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Labour 10-year plan includes ‘new arm’ of NHS

Ed Miliband has set out Labour’s “10-year plan” for the NHS promising 36,000 more staff and the repeal of privatisation laws as well as ending the culture of 15-minute home care visits.

Speaking in Trafford, Manchester, at the site of the first NHS hospital, the Labour leader said 5,000 extra home care workers would be recruited to treat terminally ill people in their own beds and spelt out financial incentives for social care workers to spend more than 15 minutes on home visits.

Miliband said these care workers will form “a new arm of the NHS”, focusing on those with the greatest needs, including those who are terminally ill so they can stay with family at the end of life, and those who are leaving hospital but need extra help to be able to stay in their homes.

He added that Labour will “end the scandal” of neglecting mental health by prioritising investment in young people, and that the party will hire more doctors through saving resources on privatisation, which will help cut waiting times for GP appointments.

Miliband went on to reiterate Labour’s previous promise that if they win the general election they would recruit 20,000 more nurses and 8,000 more GPs.

He added that they would “join-up services from home to hospital, guaranteeing GP appointments within 48 hours and cancer tests within one week”.

Shadow health secretary Andy Burnham, speaking after Miliband, went into further detail on the 10 year plan. In a speech at the King’s Fund, he said that Labour’s plan was based on the idea of whole person care. He said: “It is based on the simple notion that, if we start in the home and make care personal to each family, it is more likely to work for them and cost less for everyone.”

First he confirmed that there would be no top down reorganisation of the service. He said: “The plan reaffirms our intention to work through the bodies we inherit, with no new structural re-organisation, but adding ambition and impetus to existing plans for integration.”

But Burnham does have big changes in mind. One of the largest is for the ambulance service; he wants it to start playing a much wider role, becoming an integrated provider for emergency care. Rather than take you to hospital it might just treat you at home.

He said: “To take a major step towards integrated, seven-day working in the NHS, it is right that we look at a new future for the ambulance service.

“I see that as an integrated provider of emergency and out-of-hours care, able to treat people where they find them rather than carry to hospital.”

He added that he would look at ambulance services also taken on NHS 111, when the current contracts for the service expire, so that in time all 111 and 999 calls could be handled from the same centres.

“This will mean more experienced staff on the phones, and better classification of calls,” he said.

Burnham also confirmed he wants health and wellbeing boards to be accountable for new “year of care budgets” which would cover the health and social care needs of those “at the greatest risk of hospitalisation”, but added that the funds would “be paid to an NHS preferred provider”.

A party briefing went into more detail on the issue. It said: “Labour will introduce a new ‘year of care’ budget for health and social care needs under which providers will have to bear the costs if the health of patients deteriorates and they need expensive hospital care. By changing the financial incentives in the system this will stop services that rely on 15 minute visits [from local authority funded social care staff]”.

Burnham also wants to rewrite the NHS constitution to include several new rights for patients. First he would include a right to a single point of contact for the coordination of all care, as well as a personal care plan for patients with ongoing needs.

He would also include the right to counselling and therapy, as well as medication, as well as the right to support, such as respite care, for family carers.

The previous Labour pledge to give people the right to a GP appointment within 48 hours would also be included.

For those already working in the NHS, he said Labour would create a means for care assistants and healthcare assistants to get nursing or clinical jobs through apprenticeships and technical degrees.

Burnham also wants to see the NHS have more long-term contracts with providers, and not-for-profit providers to get longer contracts than for-profit providers. 

He said: “Given that voluntary organisations build volunteering capacity – which in turn builds the health of people and communities – we should give them the benefit of much longer and more stable arrangements, for instance for five or even 10 years.”

Meanwhile private providers offering health services would be made subject to the Freedom of Information Act, he said.

Those private providers may also be made to pay a training levy so that they contribute to the cost of training clinical staff as well, Burnham said there would be a consultation on the plan.

NICE would not be left out of the Labour changes either. Burnham said he would want it to take a wider definition of public cost when deciding whether to approve treatments.

“It makes no sense to restrict treatments to save money for the NHS if that only adds costs to other government departments. For instance, restrictions mental health care for young people may add huge costs to the criminal justice system.”

He added that he would also ask NICE to set out what people can expect under whole person care. This could include “a universal re-ablement scheme to help the most vulnerable people return home from hospital”.

Responding to the plans, Dr Amanda Doyle, co-chair of NHS Clinical Commissioners, said: “It is right to put the patient at the centre of the NHS and look at caring for the whole person. It is right also that we look for long-term solutions to integrate NHS and social care services to ensure they are sustainable and responsive to the needs of the local population, so we are reassured that Labour have listened to our members calls to trust in the local systems that are already delivering for their patients and sees a future for CCGs.”

She added that Burnham was right to say that integrating health and care services cannot be done by imposing top-down edicts and timetables.

“It must be driven at a local level and designed around local needs. CCGs, led by local clinicians who are embedded in their local communities, are already embracing the opportunity to work in partnership to join up care for patients. It is vital that we allow CCGs to continue to do this and to give those existing local partnerships the space and support to grow and mature,” she said.

(Images: Ed Miliband, credit: Stefan Rousseau. Andy Burnham, credit: Tim Goode/EMPICS Entertainment)

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