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Health

Health and health care are basic human rights, not marketable commodities. The NHS is the world’s best example of the principle of social solidarity, remarkable for having had the support of people from all political persuasions since its creation. When the country invests in healthcare it not only reduces poor health and extends lives, but also creates a healthier workforce and contributes to economic growth. Our health policy covers three main sections: the NHS, Public Health and Social Care.

1. THE NHS
Restoring the NHS – Publicly Funded, Publicly Provided and Publicly Accountable
NHS Funding - Increasing NHS funding
NHS Funding - Ending PFI
NHS Funding: Opposing Prescription Charges
NHS Funding: Using the Procurement Power of the NHS
Hospitals: Defending our hospitals
Hospitals: Safe staff-patient staffing levels
Fair pay for NHS staff
Listening to patients and staff to improve the NHS
Supporting Mental Health Services and ensuring “parity of esteem”
Strengthening maternity services
Improving General Practice
Improving Nursing
Clinical trial data

2. PUBLIC HEALTH

3. SOCIAL CARE
The Current Care Crisis
Free personal social care and integration with health
Care homes
Care staff
Welfare benefits
Reducing health inequity

THE NHS
Restoring the NHS – Publicly Funded, Publicly Provided and Publicly Accountable
Only a publicly funded, provided and accountable NHS can sustain the founding principles of a comprehensive, universal, equitable, accessible service. These principles have been severely undermined by the marketisation and privatisation of the NHS. This process was started by the Major Government in 1991, expanded by the New Labour government and turned into a fully functioning external market by the Coalition’s 2012 Health and Social Care Act.
Privatisation and marketisation of healthcare increases both inefficiencies and costs. The front line workforce is reduced to save money and becomes de-professionalised. The number of accountants and lawyers increase to deal with the additional complexities and transactions within the system. Public money which pays for healthcare is transferred to private shareholders and corporations: this often drains money out of the domestic economy as the companies are often based in offshore tax havens. Competition in the system fragments it, reducing access to care. Private providers look for profitability when they bid for a contract, not equity or universality.

We would

  • Restore the NHS to public ownership: publicly funded, publicly provided and publicly accountable.
  • Restore the duties and responsibilities of the Secretary of State for Health to provide universal and comprehensive healthcare in England. But with less political interference in the day-to-day running of the NHS.
  • Halt and reverse privatisation.
  • Abolish competition and the market in health provision with its associated huge and unnecessary costs and bureaucracy.
  • Reinstate the NHS as the preferred provider of healthcare and remove the requirement to tender out contracts to the private sector.
  • Replace the market with a system based on resource allocation, not commissioning. This system would enable effective planning of healthcare according to the needs of the population at local, regional and national level.
  • Implement the Pollock and Roderick NHS Reinstatement Bill as the best way to achieve this, as it not only repeals the Coalition’s 2012 Act, but also corrects the previous legislation which created the market.

NHS Funding - Increasing NHS funding
A key feature of the privatisation process has been the severe budget cuts to the NHS. These have been labelled as ‘efficiency savings’, but have actually been a freezing of the level of spending since 2010. No allowance has been made for rising costs, such as an increase in the UK population of 4 million people since 2008. The cuts, introduced by New Labour and greatly extended by the Coalition, have led to service reductions, closures, staff shortages, ambulance queues, longer waits, a crisis in General Practice, worse patient experience, more errors and patient harms. This is an example of the way we have been misled by the politicians. Typically the closures are presented not as what they really are, but as ‘reconfigurations’ or ‘changes to service delivery’. But they are part of the plan to shrink the Welfare State, shrink the NHS and liquidate the nation’s land and assets to sell off to the private sector. The NHS will not survive another 5 years of this spending freeze.
Meanwhile the market costs, for example in contract tendering, in private finance repayments, in finance departments exchanging invoices, have escalated. The savings, on the other hand have almost all come from cuts in the value of NHS pay, by the sell-off of assets and from service reductions. Despite this freeze the Treasury has clawed back over £5 billion of the NHS budget so far in the lifetime of this Government as ‘underspend’.

