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How would a Labour government fix the NHS?

Wes Streeting, Preet Kaur Gill, Andrew Gwynne, Abena Oppong-Asare and Karin Smyth on creating a health service that is fit for the future.

By Spotlight

The NHS is facing record waiting lists, patient backlogs and severe staff shortages. Meanwhile, capital investment is insufficient, as hospitals grapple with crumbling buildings and digital infrastructure fails to keep pace with new technology. With the NHS set to be a big focus ahead of the next election, Spotlight asked the shadow health cabinet what a Labour government would do differently.

Wes Streeting, shadow secretary of state for health and social care

Thirteen years of Conservative mismanagement has left the NHS in the biggest crisis in its history, no longer able to be there for us when we need it. Three big shifts are required to restore the service to good health, and to make the NHS fit for the future.

The first is to shift the focus out of hospitals and into the community. We will expand community pharmacy and bring back the family doctor, so people can easily book appointments to see the GP they want, in the manner they choose. And we will tackle the mental health crisis, recruiting 8,500 more mental health professionals, with support in every school and mental health hubs in every community, funded by closing tax loopholes for private equity and private schools. Fixing the front door to the NHS will mean catching problems earlier and treating them faster, which is better for patients and less expensive for taxpayers.

The second shift we need is away from simply treating sickness, to prevention. That starts with giving every child a healthy start to life. We will put breakfast clubs in every primary school, paid for by scrapping the non-dom tax status, so children start school with hungry minds not hungry bellies. And we will tackle childhood obesity by banning junk-food ads targeted at children.

Finally, we’ve got to shift from the analogue service we see today to one that is equipped with cutting-edge technology. By cutting red tape to speed up the adoption of new artificial intelligence, which can rapidly read scans and interpret X-rays, we can diagnose patients faster and free up precious staff time. Underpinning this will be the biggest expansion of NHS staff in its history. Where the Conservatives have failed to give the NHS the staff it needs, Labour will train thousands more doctors and nurses. By increasing training places and keeping the excellent staff already in the health service, we will get the NHS treating patients on time once again.

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[See also: More than one in ten Brits need painkillers every day]

Preet Kaur Gill, shadow minister for primary care and public health

As shadow minister for primary care and public health, I want to engage with and learn from GPs, pharmacists and dentists – the front door of our health service – to build an NHS fit for the future.

After 75 years, the front door to the NHS is suffering because primary care is overwhelmed and inaccessible. I saw first-hand the brilliant work that the primary-care sector does during my time as a social worker and in my role as cabinet member for public health and protection at Sandwell Council. Yet, after 13 years of Tory incompetence, GPs are majorly overstretched because there simply aren’t enough of them: the Conservatives have cut 2,000 GPs since 2015. As a result, more than a quarter of patients describe their experience of booking a GP appointment as “poor”, and fewer than half of patients get an appointment at the time they wanted or sooner, according to this year’s GP Patient Survey.

This crisis in primary care is not incurable. Labour will reform primary care by shoring up community services while reducing the burden on hospitals.

Labour will improve GP access by training more GPs to take the pressure off those currently working in the system. We will also guarantee face-to-face GP appointments for all who want them, and bring back the family doctor so that patients can see a regular clinician if they prefer or need to.

We also know patients want new and more varied opportunities to access the healthcare they need. There are pockets of great practice across the country that we should be building on: for instance, in the Jaunty Springs Medical Centre in Sheffield, a shared care agreement between the pharmacy and GP surgery means a majority of health interventions can be delivered in the pharmacy consultation room, freeing up the GP and cutting waiting times. Labour will further expand the role of community pharmacy, accelerating the roll out of independent prescription to establish a Community Pharmacist Prescribing Service, covering a broad range of common conditions. Labour will ensure pharmacists can work to the top of their licence and focus on their expertise in prescribing and medicines management.

Labour will also encourage integrated care systems to identify opportunities, to join up services, including by co-locating them on a single site where existing capacity allows. This will reform healthcare for those who have more than one condition, providing them with one point of contact for appointments, with a range of professionals and services, including their family doctor, carer, district nurse or mental health specialist.

[See also: Nurses are highly skilled workers – and should be paid as such]

Andrew Gwynne, shadow minister for social care

My first priority will be addressing the chronic workforce shortages in the social care sector, which have been allowed to spiral out of control under the government’s watch.

