Wednesday, 22 October 2014

To Speak The Truth To Those In Power, by Clive Peedell

This is a big opportunity for Simon Stevens to wake up the government to the realities of the crisis and meltdown that the NHS is facing.

He must make the point that flat funding of the NHS is a policy mistake in the context of health inflation running at 4% and an increasing population.

Hence per capita spend on the NHS has fallen under the coalition. Efficiency savings are effectively cuts, and they have gone too far. Patient care and patient safety are at risk.

The NHS clearly needs more investment, and that needs to be at least a 4% increase year on year. This could be funded by addressing the NHS elephant in the room. That is the internal market, which is estimated to cost the NHS at least £5bn per year.

Thus, instead of employing accountants and lawyers to deal with the market bureaucracy, the money could be spent on frontline care where it is needed.

We also need to hear about the wasteful PFI, and a call for it to be abolished, with existing schemes bought out or refinanced at better value for the taxpayer.

If Simon Stevens wants to save the NHS then he needs to engage with NHS staff to get them onside with his vision and plans.

This can only happen if he is open and honest with them. He therefore needs to follow the lead of the cabinet minister who admitted the NHS reforms were a mistake.

The enormous financial cost and associated upheaval of this undemocratic top-down reorganisation has been hugely damaging and must be acknowledged.

In order to address demand on the NHS, we must also see a focus on the social determinants of health such as poverty and deprivation.

Austerity policies are unsustainable and incompatible with a healthy welfare system and the NHS won't survive as as free at the point of service system much longer.

Public health must also be top of the agenda with a call to back plain cigarette packing and a minimum price on alcohol.

We must also hear the arguments that healthcare spending actually helps to stimulate economic growth and investment in the NHS will help fuel the economy and address wealth and health inequality.

I hope Simon Stevens takes this opportunity to speak the truth to those in power.

The solutions are actually there, but he should listen to NHS staff and the public, not to overhyped management consultants and to politicians with vested interests.

What the NHA Party is calling for:

  • Guarantee a minimum 4% annual rise in NHS spending to keep pace with healthcare inflation. This should be funded from​ general​ taxation including a 1​ ​​penny temporary rise to address the NHS spending gap until ​NHA ​policy ​initiatives ​(remove the market, halt privatisation, end PFI) ​bring ​billions of pounds of ​savings.
  • Aim to increase NHS funding to at least 10% of GDP to bring us closer to the levels of healthcare spending in other G7 countries.
  • End the costly Private Finance Initiative.
  • Use the purchasing power of the NHS to get the best value in procurement.
  • Repeal the Health and Social Care Act in the least disruptive way possible.
  • Remove the competitive market by abolishing the purchaser provider split.
  • Halt and reverse NHS privatisation Integrate health and social care.
  • Bring back national and regional planning structures into ​the ​NHS.
  • Involve public health and representative clinical leaders in the policy-making process.
  • Keep public health improvement teams in Local Authorities and re-establish public health teams in the NHS.
Patient care:
  • Abolish prescription charges and resist imposition of charges for NHS services currently free at the point of use.
  • Improve the patients' complaints process and protect whistle-blowers within the NHS Prioritise prevention of illness and the social determinants of health in all policy-making​, including minimum alcohol pricing, plain cigarette packaging and a sugar tax.
  • Ensure safe staffing levels throughout the NHS with an increased number of GPs, nurses and midwives. 
  • Create a sustainable workforce by improving training places, recruitment and retention​, fair pay, reducing burn-out and losing staff outside the NHS.
  • Establish parity of esteem between mental and physical healthcare​ and invest in crisis care teams for mental health patients.
  • Ensure women are able to give birth locally and safely whether at home or in hospital, and improve continuity of care by midwives.
Dr Clive Peedell is Co-Leader of the National Health Action Party.

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