Over the last two years the NHS in Central Bedfordshire, Luton, Bedford Borough and Milton Keynes have been working with the local authorities from these areas to develop what is called a ‘Sustainability and Transformation Plan’ for health, social care and related services across the four districts.
This is part of a national NHS England initiative to rationalise services and save money – not least to eliminate the large deficits across the NHS. However, there has been some limited but far too limited public consultation, and some engagement with bodies such as Health Watch and some voluntary and community organisations (VCS). There has been very limited engagement with staff and their trade unions.
The Labour Party wants to improve health and social care services, and indeed we would be the first to campaign for better health outcomes and less health inequality. We recognise that there has to be some change and that sadly not all local services especially community health and mental health services are anywhere near adequate.
We understand the logic and rationale for some changes in hospital provision including locating the highest quality specialist provision together to ensure resilience and professional expertise and capacity, and for some transfer of some services to community and primary care settings for the convenience and benefit of patients. We also passionately believe in the integration of care with fewer professional, geographic and institutional silos – for example social care and NHS care for elderly people.
We understand that medical and care practices have evolved and continue to do so. The NHS must embrace such change including the best use of technology and modern pharmaceuticals, and of modern clinical specialisms.
However, we cannot support the current proposals that seem to be emerging from the STP for a number of a reasons not least because there is no transparency of what these proposals are, why they are being considered and what the benefit – positive or negative – of them might be.
It is proposed the STP will morph into an ‘Accountable Care System’ with shared and common management, back office systems and financial and clinical accountability. Again, the case for this and its impact have not been subject to adequate, if any, public debate. The NHS Constitution commits it “to make decisions in a clear and transparent way, so that patients and the public can understand how services are planned and delivered.” Where is the clarity and true local accountability in the STP/ACS process?
As a local Labour Party, our members use and experience the NHS and social care systems locally, many work in them and we all hear about the experiences of family, friends and neighbours. We are committed to the NHS and the values on which it was founded. We support the need – as pledged in our manifesto in this year’s general election – for major investment in the NHS and social care system locally and nationally.
Over the coming months we are going to continue our campaign for improved health and care services in Mid-Bedfordshire. We know that this resonated with the electorate in June. We are also going to be monitoring the STP and the emerging ‘Accountable Care System’.
Our core twelve demands are:
- the STP and ‘Accountable Care System’ planning process must be transparent with all options shared with the public, patient groups, the VCS and staff with full costs and impact assessments
- there must be full engagement and consultation on all such proposals
- the STP must not be used as an excuse for cuts to provision or to attempt to camouflage the Conservative Government’s underfunding of the NHS and social care services
- Labour’s commitment to NHS and social care funding and investment should be implemented by this Government or it should make way for a Labour Government
- community, ambulance, primary and mental health services must be enhanced and be accessible to everyone who needs them
- any changes to hospital provision should demonstrate that they will lead to enhanced health provision and significantly better health outcomes
- patients in Mid-Bedfordshire should be able to access the most appropriate services and treatments wherever these may be located – not just locally
- where patients have to travel for treatment there must be good ambulance and public transport for them and their families
- clinical services should not be operated by ‘for profit’ businesses though we recognise the value of specialist VCS services including advocacy services
- local authorities and especially Central Bedfordshire Council should be heavily involved in strategic health and social care planning and strategic commissioning; be transparent and politically accountable – and use their Health Overview and Scrutiny committee, and Health and Well-being board to maximum effect
- staff are respected well paid and protected during periods of change with trade unions playing a key role
- Central Bedfordshire Council protects and uses its public health budget to support effective prevention programmes
Our campaign and approach will develop. As a Labour Party, we want to talk with our comrades in the other local constituency parties in the STP area, the Labour councillors in these areas especially Luton and Milton Keynes where there are Labour Councils, the trade unions and above all the people of Mid-Bedfordshire.
Our NHS is precious. It is the embodiment of Labour’s core values and principles. We founded the NHS in 1948 and in 2017 we are best placed to defend and promote a modern effective health and care system that serves the people based on need not wealth. We recognise that the values of 1948 must be sacrosanct but we also recognise that change is necessary – it has to be the right change!
Mid Beds Labour Health Team