  • We call for real terms increases in funding for the NHS of at least 4% per year to match the healthcare inflation rate. This should be achieved in the short term by a 1p rise in the basic rate of income tax. This will raise £4.5 billion per year.
  • In the medium to long term the savings from ending the market and halting privatisation will boost the funding to front line care.
  • We would aim to increase NHS funding to around 10% of GDP to bring it into line with G7 countries.

NHS Funding - Ending PFI
Since 1997, hospitals and facilities worth £11bn have been built with private funding under the Private Finance Initiative, with index-linked contracts repayable over 25-40 years or more. The latest Treasury estimate of the full costs of these contracts is just short of £80bn. This includes support services which in many PFI schemes offer another profit stream for the private consortia that put up the initial investment.

In order for hospitals to borrow finance from the private sector they had to be moved to arms’ length from government control. This was done by legislating for a new form of ownership and the creation of the Foundation Trust Hospitals.

The ‘unitary charge’ payments on each PFI scheme increase each year, while income for NHS and Foundation Trusts is static or falling. Many unitary charge payments are in excess of 10% of trust revenue which has led to financial crisis in a number of trusts. This has resulted in cuts in services within the trust or its local health economy. The crisis at South London Healthcare Trust put the survival of neighbouring Lewisham Hospital at risk. The same has happened at Mid Yorkshire Hospitals, Peterborough and Stamford Hospitals, Barts Health Sherwood Forest Hospitals, Barking Havering and Redbridge and many more.

The Coalition government has continued to sign new PFI deals even after criticising the excess and unaffordable costs of deals signed under Labour. It has watched more PFI contracts being bought and sold on the money markets, with more being concentrated in the hands of companies located in offshore tax havens, so no taxes flow back to the Treasury.

We believe

  • No more PFI deals should be signed. The policy should be ended now, not after May 2015.
  • There is no legitimate reason why future infrastructure costs should not come from Government borrowing. The repayments come ultimately from the public purse and public borrowing is always less costly than private finance.
  • Urgent intervention is needed to prevent service cuts in NHS Trusts that have been financially undermined by the inflated costs of the Private Finance initiative, or in neighbouring Trusts.
  • The Treasury must force a full investigation of mis-sold PFI contracts, penalise those responsible and renegotiate onerous contracts on the basis of fair value, with the refund of excessive payments.

NHS Funding: Opposing Prescription Charges
Prescription charges raise less than £500 million a year (less than 0.5% of the NHS budget) but also create a costly administrative bureaucracy. There is evidence that prescription charges lead to inappropriate self-rationing and prevent access to clinically necessary medications. The consequences of self-rationed treatment include more time off work, lower educational attainment, detrimental effects on career opportunities and early retirements. Prescription charges are effectively a tax on people of working age with long term chronic disease and affect people on the lowest incomes the most. Exemptions are arbitrary and pre-pay certificates do little to address the problem. The reduction in administration costs and improved access to medication from abolishing prescription charges will create medium and long term savings.

  • We call for the abolition of prescription charges. This would bring England in line with the policy of the NHS in Wales, Scotland and Northern Ireland.

NHS Funding: Using the Procurement Power of the NHS
Evidence and experience strongly suggests the NHS has not used its scale to procure goods and services at best prices.

  • We believe we need effective reduction of expenditure in appropriate, non-front line services.
  • We would leverage the size and position of the NHS to secure the best value from all suppliers.

Hospitals: Defending our hospitals
The UK already has one of the lowest ratios of hospital beds per head of population in Europe. One third of all hospital bed losses have occurred over the last two decades – at a time when the population has significantly grown. Now, under the continuing cuts and closures programme across England more beds are being lost. When A&E departments are closed most, if not all, of the accompanying wards providing acute care are closed too. An A&E department needs acute wards to take its admissions, and the acute wards have no purpose without a corresponding A&E. Closure of A&E means the hospital is no longer an acute general hospital. The lost hospital beds are never fully re-provided in the surrounding hospitals that take up the admissions.
The current justification from the Coalition, from the Labour Party and from NHS England is that many hospital admissions are unnecessary and can be prevented by ‘care in the community’, so fewer beds are needed. If this was the case (and there is an absence of evidence that it is) community provision would need to be in place and shown to be working effectively before the closures happen.

