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3 November 2022

The Policy Ask with Philip Banfield: “Health is the responsibility of all government departments”

The chair of the British Medical Association UK council on the politics of healthcare and the virtues of Clement Attlee.

By Spotlight

Philip Banfield is the chair of the British Medical Association (BMA) UK council. He is also an obstetrician, educator and academic, and is based in north Wales. He was formerly the chair of the BMA Welsh council, and has been on the UK council since 2012.

How do you start your working day?

This depends on where I am, since I travel down to London from north Wales for a large chunk of the week. If I’m at home, I always make my wife a cup of coffee (she’s a GP partner, and secondary care is there to serve primary care after all). At BMA House, I’m at my desk by 7.30am to get some clear “thinking time” before the plethora of meetings starts. I’m still a practising obstetrician, so my first cup of coffee may well be on the labour ward.

What has been your career high?

It is a huge privilege to be part of a family’s highs when they’re having a baby, but also the lows when perhaps things have gone desperately wrong, and care and compassion become the centre of the doctor-patient relationship. Without a doubt, being elected chair of BMA council is the greatest honour.

What has been the most challenging moment of your career?

The politics of healthcare in north Wales was already very messy when I was rung up one evening in 2015 by a journalist to tell me the health board was planning to announce the closure of our maternity unit the following day. There was a complete lack of transparency and we turned to the BMA in Wales for help. The local politicians worked across their party divides, the health board was found to have acted unlawfully, and we showed how the closure was unnecessary. Now the unit is thriving, and I love working with some very caring colleagues.

If you could give your younger self career advice, what would it be?   

Have more confidence and faith in yourself. You don’t need to compromise on being yourself to get to the top. Trying to be kind and understanding of others’ views generally opens more doors than shouting and stamping feet. Don’t be in a rush to reach what you thought your initial destination might be or overly plan life out – you never quite know what is round the corner and serendipity often plays a hand. And as Confucius said – when chased up a tree by a lion, remember to enjoy the view.

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[See also: The Policy Ask with Manny Hothi: “The world is waking up to the futility of the war on drugs”]  

Which political figure inspires you?

I struggle with modern politicians because the motives for their actions have seemed more hubristic than altruistic, so I’m running with Clement Attlee. Attlee’s landslide win in the 1945 general election laid the foundation of the welfare state and the NHS. I admire that he achieved so much while reputedly being modest and quiet, seeking consensus and listening to others.

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What UK policy or fund is the government getting right?

The speed and scale of the procurement and rollout of the Covid-19 vaccination programme must count as one of the more successful government policies in recent history – and while a huge collective effort from NHS workers is to thank for that, credit is due to the government for acting early and ensuring the UK had sufficient stocks.

And what policy should the UK government ditch?

In the first instance, I would stop policies being scrapped. The BMA is really concerned about the government’s apparent U-turn on addressing obesity, which impacts deprived families the most. It’s hard for people to maintain a healthy weight when you have relentless junk food advertising, omnipresent buy-one-getone-free offers and products filled with sugar. When almost two-thirds of adult Britons are overweight or living with obesity, it’s crucial these policies are kept and built upon.

What international government policy could the UK learn from?

Use of the income taxation system to equitably fund health and social care properly as in Denmark. The Health and Social Care Levy, announced last year to deal with Covid backlogs, has already been scrapped, which just goes to show how vulnerable these “ring-fenced” funds are to changes in leadership. General taxation has the advantage of avoiding political gimmicks.

What upcoming UK policy or law are you most looking forward to?

After the last couple of years it should be clear how much international cooperation and solidarity are needed to deal with global health challenges of our time. I’m happy to see the government has endorsed a new international treaty for pandemic preparedness and response, though any meaningful instrument must be firmly grounded in principles of equity and human rights. For example, rich countries like the UK must commit to intellectual property waivers that would enhance production of vaccines, diagnostics and treatment in low- and middle-income countries. An increase in local and regional manufacturing capacity will help to ensure equitable access to these products and create sustainable health systems that are resilient in the face of any future global health crises.

If you could pass one law this year, what would it be?

Many of the factors that impact the population’s health are outside of the control of health services: quality of jobs and education, housing, access to green spaces. Health is the responsibility of all government departments; health impact assessments (HIAs) are a practical tool for assessing the impact of policy on people’s health, and are already mandatory in Wales in specific circumstances. Introducing these consistently would create a more long-term approach, rather than just seeing citizens as recipients of health services.

[See also: The Policy Ask with Adam Lent: “You can’t rip resources away from councils and claim to have a moral compass”]