioning strategies of the National Commissioning Board or the CCGs in their area.

    I think Labour needs to think very carefully about how to make HWB more effective. One suggestion may be to have directly elected members (rather than local authority councillors) in addition to the commissioners, and to co-opt these elected members as voting members on other relevant local authority committees (at the moment, it is the opposite way around, councillors from local authorities are co-opted onto the HWB).

    We need to have health and wellbeing to be at the centre of everything that the local authority does, and hence, having a directly elected HWB member on local authority education and housing committees (for example) will give them the legitimacy to challenge decisions from a health point of view.

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