A second justification is that large specialist centres are being created concentrating expertise and removing the need for local A&E departments. There is no evidence that a specialist centre is needed for the treatment of the vast majority (95%) of the conditions for which people are admitted to hospital through A&E. There are existing specialist centres of excellence that provide care which cannot be provided by a District General Hospital (DGH), but they do not function as a replacement for them.

  • Our policy is to defend the District General Hospital (DGH) as a good model of care for the majority of people who need admission to hospital. They provide people with care close to home, which means easier and less costly visits from relatives during their stay. This is a key feature in retaining the founding principle of access and equality. It costs proportionately more for people on low incomes to travel to visit or for hospital appointments.
  • We believe that the networking of DGHs to larger specialist hospitals is essential to ensure that patients who need highly specialised care get access to specialised services.
  • We say there should be full equality impact assessment published before any hospital or service closures.
  • Reconfigurations of service should have local community and clinician support and be subject to a full consultation process.

Hospitals: Safe staff-patient staffing levels
Permanent or ‘establishment’ staffing numbers have been cut as part of the drive for hospitals to meet their budget targets. As more experienced specialist staff cost more their roles are being cut disproportionately. In many hospitals and health services staff:patient ratios often drop to levels which reduce the quality of care or jeopardise safety. To make up the shortfall the NHS has become increasingly dependent on agency staff. This increases costs and has the perverse effect of lowering overall skills levels and reducing efficiency. This is all part of the ideologically driven market ‘reforms’ and is damaging to service provision and patient care.

Fair pay for NHS staff
NHS staff pay has been frozen at 1% or less over the past 5 years amounting to a real terms reduction in pay of 15%. Some NHS staff are on the minimum wage and have to claim in-work benefits just to make ends meet. This is unacceptable and will undermine recruitment and morale.

We call for

  • Minimum staff: patient levels to be set for each specialty to ensure safe, quality care.
  • The implementation of a pay structure to reward NHS staff fairly for their skills and their work. Staff should not be exploited as the immediate source of cash savings through frozen and falling real-terms salaries when the service faces financial pressure.
  • Salaries should rise in line with inflation. Terms and conditions of service should be protected.
  • The living wage, not the minimum wage, as the lowest rate payable in the NHS.
  • Improved recruitment and retention to prevent burn-out and losing staff outside the NHS, to create a sustainable workforce

Listening to patients and staff to improve the NHS
Patients and public must have a real say in how local services are developed and delivered by strengthening the powers of patient representative organisations at local and regional level.
A complete reform of the NHS Complaints process is essential and urgent. The current system is toothless and not helpful for patients or their relatives.
The government has failed to come up with an adequate means for patients to be heard after Community Health Councils and then Patient Forums were abolished by previous governments. They had the ability to offer a resolution and then escalate the complaint to local NHS authorities or the Health Secretary if appropriate. There has been no adequate replacement for this vital service. Health Watch appears to be toothless in this respect.

Patients need expert, independent help to make effective complaints and this independent help must be easily and generally available early in the process and long before legal action is considered. Legal action must always be the last resort.

Even more important is the need to avoid complaints. This can be achieved by improving communication between NHS staff and their patients. With open, comprehensible information-sharing and discussion many complaints can be avoided before they develop.

