Labour’s decision to launch its 10-year health plan at the Sir Ludwig Guttmann centre in Stratford this morning made sense as a bid to exemplify the unit’s multi-service approach. On health grounds, however, there seemed a real chance the presser might push up NHS waiting lists as spectators fought to remain conscious in the suffocating heat. It wasn’t just the fainting risk that was concerning attendees: the appearance of Rachel Reeves was a surprise after her teary PMQs session yesterday, with the Chancellor having to smile nonchalantly through countless variations of ‘are you alright?’.
Labour needs to be in power for three terms to see its plans through
Health Secretary Wes Streeting kicked off proceedings with a jab at those on the ‘right’ sceptical about the viability of a free-at-the-point-of-use system, while the usually staid Keir Starmer was tasked with explaining just how radical his government’s health reforms would be. The 77th birthday of the NHS finds the service in its worst state yet, the Prime Minister admitted, but Labour isn’t giving up on a free-for-all approach quite yet. Funded by £29 billion from the Treasury, Streeting’s reforms can be broadly separated into three categories: firstly, focusing on preventing disease before it becomes too late; secondly, improving community healthcare services to help reduce pressure on hospitals; and thirdly embracing the tech revolution to bring the NHS into the ‘digital age’.
Much of today’s announcement was leaked in advance, with Labour’s ‘neighbourhood health service’ and AI plans widely reported on. In conjunction with the government’s vision for welfare – slightly derailed this week – getting patients on long-term sick leave to return to work is another key focus, with the introduction of back-to-work targets for NHS groups. Not so far from UK shores, similar-sounding initiatives are proving successful: in Guernsey, healthcare workers praise the island’s ‘Sohwell’ programme which offers early intervention to people having to take time off work due to an injury, health condition or disability. The programme is thought to be saving the island’s government up to £20,000 a week in benefits payments, with reports last September of a 120 per cent increase in the number of people getting back to work after illness compared with previous years. Further afield, Brazil and Costa Rica have seen success with door-to-door healthcare teams hoping to spot disease early.
But an obvious stumbling block here is staff numbers: the NHS still faces a workforce crisis, with doctors and nurses opting for sunnier climes, better pay and more manageable hours than those offered by Britain’s health service. While pay isn’t on the table, Streeting told broadcasters this morning that in a bid to improve retention, NHS staff will be provided with more options for flexible shift work, receive more training and see a national and regional ‘talent management scheme’ introduced. Will this give resident doctors currently being balloted for industrial action pause for thought? It seems unlikely – but more holistic improvements to NHS working conditions are long overdue.
The NHS app will be updated and improved and community hubs will bring together multiple specialities to provide more acute care close to home, which will, in turn, theoretically reduce demand in hospitals. There is a reframing required here: how to make clear to patients that community health services are not ‘lesser than’ the care provided in hospitals for non-emergency conditions. And practically, there remain question marks over the rollout of these new types of hubs: where will the staff come from, and given there is a shortage of suitable premises, what is Labour’s timeframe? Will GPs be expected to run these centres, and is it feasible to expect that general practitioners currently have the training to be expected to deal with more acute cases?
Clinicians believe it is likely this project will require the role of the GP to be redefined, which would require close working with the Royal College. At present, a select group of community doctors work across the country in integrated care units – but Labour’s plans will surely require all general practitioners to be trained in this way. The size of this task should not be understated.
And while Streeting and Starmer are keen to ensure that British doctors are prioritised for training jobs in the UK in a bid to help retention rates, recruitment remains an issue too. To have a health service that is more self-sufficient, more doctors need to be trained in the UK which requires more work at a grassroots level to support people from all backgrounds getting to study medicine. As midwives present at Starmer’s health launch today remarked afterwards, overall the plans are promising, but more detail is required – given it’s clear this NHS revamp will come attached to a sky-high bill.
‘This is what change looks like: a promise made, and a promise delivered,’ the Prime Minister told the press conference today, just days after a YouGov poll revealed the number one reason voters were turning off Labour was ‘broken promises’. ‘We made choices no other government would make,’ he added proudly.
Certainly it’s hard to believe any other government would have decided to U-turn quite so much during its first year in power. While the PM studiously avoided alluding to the welfare bill chaos during his speech, he admitted to journalists afterwards that ‘we didn’t get it right’. He backed Reeves as reporters asked about her crying in the Commons on Wednesday, although the Chancellor’s smile tightened a little when Starmer said he looked forward to working with her for ‘many years’ to come – not quite managing to specify whether she’d still be in post at the next general election.
Labour’s 10-year health plan is a promising one – albeit if its broad themes are not all that original in themselves. The government’s ideas for community hubs and better use of tech are exciting – but with tight budgetary constraints, its vision will be a challenge to pull off. And, as one journalist noted today, Labour needs to be in power for three terms to see its plans through. After the events of this week alone, it is clear a victory at the next national poll is by no means guaranteed.
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