Cllr. Chris Lucas speaking on the NHS at Lib Dem Spring Conference in Gateshead, March 2012

Health Matters

Unless you’ve recently arrived from Mars it would not have escaped your notice that the NHS is once again grabbing the headlines. The Health Secretary Andrew Lansley has been in for a lot of flack as he tries (with Lib Dem help) to get through his highly controversial Health and Social Care Bill. At our Spring Conference in Gateshead the issue caused much consternation amongst the rank and file as rival factions fought to be have the issue debated as an emergency motion. Delegates had to run the gauntlet of trade unionists, health service professionals, not to mention the odd Labour Party MP thrusting bits of paper and shouting anti-Tory slogans as we attempted to gain entry to the Conference centre.

The motion that won the ballot was entitled: Protecting our NHS: the Shirley Williams Motion which, as the name suggests, was drafted and fronted by none other than Baroness Shirley Williams (for the sake of time, space and brevity I won’t write the entire motion out here but for full details please click the following link and go to page 5: http://www.libdems.org.uk/siteFiles/resources/docs/conference/2012-Spring/Spr12%20CD%20Sunday.pdf). As someone who has been involved with the NHS for most of my life, the subject of NHS reform is very dear to my heart. I therefore set about conducting a huge amount of research in to the issue to ensure I was as well informed as possible ahead of the debate, and not simply buy-in to the rhetoric (on both sides). It was to this end that I came to the conclusion that what was once a typical Tory “public sector: bad; private sector: good” Bill that pretty much ignored important issues such of local accountability and commercial conflicts of interest was vastly improved as a result of Lib Dem influence. Baroness Williams and her colleagues in the House of Lords such as Baroness Judith Jolly and Baroness Liz Barker invested an enormous amount of time and energy redrafting, amending and reworking the first draft and what they have come back with provided the following safeguards:

1)   Competition based on quality not price

2)   Profit from private sector patients used to improve NHS services

3)   No more private sector “sweetheart” deals, paying them for operations that are not carried out

4)   The Health Secretary maintains responsibility for the whole NHS

5)   Measures to prevent any conflict of interest amongst commissioners

And many others too.

So I decided to put a card in to speak in favour of the Shirley Williams motion and my speech was as follows:

Conference,

I think before I go on, I must declare an interest… No, I’m not a doctor or a nurse, midwife or physio. I’m simply someone whose mother was a nurse for 40 years in the NHS, and she taught me the importance of its founding principles: free at the point of delivery, irrespective of your ability to pay.

But Conference, in those 40 years since she trained to be nurse so much has changed.  In this time, we’ve seen huge medical advances. Vaccines for:

–       Polio

–       Measles, mumps, rubella

–       Chicken pox

–       Meningitis

–       Hepatitis A& B

Not to mention advances and increases in:

–       IVF

–       Transplant services

–       Cancer services

–       HIV/Aids

–       Diabetes

To name but a few.

And whilst this is cause for celebration, it also creates another problem… these treatments cost a fortune to produce, requiring frequent and expensive visits to the hospital resulting in us all living longer, and the subsequent strain this puts on our beloved NHS. In the next 25 years the number of people over the age of 85 will double… So we must ask ourselves the question: has the NHS adapted to efficiently and effectively meet these changes in demand? The answer is a flat: No. Successive governments have all tried in their own way. The Tories under Thatcher tried to impose the ‘Internal Market’ with ‘providers’ and ‘purchasers’ of services. And Labour by simply pouring huge amount of money in to the system tried to bring about “change” and “modernisation”, but these were simply by words for ever more business managers and even less frontline staff. But the net result of successive government changes is a health service that is creaking at the seams, inefficient and structurally flawed. I’ve not met anyone who says that the NHS is perfectly constituted and not in need of reform, and it was right that our Coalition Government looks to address this.

Conference, I’m sure you all agree with me that the first draft of Bill was a little bit scary…! Removing accountability to the Secretary of the State for Health, private companies able to compete on price, no local accountability, plus many other typically Tory proposals made us all really uncomfortable. But through this – our democratically elected conference, we, the ordinary rank and file members of our party ensured the government pause and listen to the concerns of the people.  And now, thanks to the stirling work done by Baroness Shirley and other Lib Dem peers in the Lords, we now have a Bill that nullifies many of the more undemocratic and unfair proposals resulting in a Bill that is much more workable:

–       We ensured the budget that controls your care directly in to the hands of those who can best match your health needs with the best local care providers: your doctor.

–       Local councils will now have a say in developing and shaping the care priorities in your community

–       And we’ve joined up critical care with palliative care giving patients the choice to be treated in their GP surgery or in their own home rather than being forced to go to hospital.

But the one provision that puts my mind at rest the most is the safeguard that ensures GPs can’t simply push their patients towards the cheapest option.

So Conference, is the Health & Social Care Bill now a perfect piece of legislation that is going to be the answer to all our NHS woes? Nope – far from it…

But this Bill now acts to:

–       promote fairness

–       enable choice

–       and put democratic accountability at the forefront of our care provision

And as such provides the necessary bedrock to protect our NHS indefinitely.

So please Conference, support this motion and prove to the country that as long as we draw breath we will fight to ensure that the NHS remains free at the point of delivery and that regardless of the economics conditions we face we can be relied upon to ensure that patients’ rights will never be compromised.

Please support this motion.

Thank you.

As one can imagine, emotions ran high during the debate and there were impassioned speeches from all sides, however the motion was passed with the exception of a line calling on Lib Dem peers to support the Third Reading being removed.

Labour have now forced an emergency Commons debate that will take place later on today (20/3/2012). Opponents of the Bill want the NHS transitional risk register published in the hope that it will add weight to their argument that the proposed changes will be too detrimental. Personally, I don’t see what this will achieve. Most of what is recorded in the register has already been published in impact assessments. Not withstanding, our peers have been through the Bill with a fine tooth comb and whilst I understand the fears of those who are concerned about the creeping influence of the private sector within the health service, I hope it wouldn’t be too glib to suggest that that particular horse has bolted. Since its inception in 1948 the private sector has always been involved in the NHS, and again the doctors were opposed to it. Aneurin Bevan, the Health Minister who introduced the NHS famously stated: “I stuffed their [doctors] mouths with gold” to get them to agree with it. And New Labour took this on even further during the last government by giving private health providers £250m, initially meant to cut waiting times but resulted in paying for operations that weren’t carried out.

Yesterday the Bill passed through the House of Lords and is now back in the Commons for the final legislative hurdle. With any luck this will now go through and we can get on with the job of maintaining standards within the NHS and ensure that:

– It meets the needs of everyone

– It be free at the point of delivery

– It be based on clinical need not ability to pay

– It be accountable to local people and the Secretary of State for Health

– Doctors can choose the best quality health care solution from wide ranging local service providers depending on individual need.

If the new Bill enables all these things then surely this has got to be progress.