“short on detail ” but ” a breath of fresh air” was how one local campaigner described the consultation document recently released by the Health and Social Care Policy Commission. This reaffirms conference policy to renationalise the NHS . What needs to be confronted now, and I am sure many responses to the document will reiterate this, is the sheer scale of this project which will mean dismantling the Health and Social Care Act of 2012 and all of the associated bodies set up to allow outsourcing and eventual full scale privatisation of the most profitable elements of the NHS.
Historically, the Lansbury Act set up a division between “purchaser” and “provider” so allowing certain services to be contracted out to private providers. The document outlines the fact that this experiment has been an expensive failure and with 9 years of austerity has led to increased waiting times, unnecessary deaths in hospitals, cuts in services, and demoralisation of the workforce.
The recent establishment of STP’s now morphed into ICP’s ( Integrated Care Partnerships or organisations or systems ) has further eroded the capacity of the NHS to provide services on the basis of need rather than being determined by budgetary constraints. The result of all this has been a £1.23bn deficit overseen by NHS England and with the “uncertainties” of Brexit we will further see and have already seen a crisis of retention and recruitment of the skills base located in the EU.
Demographic changes and in particular the growth of an ageing population with multiple health needs means, as the document points out, that we need a properly funded health service fully nationalised and free at the point of delivery. None of this comes without a price. Of course, Labour is, as the document points out, keen to avoid further disruption to the NHS. The renationalisation of the service, however, means fundamental changes to the way in which decisions are made, the reintroduction of genuine accountability at every level, the dismantling of ICP’s and of the division between “purchasers” and “Providers” and some resolution of the problem of public health provision which has suffered because of 9 years of austerity imposed on cash-strapped local authorities.