The Andy Burnham premiership is an opportunity to reset the public conversation on the NHS and social care. Burnham has committed to speeding up change on social care by bringing forward the findings of the Casey Commission to 2027. But what will he say on the NHS?
Burnham says that drastic reform of social care will save the NHS £billions. Promised change in social care will be heartily welcome, but there must be an immediate focus now and at the Budget on the plight of the NHS and the impact on the health of the population and the economy. If Burnham ignores the crisis in the NHS, then the deadly impact on the population will be on his watch. Burnham has an opportunity to transform the lives of working class people and the parts of the country ‘left behind’. Central to that, he must address health inequalities and the NHS now.
Wes Streeting was Health Secretary for two years until May. For reasons of personal ambition, he overemphasised headline NHS waiting lists and overclaimed the reduction in figures, while totally ignored the 16,000 annual avoidable deaths in hospitals caused by delayed urgent treatment highlighted for years by the Royal College of Emergency Medicine (RCEM). (1) Most of the media took his cue and failed to cover what is a weekly toll of 305 avoidable deaths. Alongside this, the public continue to experience serious problems in accessing their GP, finding an NHS dentist or mental health support. The Ockenden and Amos reports on failures in maternity services reveal their own shocking statistics of avoidable infant and maternal deaths and injuries, and broken midwives leaving the service. NHS staff morale is damaged and public confidence weakened because, for too many, day-to-day experience of NHS services has not improved their lives.
Streeting asserted his policy tropes repeatedly: ‘the NHS needs reform not more funding… better management… more efficient use of technology and AI… more effective partnership with the private sector’. He insisted no greater funding was needed to repair NHS buildings and rebuild the safe care for which the NHS was top of international league tables, even up to 2015. If the new Health Secretary, Yvette Cooper repeats Streeting’s tropes and Burnham does not insist on change, a rare opportunity will be missed. The impact on the economy and the population will scupper his chances of surviving the next election.
The economy needs a healthy population. A healthy population needs a healthy NHS. A healthy NHS needs funding invested in rebuilding the publicly provided services it excels at when funded to succeed. Public expenditure on healthcare, education and social care together are investments we cannot afford not to make. This should be viewed as an essential investment in the wellbeing of our children, the community and the national economy not as a cost.
A radical change of policy and urgent actions
Key policy changes and actions would make an immediate difference and offer hope of real change.
Make safe emergency care a national priority
The ending of corridor care in our A&Es and wards is possible. Alongside extra staffing and reopening of hospital beds, the RCEM’s recommendation is to fund local authorities to create 8,000 additional community care places. This would slash the 13,000 hospital beds occupied daily by patients who are medically ready for discharge and would relieve pressure on urgent and emergency care. It would be a meaningful first step towards a publicly funded and publicly provided National Care Service.
Recommit to a publicly funded, publicly provided, publicly accountable NHS
The introduction of a moratorium on new outsourcing of NHS services to the private sector, alongside a statement of intent to review and end poor-value contracts, would be a morale boost for NHS staff –and consistent with Labour’s 2024 manifesto. Public funds should not be syphoned to private profits. Profit-taking from NHS funding such as 32% profits the cataract companies extract must be stopped.
The plan to resurrect private finance deals for building new hospitals, health centres and NHS estate refurbishment should be reversed. Public borrowing for new and refurbished NHS building should be framed as positive, cheaper and responsible investment creating long-term public assets rather than long-term private liabilities.
Rebuild the NHS as a national investment, not a drain on public finances
The tens of thousands of NHS redundancies happening now must be stopped. The punitive caps on NHS trusts must be reversed. With nearly three million people out of the workforce for health reasons, Burnham’s focus must be on rebuilding NHS capacity to address waiting lists and unmet need. IT, technology and AI must be provided as long-term tools to support staff by improving systems and reducing pressures, not be presented as substitutes for the workforce, beds, buildings and services the NHS needs.
General practice is the cornerstone of public healthcare but it has been badly let down. An improved GP funding formula per patient and investment to increase the number of GPs and community nurses would restore access and continuity of care. Unemployed and locum GPs would join primary care with greater security, support earlier intervention, reduce pressure elsewhere in the NHS and transform patient experience.
Set a new ethical standard for public contracts and private sector involvement
An unambiguous statement that the Government will end its contract with Palantir for England’s NHS data platform at the February 2027 break clause would start to repair the damage done to public trust. It would evidence a new ethical standard for NHS data and public contracting and suggest that the new leadership is serious about transparency, public trust, evidence-based practice and the protection of NHS patients’ and staff data.
If on the other hand there is a repeat cycle of raising the public’s hopes only for them to be dashed, the door would be opened to dangerous alternative rightwing policies threatening the end of the publicly funded and provided NHS and a risk of heightened health inequality. (2)
- https://rcem.ac.uk/press-release/how-many-deaths-will-it-take-before-we-see-a-meaningful-plan-to-end-the-crisis-deaths-associated-with-long-ed-waits-surge-almost-t/
- https://keepournhspublic.com/reform-uk-a-clear-threat-to-our-nhs-and-the-health-of-the-nation/
Tony O’Sullivan, Co-chair Keep Our NHS Public
This article was first published by Public Sector Focus
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