We call for

  • The introduction of local independent health commissioners, accessible to patients, relatives and staff, in all major towns working under a new and specific Health Service Ombudsman, based on the New Zealand system. The Independent Health and Disability Commissioner of New Zealand, with offices in all major towns, is a good model of an independent, accessible official to whom patients, relatives and staff can raise complaints and concerns with preservation of anonymity if desired. The Commissioner has the knowledge and ability to cope with these or to pass them on to the highest authority when appropriate.
  • the NHS Complaints Process to be patient-friendly and be used as a means to improve the NHS.
  • a reduction in the NHS and Department of Health dependence on management consultants and increase the influence of healthcare professional bodies, health staff and patient groups, and the restoration of responsibility for health planning to public health and clinical leaders.

There are further urgent concerns about staff who wish to raise issues of poor practice (whistle blowing).

We support

  • Strengthening of the whistle blowing system that allows staff to identify and report their concerns about quality of care and patient safety without fear of recrimination.

Supporting Mental Health Services and ensuring “parity of esteem”
For too long mental health services have been at the bottom of the healthcare agenda. Despite all the Coalition’s promises for ‘parity of esteem’ for people with mental health problems, there is clear evidence that mental health services have suffered the most significant cuts. Bed numbers and staffing levels have been slashed and vulnerable patients are being sent hundreds of miles away from home for treatment. The planned introduction of Personal Health Budgets threatens – under the misleading mantra of ‘choice’ – to further fragment and destabilise services even further. This will leave growing numbers of mental health service users without access to the care they need. Only the NHS can deliver a comprehensive service integrating in-patient care where necessary with community-based services and support for mental health in primary care.

We call for

  • the mental health funding plan to be addressed as a matter of urgency.
  • increased staffing levels and an increase in training places for mental healthcare professionals.
  • an end to the privatisation of mental health service provision and its return to the public sector under the NHS.

Strengthening maternity services
Safe delivery for women and good outcomes for new born babies are two of the important measures of a properly functioning health service. Budget cuts and midwives leaving the profession due to low morale have led to a shortfall of 4,800 midwives. Almost half (47%) of UK hospitals claim they do not have enough consultant obstetricians. These staff shortages coincide with a steady baby boom in England over the past decade. Midwives and obstetricians are looking after women with much more complex needs. There has been an 85% increase in births to women aged 40-44 in England and women with other health issues such as obesity and pre-existing conditions. This strain on maternity services could put mothers and their babies in danger.

Since the Health and Social Care Act came into force in April 2013 there have been concerns raised in a Public Accounts Committee report regarding the commissioning and delivery of maternity services. There is confusion in the Department of Health about who is ultimately responsible for the most fundamental aspects of care, such as ensuring the NHS employs enough midwives. Commissioners are unclear about government policy and so are unable to comply with a national policy. There is doubt that the new tariff provides sufficient income to providers to deliver the objectives even if they know what they are.

We would

  • Ensure a safe and effective service for women and their babies at one of the most vulnerable times in their lives.
  • Address midwife shortages and training numbers
  • Increase maternity and paternity pay
  • Increase support for working parents
  • Focus on maternal mental health issues

Improving General Practice
The Royal College of GPs and the BMA have declared that family practice is “in meltdown”. Budget cuts and a severe shortage of GPs have caused access problems and a breakdown of continuity of care. Hospital services are being pushed into primary care with no resources to support them. Moral is poor and GP training places are not filled. There is a recruitment crisis.

GPs are in danger of losing the trust of patients as they are forced into the role of rationers of services, and the need to study financial spreadsheets. Pressure is exerted to under prescribe, under-treat and under refer. A new “elephant in the room” is now money. Patients cannot be certain decisions are made purely in their best interests or for financial reasons.
As traditional GPs become rarer, practices are increasingly being taken over by private companies which disappear suddenly when their share-holders aren’t profiting enough.

