The Fight for the NHS
Boris Johnson wants to sell our NHS off to US corporations. Labour must respond by rebuilding the public health service – and tackling its inequalities.
A baby girl born in Liverpool can expect to live for thirteen fewer years in good health than one born in Richmond.
Men from the most deprived backgrounds in Britain can expect 52 years of healthy living. That’s fifteen years before they get to retire — and the Tories want to push the retirement age out further.
After nine years of austerity, advances in life expectancy, which were steadily increasing for 100 years, have ground to halt and even gone backwards in some of our poorest areas.
Infant mortality rates — children dying before their first birthday — have risen three years in a row for the first time since the Second World War.
Rates of premature deaths — including deaths linked to heart disease, lung cancers, Chronic Obstructive Pulmonary Disease (COPD) — are two times higher in the most deprived areas of England than they are in the most affluent.
Children and adults living in poverty are up to three times more likely to develop mental health problems than those in the highest income brackets.
Suicide is always a tragedy. And in the most deprived communities we witness higher rates of suicide, higher rates of addiction and higher rates of drug overdose deaths as well.
The simple truth is that inequality, poverty and deprivation lead to people getting ill quicker and dying sooner. As socialists we should never settle for this. I certainly won’t.
Our movement has always understood that inequality is fundamentally about life and death. That’s why Labour through the extraordinary political skills of Nye Bevan created the National Health Service 71 years ago. Bevan described it as a “real piece of socialism” because its creation was came with the recognition that healthcare is a human right.
But in recent years our NHS has come under attack like never before. A decade of Tory austerity has left us with waiting lists of over 4.4 million and 580,000 waiting beyond 18 weeks for treatment. Over 260,000 people wait more than four hours in busy, overcrowded A&E departments each year.
At the same time 100,000 children are denied mental health treatment because their problems aren’t ‘serious’ enough. For problems deemed serious, 500 children wait beyond a year for specialist mental health treatment.
Meanwhile our NHS struggles with shortages of 100,000 staff including 40,000 nurses, 3,500 midwives and almost 10,000 doctors. Years of austerity has resulted in treatments being rationed and, increasingly, patients being denied procedures altogether.
Earlier this year, a hospital asked patients to pay for hip and knee replacements at £18,000 each on NHS wards — treatments that were previously available for free on the NHS. The hospital was thankfully forced to back down following a national outcry.
The current Tory Health Secretary Matt Hancock told Parliament there would be “no privatisation on his watch” while overseeing £9 billion worth of clinical contracts handed to private sector companies like Virgin Care, as well as billions more spent on buildings and support services.
Lifting austerity and ending privatisation will be our starting point in government. As we get closer to the general election we will outline a financial rescue plan for the NHS to provide the quality comprehensive care patients deserve and start recruiting the staff we need.
We will bring about a reversal of privatisation by restoring our NHS as a universal publicly-provided and administered service. The Tory Health and Social Care Act will be binned, and in its place we will implement NHS reinstatement legislation.
Our campaign to end privatisation becomes more urgent in the context of attempts by Boris Johnson to sell off our NHS to big US corporations as part of a trade deal with Trump.
So called ‘standstill’ and ‘ratchet’ clauses in trade deals will effectively lock in the current market liberalisation that the Tories have imposed on the NHS, making it difficult if not impossible to reverse privatisation without risking being taken to a costly international tribunal.
We have to fight a trade deal that undermines our NHS with all we’ve got. But leading an assault on the unacceptable health inequalities that persist in this country demands we must be more ambitious still.
The next Labour government will adopt a comprehensive national strategy to tackle health inequalities, attacking the wider social and commercial determinants of ill health and putting prevention first.
That means action to improve the homes we live in, the childhood experiences we are exposed to, the communities we grow up in, the schools we are nurtured in, the condition of the work we do, the food we eat, the quality of air we breathe and the support we rely on in our older years.
As a start, we will fully fund public health services — sexual health services, smoking cessation services, drug and alcohol treatment services, which have been hammered with £800 million of cuts.
A strategy to tackle preventable illness and inequality must honour the long promised but never delivered commitment of parity of esteem between physical and mental health.
The World Health Organisation defines health not just as the absence of disease but as “a state of complete physical, mental and social wellbeing”. Yet too often a focus on wellbeing has been absent from our debates.
Welsh Labour led the way with a Wellbeing Act that required public bodies to improve overall wellbeing and meet the sustainable development goals. In New Zealand, the Labour government recently introduced a wellbeing budget. Their minister of finance Grant Robertson explained that its goal was to help people live “lives of purpose, balance and meaning.”
Like Wales and New Zealand, I want to put wellbeing at the centre of our framework for tackling health inequalities, which is why I recently announced a Labour government will introduce a Future Generations Wellbeing Act.
That act will commit the next Labour government to a ‘health in all policies’ approach, with health equality audits of all government decisions; it will enshrine in legislation our commitments to ensuring life expectancy matching the best of our international peers, as well as the best possible health outcomes for children; and it will place a new duty on both local health services and national leadership to reduce health inequalities.
A focus on improving wellbeing straddles all areas of public policy and is integral to alleviating health inequities. What’s more, it’s the fine tradition of our movement.
Throughout our history the pages of Tribune have debated how to radically improve the ‘social wage’. Further back in left-wing thought Marx spoke of society where one could hunt in the morning and criticise after dinner. Tony Crosland, though never a Tribunite himself, famously sought the aesthetic life for all exemplified by open air cafes.
Prioritising wellbeing and tackling inequality for me is about the kind of society we want to leave for those who follow us. It’s a society where people live longer, healthier, happier lives. That’s something worth fighting for.