Progress | Centre-left Labour politics

Editorial: the birthday insult

This Conservative government’s stewardship of the NHS is simply inadequate. Most would hazard a guess that this will not have changed by the time of the next election, and the new money promised last month will not have been found

‘The NHS will last as long as there’s folk with faith left to fight for it’ are words ascribed to Nye Bevan in Trevor Griffith’s 1997 television play Food for Ravens. The government that came to office in the same year as the docudrama was aired fought tooth a nail for the National Health Service – both for its actually survival and the revival of its support across all social classes. It left office with the highest approval rating for the NHS ever seen. A testament to the invest, reform and huge healthcare outcomes achieved in that time. Eight years into a Tory government the need for a similar saving of the service is great. The pressure is not yet from waning support across the classing but an expectation that the service will be as good for future healthcare needs as it has in the past. If it does not meet this the promise, the fear is cross-class support may drop – and be fatal for the NHS’ next 70 years.

Looking at Bevan’s creation 70 years on and you cannot think much else but about how proud he would have been. Established to fight the great evil of ‘disease’, it has succeeded. Postwar ailments have largely been eliminated and life expectancy has transformed. The pension age is now higher than the average life expectancy for men in 1948.

But that success poses new challenges.

The health service faces an uncertain future held back by austerity and a creeping privatisation – of a type previously unseen – since the 2012 Health and Social Care Act. The Labour government might have allowed for private sector capacity to help a free at point of delivery service meet demand but it never let, nor provided a gateway for, Virgin Care to sue NHS trusts for failing to win contracts. This is a catastrophe that shadow health secretary Jonathan Ashworth rightly rails against in our interview with him – and which he has raised countless times in the House of Commons. It prevents the NHS being able to do for the country what our citizens, communities and economy demand. Only a Labour government will get this right.

The Tories are desperately trying to claim a ‘birthday’ windfall for the ailing health service. The up to ‘£600m per week’ by 2024 is both uncosted and insufficient. The NHS needs this money following nearly a decade of below par increases; funding levels are even lower than they were under Margaret Thatcher and John Major, let alone Tony Blair and Gordon Brown.

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The claim any of it will be paid from a ‘Brexit dividend’ is nonsense. Even if Brexit was not going to force a tax intake collapse when we leave the European Union, our contributions to the EU budget continue until 2021 at least. But more importantly, as Labour commentator Matthew Doyle pointed out: ‘If [the government’s plan] being funded by “increased borrowing and tax rises” then it’s not a “Brexit dividend” but a political choice that could have been made any time.’ This Conservative government’s stewardship of the NHS is simply found wanting.

Regardless of how the Tories have hamstrung the NHS, its amazing staff and visionary leadership from Simon Stevens has kept it delivering for people. The Brexit deficit of staff is really starting to bite – Ben Bradshaw told Progress magazine in December 2017 that there has been a 96 per cent drop in EU nationals applying for NHS roles and a 69 per cent increase in EU nations leaving NHS posts. Even if Brexit were not happening, our importing of a foreign healthcare workforce is time limited as these sectors grow, and pay better, elsewhere. Added to this, the cut to the student nursing grant could not come at a worst time. Not only should it be reversed, it is a clear candidate for more funding as more nurses – and medical professionals generally – will be needed longer term.

Despite the current staff’s best efforts, the NHS is struggling – and not just because of funding. An ageing population, the growing awareness around mental health care and the reducing taboo around sexual health are just some of the new expectations of what the NHS should provide for.

Progress interview with shadow secretary of state for health and social care Jonathan Ashworth 

The nature of the support older people now need means they now have multiple support needs and interactions with numerous NHS and social care staff. They, and their family trying to get the best for them, need designated care champions to stop things falling through the net. This would cut unnecessary worry, wait and allow the NHS to consider the whole person. Atul Gawande, in his book Being Mortal, argues for more ‘geriatric specialists’ and significant geriatric training for doctors in other areas. On the Progressive Britain podcast last month, Mary Wimbury supported this point and argued that ‘sometimes it is better to keep an older patient living independently than perfectly fixing a minor fracture perfectly with debilitating consequences including muscle loss or mobility issues, or both’. A patient centred, or more bird’s eye care, might ensure better quality of life and peace of mind for longer.

Therefore, a serious renewal plan – not just pledges for more money and rants against egregious privatisation – is needed. You can already see private providers praying on the frustrations and queues in the NHS to encouraging people to turn their backs on this much-loved institution. Paul Corrigan in the latest issue of Progress magazine reiterates Bevan’s point that preventing this and keeping cross-class support for our ‘free at point of use system’ has been the key the NHS’ success. Anyone running, or wanting to run the NHS, must keep this in mind at all times – and respond with new ideas, not old slogan. That job, once again, falls to Labour.

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