Our policy

  • We support the traditional model of British General Practice supported by primary care teams working in defined areas, distributed fairly and based on long-term relationships with patients and underpinned by the vital concept of continuity of care.
  • To improve access and thus continuity we call for GP numbers to be increased by 10,000, in line with recommendations from the Royal College of Gps.
  • GPs should remain free from pressures, particularly financial incentives, which could detrimentally affect clinical decision-making, and should always be in the best interests of their patients. They need to remain the patient’s champion and committed advocate.
  • British family medicine is extremely cost-effective but needs investment and consequently the reversal of the cuts to general practice funding (nearly £1 billion in last 5 years), with greater investment in premises and good GP-led local out-of-hours services. We also call for the reversal of the Minimum Practice Income Guarantee (MPIG) cuts and ensure practices in deprived areas receive adequate funding.

Improving Nursing

Our NHS cannot survive without its nurses, yet we have fewer nurses per head now than we did when this government came to power in 2010. The Royal College of Nurses says while the government claimed the number of nursing posts has increased, the headcount figure for nurses actually fell from 317,370 in May 2010 to 315,525 in December 2014.

We need tens of thousands more nurses to provide safe care, yet we are losing thousands of our most experienced nurses who have been let go to be replaced – if replaced at all – by cheaper, less experienced staff to cut costs. 

A pay cut of 15% in real terms has contributed to an exodus of British nurses to Australia, New Zealand and America, while trusts attempt to plug the gap by recruiting from the EU and elsewhere. Nurse training places – which are already hugely over-subscribed – have been cut by thousands by this government. 

Those NHS nurses who do struggle on must do so beset by understaffing and stress, while trusts spend £1,200 a minute on emergency cover from agencies. 

This is a wholly wrong, ludicrously wasteful, debilitating crisis that has been created by this government in pursuit of its wrong-headed Austerity policies. It cannot go on much longer without causing the system to collapse.

This government's policies are decimating our NHS. The NHA Party says it is vital to restore nursing in the NHS to the gold standard: good, properly funded, permanent jobs that our nurses can train for and will want to stay in – for all our sakes!

We support and will adopt the Royal College of Nursing's manifesto:

  • Improve patient care - safe staffing levels, access to training and environments where staff concerns are listened to.
  • Value nursing - fair pay for nursing staff, an end to downbanding and for a focus on the future of nursing.
  • Invest in health and care - no more cuts to nursing, increased community resources and workforce planning around patient need.

Clinical trial data
At present researchers can limit the data from trials that it makes available to be peer reviewed. When the pharmaceutical industry does the research, they may have conflicts of interest reporting results which may negatively affect their sales.
We support

  • Publication of all data from all clinical trials.
  • The AllTrials campaign which is designed to put pressure on all Governments, regulators and regulators to achieve this.

PUBLIC HEALTH

Public Health is high on the National Health Action Party’s policy agenda. It is about organisations in society making an effort to improve health and prevent disease. Good public health legislation makes a great contribution to the overall quality of our lives and affects almost every other area of policy making .The health of our population depends on economic and social factors such as our wealth and work, which are largely outside individuals’ control. Of course encouraging and promoting responsible action by individuals is a part of public health, but only a small fraction: the main public health approach is through political and economic action by Government, local communities and large national organisations. ​

