The model of a universal, free-at-the-point-of-use NHS works. This ‘NHS for all’, publicly owned, provided, and accountable has frequently been ranked one of the best health care systems in the world. It is not the model that is broken, it is governments that have failed the NHS – and the population they are there to serve.
The NHS founding principles were sound, but the steady privatisation and defunding of our NHS has led to the worst crisis and worst performance in its history. We must change course before the service collapses completely.
1. A PUBLICLY PROVIDED NHS: END PRIVATE INVOLVEMENT
◼︎ Ensure access to health care is based on need, free at the point of use
◼︎ Uphold the founding principles of the NHS: universal, comprehensive care
◼︎ Provide free NHS care and treatment for everyone in the UK at the time of need
◼︎ Abolish NHS charges for migrants living in the UK
◼︎ End the myth that privatisation brings efficiency
◼︎ Commit to all NHS clinical and support services being publicly funded and managed, and bring back outsourced services into the NHS where they belong
◼︎ End the diversion of NHS funding into private hospitals
◼︎ No more NHS disintegration and private involvement on Integrated Care Boards
2. AN NHS FUNDED TO SUCCEED – NOT DEFUNDED TO FAIL
◼︎Defunding the NHS is ideological and unnecessary – investment in the NHS is practical, cost-effective and delivers results
◼︎ It is a myth that publicly provided care is unaffordable
◼︎ Bring annual NHS funding up to the average per-person funding of comparable economies (eg France, Germany, Netherlands) and paid for through a revised tax system including tax on wealth and unearned income
◼︎ Invest new capital funding to restore infrastructure and meet standards required for comprehensive, responsive, and efficient healthcare
◼︎ Restore NHS buildings and bed numbers, ensure scanners and other equipment are provided End the scandal of excessive waiting times
3. RESPECT, RECOGNITION AND DECENT PAY & CONDITIONS
FOR ALL HEALTH WORKERS
◼︎Restore safe patient care, job safety and satisfaction for all health and care staff by providing safe staffing levels, decent pay and career progression
◼︎ Fund long-term NHS workforce plan based on assessment of needs and revise this annually to meet the current and future health and care needs of the population and staff, matching training numbers to safe staffing levels
◼︎ Fully fund training for staff at all levels to meet the workforce plan and end de-professionalisation and deregulation of the health workforce [1]
◼︎ Ensure necessary recruitment and retention, and put into practice ethical recruitment principles
◼︎ End the two-tier working conditions of NHS staff outsourced to private companies
4. RE-INVEST IN PUBLIC HEALTH & TACKLE HEALTH INEQUALITIES
◼︎ Rebuild a coherent and comprehensive public health service able to analyse, understand and respond to ongoing community needs and recognise that public health cannot be reduced to leaving it to individuals to make healthy choices
◼︎ Ensure effective planning for emergencies and pandemics
◼︎ Ensure equality of access for all communities and disadvantaged groups to quality treatment and focus resources where they can do most good
◼︎ Tackle health inequalities by addressing social inequality, poverty, low pay and unsafe working, poor housing, under-investment in children and young people, discrimination and racism, pollution and climate change – all giving rise to ill health
◼︎ Defend women’s health services, including ensuring improved maternity care and a woman’s right to choose
◼︎ Address systemic racial health inequalities in the NHS affecting patients and staff, ensure equity and respect for disabled people
◼︎ Equity of access to healthcare and opposition to unlawful discrimination based on age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, sexual orientation.
◼︎ Strengthen collaboration across sectors and organisations, including health, social care, housing, transport, education and early years services, and training
5. REBUILD, RESTORE AND EXPAND OUR NHS
◼︎Strengthen democratic accountability for health service provision at national and local levels; develop services together with patients and public and improve transparency planning and decisions
◼︎Locate routine NHS services where they are accessible to local people
◼︎ End NHS charges for prescriptions, dentistry, eye care
◼︎ Rebuild general practice and NHS community services, providing enough GPs, surgeries and services to meet the primary care needs of local populations
◼︎ Restore lost NHS services that worked for patients, treatments and prescriptions including effective but low-level healthcare e.g. earwax removal
◼︎ Ensure that the use of digital and virtual forms of healthcare are underpinned by safe staffing, and driven by quality of care, clinical effectiveness, patient choice and equity of access
◼︎ Improved social care and support free at the point of use, publicly funded and provided. Set up a national care, support and independent living service which is radically re-imagined and co-produced with service users, carers, care workers and local communities to provide choice, control dignity and independence for all
◼︎ Ensure care services are in place and meet carer’s needs prior to discharge from hospital
◼︎ Make NHS dentistry available to all, providing enough dentists to deliver comprehensive services
◼︎ Establish parity of esteem for mental health, learning disability, older people’s services, end of life care and other NHS services
◼︎ Restore full NHS control over patient data and ensure data is used to benefit patient care and not for private profit
By committing to ‘Our Vision for the NHS’, politicians have a real chance to improve the lives of everyone in society, strengthen our economy and re-establish our country as one of the best health care models in the world.
We will need to repeal or replace some laws in order to achieve our vision, but legislation alone will not be enough. We need the strongest and widest support possible, from campaigns, trade unions, local groups and the public in order to restore our NHS.
[1] References UNISON policy motions 44,45 at the National Delegate conference July 2023