This is the speech I gave to the West Midlands Regional Conference of the Co-operative Party on the 26th February 2022. The title of the Conference was Building Community Power, and as part of the program I was launching the Party’s Health Policy Consultation. I was speaking as Chair of the Coop Party’s Policy Committee and as the NEC Member for the West Midlands, however all views expressed were my own.
“Good morning conference. It is so good to see so many of you joining us today at the start of the Coop Party’s consultation on our Health Policy.
It has been some time since it was last reviewed, and in that time we have seen a number of significant changes in the NHS.
We have had the sweeping reforms introduced by the Health & Social Care Act 2012, and we became accustomed to thinking in terms of new bodies such as Clinical Commissioning Groups, Health and Wellbeing Boards, STPs and much more. We have also seen local Public Health move into Local Government.
We have also seen a procession of Secretaries of State of varying effectiveness.
Despite all of that………., we still hear consistently from patients and public on a range of issues:
On GP access in terms of face to face consultations and fears about digital exclusion
On Health inequalities for many groups in society, in terms of both service provision and health outcomes
All too often inequalities seem to be driven by who you are and where you live
We hear about crippling delays in assessments, diagnostics and treatments
About the erosion of community Mental Health Services, especially for younger people
And we hear about enormous problems in NHS Dentistry
Time and again we hear the Government blaming the Pandemic
But these problems were there long before the pandemic began. The pandemic has simply brought them into much sharper relief
Before the pandemic began the CQC has identified weaknesses across the system. We have long had huge workforce challenges across the piece
Vacancy rates running at nearly 10% across all services, on top of absence rates.
Staff turnover is up, employers constantly running to keep pace with that.
Lost 1,600 care beds in six months.
More than a decade of austerity has eroded the ability of both the NHS and Social Care to respond to the challenges of the pandemic. It is now making it much harder to deal with the unwanted legacies of the pandemic
I would also argue that the involvement of the private sector in care delivery has not been the silver bullet that some believed it would be. In some cases it has added to the difficulties. I offer Test and Trace as an example
So many of the inequities we have seen arose from “Business as Usual”. So we must resist the urge to rush back to “normality”
We must look to create a new normal where services really do focus on the needs on the individual
Health and social care services are the most intimate, personal, and human of things that one person can do for another
And when you try to deliver those most sensitive of services on an industrial scale with too few resources the results are inevitable
It results in a damaging chaos that impacts so much on the wellbeing not just of the people receiving the services, but quite often on those delivering them as well
There is an obvious question to ask “Is more money the answer?”
I would argue that simply putting in more money will not be enough to fix all of the structural and cultural problems that exist in Health and Social Care.
Those systems are broken.
But much more funding is undoubtedly needed if true transformation is ever to be achieved
The response of this Government has been to ignore an old truth.
You cannot integrate your way out of a financial crisis
The response has instead been the Health & Care Bill and Integrated Care Systems with a proposed “Go live” date of the 1st July 2022.
The ICS are geographically based partnership that grew out of the STPs and have in reality been in development for many years
They will work at System, Place and Neighbourhood level and are intended to move the NHS away from competition and towards collaboration.
Removing some of the artificial divide between Health Services & Social care services
My fear is that the NHS system will now become even more layered and complex than ever. A dazzling array of Integrated Care Boards, Integrated Care Partnerships, Care Collaboratives, Place Partnerships, Primary Care Networks and more.
It could turn out to be an overly complex system
So whilst I applaud some of the stated the aims of the ICS model, I do wonder where the needs and aspirations of patients and carers fit into this complexity?
I also wonder how much Officer time will be spent “feeding the beast”? Will it divert resources from front line care?
And what is the perceived role for Private Sector Providers?
My Questions for our Policy Review are simple
Given what is happening, where to now for Coop Party Health Policy?
Can the inspirational ideas underpinning Community Power offer us a way forward?
At what level in the system should we apply the ideas behind Community Power to have the greatest impact for patients?
The answers to these questions will in effect determine our relevance in the debates that must surely come as integrated care evolves
I hope we will have a good debate today and back in our Branches and Party councils and I look forward to seeing what comes out of them.”
Chris Bain 