​There are many factors that impact negatively on the nation’s health – including lack of employment, poor housing, low food standards and the relentless marketing of dangerous substances and practices – that are, or should be, a government responsibility to remedy.
​There are still, in the 21st century, and after almost 70 years of universal free healthcare, clear regional and class inequalities in general health standards and life expectancy. Therefore, changing economic and social policy arenas is the way to ‘empower’ individuals and families, by first working towards full employment and secondly by ensuring that all employed people have decent conditions of employment and, most important of all, a minimum healthy income.
Furthermore the sick should not be scapegoated for the actions, or failure to act, of successive governments; no MP should point the finger at those addicted to alcohol, or tobacco, or gambling, without acknowledging his or her own party’s failure to act decisively against those who profit from those addictions.
In the run up to the 2010 election the Conservatives pledged to sort out secret corporate lobbying. David Cameron even suggested that lobbying would be ‘the next big scandal’ to consume Parliament. But the corporate lobbyists have not been restrained and strict regulatory changes have not taken place. The corporate sector contributes large donations to political funds. Early in 2014 the BMJ reported that ‘corporate responsibility for self-regulation has taken over the role of governmental public health policy’.
The National Health Action Party believes the basis of all public health policies should be authoritative evidence, untainted by corporate lobbying​, with the role played by government made paramount.
As a 2015 Lancet report on obesity said: "Children are... exposed to whatever environment we create for them, and while it is important to have child-specific interventions and actions, societal change as a whole is also required.  ​Halting and then reversing the obesity pandemic by changing our societal approach to food, beverages, and physical activity is not an optional choice or a target that can be missed. It is one of the most important challenges that must be tackled collectively by our civilisations. Our sustainable future as a species will benefit too."
According to NHS figures more than 3.5 million children are now classed as overweight or obese. This is linked to the rise in consumption of hidden sugars in drinks often marketed as an energy boost or to improve sports performance. It is estimated than the under-10s receive almost a fifth of their daily calorific intake from soft drinks and in the 11-18 age group this rises to almost a third, whilst the health service spends more than £1.5m an hour on tackling diabetes.
Obesity established in childhood is very difficult to reverse in later life, so pursuit of a quick profit is setting up a generation of our children for a lifetime of health problems. The situation that we have watched develop in America is now here too – with the same multinational corporations the culprits, in many cases. And there is intense pressure to sweep away whatever protection our national and EU laws currently afford us.
Public health experts must be given power to make authoritative evidence the basis of all policies which affect health. Those policies will affect most sectors of the economy and society, for instance, obtaining healthier nutrition by regulating the retail trade’s attempts to sell unhealthy amounts of salt, sugar and fats. A government serious about public health must take action to separate itself from industry involvement.
Voluntary agreements with industry are not an adequate substitute for public health policy. Liver disease in the under-30s has more than doubled in the last 20 years, with alcohol the biggest single cause of death in the under-60s in the UK. Gateway alco-pop drinks for young people, longer opening hours, laxer licensing laws are sending out the wrong message. The government response to alcohol related crime and disease, with an estimated cost to the economy of £21bn a year, is a voluntary ‘Responsibility Deal’ with the drinks industry which has committed to put a health message on 80% of all bottles and cans. “Drink responsibly” it warns – shifting the blame for whatever happens next, and the associated costs to society, onto individuals, rather than acknowledging that the responsibility belongs with the industry and the successive governments that have given it free rein. The same goes for the tobacco industry – now augmented by the threat of marketing of “vaping” to a rising generation that has never yet smoked.
At the same time as allowing or even encouraging all manner of legalised addictions for profit, successive governments have criminalised addicts of non-legal substances, ignoring overwhelming evidence that this does nothing either to help the sufferer or to diminish the trade. Addiction of all kinds should be considered a health, not a criminal, matter and treated accordingly to provide the best chance of limiting its damage to individuals and society as whole.
The corresponding attitude of governments to their own decrease in regulation for the corporate world is an increase in the level of blame that individuals carry for their own condition. In this view of society ‘choice’ is the mantra and personal choice, not public policy, is the reason for obesity, smoking and alcohol related diseases. Think tanks and even those responsible for commissioning our health services have raised the threat that treatment will be restricted or refused to those suffering ‘life style’ diseases.
Also, over this last government, many NHS public health services such as immunisation, sexual health promotion, health visiting and smoking cessation have been outsourced to the private sector, and are increasingly linked to commercial exploitation. This must stop as it goes against everything the National Health Service stands for, where patients, not profits, are the bottom line.
The National Health Action Party believes the commitment to and responsibility for public health should not fall only on the health and care services but extend to an integrated approach to policies in housing, employment, environment and planning that is directed towards the well-being of all citizens, including generations yet to come
Our policy position is that for improvements to health to be implemented at individual level, change must first be implemented in society.
Our solutions.
  • ​Ensure effective enforcement of plain packaging of all tobacco products; investigation into e-cigarettes
  • Introduction of minimum unit ​alcohol ​pricing, tougher ​ penalties and ​ stricter enforcement of rules regarding sale of alcohol, stricter controls on marketing of alcohol and calorie labelling.
  • A sugar tax for processed food; simpler, more overt labelling to enable consumers to make informed choices.
  • More stringent requirements on the fast food industry to cut the use of additives, including sugar and salt.
  • Stricter rules on links between public health research, public officials, and the food, drink and pharmaceutical industries. 
  • Promotion of healthy lifestyles, with greater access to exercise and sport in schools and communities; long-term investment in urban transport so that walking and cycling will be a safe and attractive option.
  • Essential public health services must not be milked for profit or come under the influence of industry; there must be adequate funding of public health education and policies within the public sector.
  • The part that full employment and good public housing plays in public health, especially mental health, must be recognised and that recognition feed into decision-making.
  • Britain to be a strong, principled and people-centred voice in the drafting of European public health legislation including the environment, pollution and the regulation of medicines and of medical personnel. 

