One Nation, One Health and Social Care Service

Andy Burnham opened Labour’s health policy review today by setting out how the next  Labour government will deliver better health and social care in an era in a financially constrained environment . In an age of austerity, compounded and worsened by the absence of anything like a national economic growth strategy, this is an essential starting point. Contrast this approach with the myopic ideology of the Tories – aided and abetted by their wholly owned subsidiary the ‘Liberal Democrats’ – which led the government to waste billions on a top-down re-organisation of the NHS that was shamefully hidden from the public before the last election.

Labour’s vision is of an NHS designed to meet the needs of our nation in the 21^st Century – not the production line model of the 20^th. This new, integrated vision has a committment to ‘whole-person care’ at its heart. Whole-person care will bring together physical health, mental health and social care into a single service to meet our changing care needs, in vivid contrast to the Cameron-Lansley-Hunt plan for the accelerated fragmentation and disintegration of the NHS.

Burnham’s vision is a true One Nation vision: a health and care system which is shaped around people not bureaucratic structures or market dogma, and where the institutions that bind us together like the NHS are protected for the future, even in an era where public finances will continue to face real pressures.

The 21^st Century is asking questions of our 20^th Century health & care system that it is increasingly unable to answer. The current system faces a huge sustainability challenge characterised by an era of economic austerity and rapidly rising demand.

We live in an ageing society where there are now 3 million people over 80 and this will nearly double by 2030. But under the Tories we are seeing the social care system collapsing, with rising charges for families and an ever-greater burden being placed upon the NHS.

And the system must be able to provide for increasing numbers of people with complex needs, mental health problems, or long-term conditions. The number of people with  long-term conditions, such as diabetes and asthma, will rise from 15 million today to 18 million by 2025. But Cameron’s marketisation is fragmenting care, not integrating it; irrespective of the ideology behind his plans, the facts are that this approach cannot meet the needs of society in the 21^st Century.  

The problem is this: we currently have 3 fragmented systems to deal with different aspects of health & care: physical health, in acute hospitals; mental health, often in separate services on the fringes of the NHS; and social care, in council-run services.

This system has two major failings: First of all, it’s a system that works for Whitehall, but not for people. Secondly, it’s wasting billions and we end up paying for failure. There are important progressive principles at stake here; every penny of the tax-payers’ money should be spent to its maximum effect (even more so in austere times) and as arguably the nation’s most valued public service, the first duty of the NHS is to the public, not public servants.

Cameron’s increased fragmentation of the NHS makes it harder for the system to deal with the care challenge facing the country. By contrast, Labour’s solution – ‘whole-person care’ – represents a radical shift to equip our health & care services for the challenges of the 21^st Century.

Today’s launch at the Kings’ Fund received a warm response. Bold, exciting, progressive. The challenges of the 21^st century will not be met by the systems of the 20^th. There’s a great deal of work to be done – lets get on with it.

Jamie Reed MP is a Shadow Health Minister