The NHS, and our campaigning weaknesses

The Government’s proposals for NHS reform are opposed by almost every part of the NHS, but they have been very good for the development of the Socialist Health Association. During 2011 we have really lived up to our description of ourselves as a campaigning organisation, in a way which hasn’t been seen for most of the last 60 years.

We’ve been in demand in the Labour Party where we’ve talked to 40 constituencies at least, and at a wide variety of other organisations. Our membership is not only larger – around 800 – but much more active and engaged. We’re rebuilding our website so that the 150 thousand visitors we get every year are more engaged and the site is better integrated with social media. We plan that our redesigned website should be the focus of debate where health and politics meet.

Lansley’s proposals have brought all the fundamental assumptions about the NHS into question. They have also got many clinicians focused on the political process as they haven’t for years. Doctors, of course, have huge political credibility, and one of our central tasks is to get more clinicians involved in political activity. The other is to help the Party understand healthcare.

Under Lansley’s plans, as messed up over the last year, there should be plenty of opportunity for political resistance inside the NHS. Health and Wellbeing Boards are being established in every local authority; local Clinical Commissioning Groups are to have lay members and Foundation Trusts have elected Governors. If we are to continue to fight for our principles in the NHS, these are the trenches in which we will have to fight. Up to now few Labour Parties have engaged with the NHS locally and elections in Foundation Trusts have been completely apolitical beauty contests.

Campaigning around the NHS has shown up weaknesses in the Labour movement’s ability to campaign outside its heartlands. It’s easy to rely on local MPs and councillors to lead political resistance and to organise demonstrations in Northern cities or central London but the political returns of this sort of activity are rapidly diminishing. We urgently need to devise ways of taking the battle to the enemy’s geographical territory where there are no Labour MPs and few councillors. We should be working out ways to support our sympathetic Trades Unions, Non-execs and councillors especially where they are in a minority, and this needs to use social media in a way which the Party appears unable to do.

Now that the end of the battle over the NHS reform Bill is approaching we are beginning to think about the development of future Labour health policy. It may be some time before the effect of Lansley’s Bill becomes clear, so we will focus initially on broader topics around public health and wellbeing and social care.

We also want to see more discussion of the different approaches taken to health in Wales and Scotland, both of which shun the Internal Market route. During the Labour Government we were never allowed to discuss the Internal Market or Foundation Hospitals, and many outside the Party blame Blair and Milburn for leading the NHS down the road towards commercial competition. The distinction between the tightly regulated market we established and the free market Lansley wants is not easily explained. If we are going to produce credible policies for the future we will have to confront these issues.

Labour achieved a great deal in the NHS, but our future policy development needs to consider our failures as well as our successes in the light of experience. This too needs to be done using social media to enable Party members to communicate with each other if we are to demonstrate that Labour has reforming zeal and ideas for the future.

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