Only Labour Can Save the NHS

But not for the reason you might think

One of the most annoying things in politics (and it’s a crowded field) is the claim you often see bandied around that ‘Only Labour can be trusted with the NHS’ and in the run up to the General Elections, people tweeting ‘Only 24 hours to save the NHS’. It’s all part of a conspiracy theory that the Conservative Party has a sinister plan to privatise the NHS. The theory goes something along the lines of the Tories plan to run the NHS into the ground through underfunding so that things get so bad that either people get so frustrated that they blame the NHS model, paving the way for it to then be sold off to some shady hedge fund managers, generally in America.

This is obviously nonsense. The NHS budget is huge, and it looks as though it is the only spending which will be spared in next week’s Fiscal Statement. Whether that’s enough money is a matter of legitimate debate which, but to claim that the Tories are trying to deliberately destroy it is completely ridiculous.

It also ignores the fact that, despite the many things the NHS does really well, things are already pretty grim when it comes to health and social care in England. The UK is, for example, one of the worst places in Europe to get cancer. It obviously depends on the type of cancer, but it’s likely to be diagnosed too late and your chances of survival are much lower than in many other countries.

However, it is impossible for any Tory MP to even suggest that the NHS might not be the best system in the world and could benefit from a bit of reform. To do so would see them widely condemned – including by their own party – and accused of wanting to introduce an American style system and talking down Our Precious NHS. As such, meaningful healthcare reform is unlikely to happen under a Tory government.

This is where Labour comes in. Given that the party is viewed as being the party of and for the NHS, any reforms put forward should be viewed with less suspicion and so should face less opposition. I have been really encouraged by the Shadow Health Secretary, Wes Streeting recently. For example, he has set out that he will be ‘brutally honest about the challenges in the NHS’ and that it is ‘not the envy of the world’. He has also pointed out that the NHS does need the private sector, a heresy which would get any Conservative run out of town. He’s even taken on high street accountant and Magic Money Tree proponent, Richard Murphy.

So, it’s Wes Streeting’s first day in the job at the Department of Health and Social Care. What should his priorities be? 

Embrace technology

One of the most effective ways of improving patient care is by increasing the use of new technologies in health and social care. Back in 2018 I wrote a policy paper for the TaxPayers’ Alliance using analysis from IPPR (the crossover nobody was expecting) on the use of technology in the NHS. The paper was launched by I’m a Celebrity… contestant Matt Hancock back when he was merely Secretary of State for Health and Social Care.

The paper found that the NHS has been pretty rubbish at using new technology and was often reliant on outdated forms of tech and operating systems. Back then it held the dubious title of the world’s largest purchaser of fax machines. We also found examples of doctors having to share the medical records of patients via SnapChat as they had no other quick and reliable way of doing so. 

The paper is full of numerous case studies and the overall thrust is that if we removed barriers to entry and embraced automation and AI in health and social care, then patient outcomes would dramatically increase while also making life easier for doctors, nurses, and other medical professionals. We would see better maternity care, cancers diagnosed early, more effective mental health treatment, improved diagnosis for cardiovascular disease, and provide better and more compassionate care for those in their final stages of life. This would involve utilising the private sector much more than is currently the case, but if it helps the NHS to provide the best possible care from the cradle to the grave then this shouldn’t concern anyone.

This will obviously be expensive and so the money will have to be found from somewhere. However, the paper found that the potential savings are huge. Over £18 billion a year by 2030. The figures will now be out of date and this was before Covid, but the savings would still be significant.

Tackle inequality

People living in the most deprived areas of England are diagnosed with serious illness earlier and die sooner than their peers in more affluent areas. A study by the Health Foundation found that for the majority of their lives, people in the poorest areas of England, on average, have more diagnosed illness over 10 years earlier than those in the richest areas. 

It really isn’t fair that your health and life expectancy are dictated by your socio-economic status or your race. However, this is the reality and the fact is that people living in poorer backgrounds are more likely to suffer from chronic pain and die earlier than those living in wealthier areas. It’s also sadly the case that people from Pakistani, Bangladeshi, and black Caribbean backgrounds are found to have higher levels of long-term illness than the white population, once the data had been standardised for age. 