The deputy leader of the Labour Party, Angela Rayner, has announced that the social-care sector will be the first to benefit from a fair pay agreement in adult social care. This will deliver better rights at work, fair pay and proper training that offers opportunities for progression. This will be key in filling gaps in the workforce, but also in retaining social care staff who are leaving in droves. I’m also acutely aware that too many unpaid carers feel neglected and ignored, so I’ll be working really hard to ensure that they are properly supported and recognised for the invaluable work that they do.

Alongside this, I’ll be relentlessly focusing on driving up standards right across the sector. The next Labour government will require all care providers to demonstrate financial sustainability and responsible tax practices, to value their staff, and to deliver high-quality care for service users before they are allowed to receive contracts from local authorities and before they can gain registration from the Care Quality Commission. There are providers backed by private equity firms making a fortune overcharging users for substandard care. The next Labour government will put a stop to that.

Ultimately, all this work will feed into my long-term ambition, which is to work with users, their families and the social care workforce to co-produce a plan to build a National Care Service; one that is separate from the NHS, but powered by far better local partnerships between the NHS and social care on things such as hospital discharge, home-first care and prevention. That means people getting the joined-up health and care services they need, as well as a greater use of technology to support independent living.

Social care has enormous potential. If done right it can empower people to live the life they choose, in the place they call home, with the people they love. Realising that potential will be a key priority of the next Labour government.

[See also: The Conservatives are bringing the culture war to the NHS]

Abena Oppong-Asare, shadow minister for women’s health and mental health

A recent report from the Chartered Institute of Personnel and Development shows that British workers are taking more days off sick than at any time over the past decade. This is a symptom of a crisis in public health, especially in mental health. Improving public health, through prevention, earlier diagnosis and faster treatment, will be a priority for the next Labour government.

With the longest waiting times for adult and child mental health patients since 2010, it is clear we face a mental health crisis. Changes in medical expertise and treatments, as well as evolving public attitudes, mean that the way we should deal with mental health conditions has changed. We will give mental health the same priority as physical health.

Patients are waiting months, at risk of their health worsening. We must revolutionise mental health treatment. So, Labour will recruit more than 8,500 more mental health professionals to cut waiting times for children and adults, funded through closing tax loopholes. Every school will have specialist support, and every community will have an open access mental health hub for young people, to boost prevention through early intervention.

Labour will tackle the health inequities across our country, especially in women’s health. The UK has the largest female health gap in the G20 and the 12th-largest globally. These stark inequalities are linked to ethnicity and income. It is a scandal that black women are four times more likely to die just before, during or after childbirth than white women. According to figures from the Office for National Statistics, girls born in the most deprived areas of England will have almost 20 fewer years of good health compared with those in the least.

As the party of equality, Labour will seek to end these shocking disparities. We will train more midwives and health visitors to care for mothers, babies and partners. We will incentivise continuity of care in general practice and improve course content for medics on the presentation of illness and pain among different groups. We will set an explicit national target to end the black maternal mortality gap and we will support women through the menopause, including by requiring large firms to publish and implement menopause action plans.

[See also: The BMI scale is a cheap and accessible starting point to prevent disease]

Karin Smyth, shadow minister for health

We know that our healthcare system is struggling and that Labour is more trusted by the public on the NHS than the Conservatives. So the responsibility of making the NHS fit for the 21st century, to maintain public support, is enormous.

My priority will be ensuring access to care, tackling the problem of long waiting times, and supporting innovative ways to improve outcomes for individuals and population health.

I joined the NHS as a junior manager in 1988, working on and off in the service until I was elected in 2015, including as a non-executive director of a primary care trust. I have been part of multiple reorganisations. While I have seen improvement and progress over the past 30 years, I also know that each restructuring process takes years away from reforming and developing services. Each iteration leads to a huge loss of organisational focus and experience. And at this time, we can ill afford to lose any more focus or experience.

Most people experience the NHS very locally, via their GP and in using community services. If we are to build a 21st-century NHS, it has to be responsive locally. This is about better access but also better accountability. The Hewitt Review of integrated care systems is a helpful contribution to this debate. It is my experience, borne out by evidence, that relationships locally are more important than structures. Developing local systems within a national system will be key to our reform agenda.

If we are to ensure the survival of the NHS and make it fit for the future, we will need to fundamentally change the way the service works. The next Labour government will shift the focus of healthcare out of the hospital and into the community; we will support the NHS into the digital age; and we will move our focus from treating sickness to preventing it in the first place, to help people live healthier lives.

That will be the basis of the next Labour government’s ten-year plan for health and care.

[See also: The BMI scale is outdated, simplistic and discriminatory]

This piece first appeared in a Spotlight Healthcare print report on 13 October 2023. Read it here.

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