The causes of health inequalities are complex and so there is no panacea. It will involve the Health Secretary working closely with other departments to identify and tackle the root causes. 

An obvious starting point is the benefits system. Many Universal Credit claimants are struggling with the high cost of living and are often unable to afford to buy enough food for themselves. Given the role that diet can play in health, there is a strong case to be made for uprating Universal Credit to help tackle health inequality.

The government could be even bolder at this point and push for a complete overhaul of the benefit system. I’ve written before about the impact that Universal Credit has on the wellbeing of claimants. It is difficult to say precisely just how damaging Universal Credit is to the physical and mental health of those on low incomes as the former Secretary of State for Work and Pensions, Thérèse Coffey suppressed the release of reports on this issue. However, we do know that looking for work while unemployed is an intensely sad activity. Given that the majority of claimants have to spend 35 hours a week looking for work, this would suggest that Universal Credit is exacerbating the misery faced by some of the poorest people in the country. Ideally, Universal Credit would be replaced by a Universal Basic Income which would provide a true safety net for people and allow them to live their lives as they see fit, not one dictated to them by the State.

The government also needs to tackle inequalities in how various medical conditions are treated. For example, despite the push for parity of esteem, mental health provision is often a poor relation in terms of funding and access to treatment. Not only are people struggling to receive the care and help they so desperately need, recent cases have highlighted the shocking failings in the system and how patients are treated including instances of abuse.

Increase research funding

The government should also increase funding for research into improving the detection, diagnosis, and eradication of diseases such as cancer. The priority here should be increasing funding for cancers which are less survivable and currently receive less funding than more survivable cancers. Take brain cancer, for example. This is a cancer which this week caused the death of an old friend of mine, it is underfunded compared to many other forms of cancer. As such, survival rates are much lower.

The focus should also be on finding cures and better treatments for cancers which disproportionately impact younger people. The main reason for this is because younger people have more years left to live and so it is only right that we do all we can to ensure that they are not robbed of them. It will also help redress the balance in healthcare spending between the generations. It is right that we take care of the elderly and so it is important that they get properly funded healthcare, but we should be aiming to spend a similar amount improving the lives of young people by tackling the diseases which disproportionately impact them.

It should be the aim of the government to find cures for all diseases and delay the ageing process in order to extend the human lifespan, perhaps even indefinitely. This may seem fanciful but the eradication of other diseases in the past would have seemed just as improbable to previous generations. Like the people in Nick Bostrom’s Dragon Tyrant, we are often too willing to accept death and disease as a part of life or as an insurmountable challenge.

However, it needn’t be this way. With the right people working on it we can help to end pain and suffering and allow people to have more time with their loved ones and live long, healthy, and happy lives. It will also bring about huge savings in the long run. We just need the funding. Government spending is all about priorities and I can think of few things more important than this. 

What can we learn from other countries?

Any talk of reforming the NHS or increasing private sector involvement immediately gets people worried. They think a US style system is being proposed and where poor patients will have to start cooking meth in order to fund their healthcare. Such a mindset stems from the mistaken belief that there are only two types of healthcare: free and universal with the NHS or private insurance like in America.

This is not the case. The vast majority of countries around the world have a funding model different from that of the NHS but that remains free for all. They also tend to have better patient outcomes than the NHS. We should do something similar in the UK. As long as it’s free, universal, and improves patient outcomes that’s all that really matters.

Conclusion

There are other things we can do to improve patient outcomes and make working in health and social care better. We should, for example, increase the number of medical school places and pay nurses, junior doctors, and care workers more money.

However, what the NHS needs is radical reform. For the reasons set out I think this is more likely to happen under a Labour government. Of course, it doesn’t have to be under a Labour government and this is something the Tories should be pursuing. Regardless, whoever is in charge needs to embrace technology, tackle health inequalities, increase research funding, and learn what works well in other countries.