 

SOCIAL CARE
The core founding principle of the NHS is that it should provide health care irrespective of ability to pay, from the cradle to the grave. This principle has been eroded by the gradual redefinition of much health care as social care which is then means tested and charged for.
It is important that older or disabled people who need care should receive high quality care in their own home or in residential care homes or nursing homes.
Unlike healthcare which is free, social care is means tested and charges are applied. This is done through the local authority which also provides some of the care, along with the private sector.

This leads to many problems, the most serious of which is affordability for those who have to pay charges, but also a battle between health and social care agencies about what is health and what is social care in order to decide who should pay. In practice it is very difficult to distinguish between a healthcare need and a personal social care need. Attempts to make this distinction has led to an undignified, often cruel, bureaucratic and costly process of assessment for eligibility for NHS funded health care.

The Current Care Crisis

This government's Austerity policies have led to local authority spending cuts of 15% in real terms since 2010, with social care suffering cuts of 26% or £3.5 billion. This is at a time when the need for social care services has only grown. The most vulnerable in our society – children, the elderly, disabled people, those with learning disabilities – have borne the brunt of a financial crisis not of their making.  In particular,  we have an ageing population with complex and multiple health needs.  Age UK says one million elderly people have now been left without basic social care - with the NHS left to pick up the pieces.  No wonder that 70% of hospital beds are occupied by people over 65.

Free help with everyday activities such as bathing, dressing and eating has been removed from a quarter of a million older people in just four years, as council budgets have been slashed and services rationed.But if people don't get the help they need, it not only places extra strain on friends and family carers (where available), it often leads to avoidable hospital admissions.

A third of people who use social care are disabled people of working age. A report by a group of disability charities found that, when asked about the social care services they received, 40% said they don't meet basic needs like washing, dressing or getting out of the house; 47% said they don't enable them to take part in community life like seeing friends or volunteering; 62% said they had spent their own money on help to eat, dress, wash or get out of the house.

Cuts to social care budgets have also had a very serious impact on child protection. Only the most serious child protection cases now meet the threshold for social services intervention, and there are fewer resources for preventive and family support work, or to support children in need.

  • We will reverse the cuts to local authority budgets and increase funding for social care to a level that fully meets the needs of vulnerable, elderly and disabled people.
  • We will reverse the cuts to social services budgets for children and families.

Free personal social care and integration with health
All three main parties say they want to integrate health and social care. While the idea of better integration of health and social care has its merits, there cannot be any real integration of health and social care unless the conundrum of free health care but means tested social care is resolved. The only practical and humane way for this to happen is if personal social care becomes free just as health care is.

This was the recommendation of the 1999 Royal Commission which the then Labour government in England rejected, but which was implemented by the Scottish Labour government in 2002 and which continues to be the policy in Scotland.

The recent Barker Commission report commissioned by the Kings Fund recommended that personal social care for people over 65 with critical or substantial needs should be free. They estimated this would cost an extra £3 billion a year. Age UK  estimates that it would cost £3.36bn – only 0.22 per cent of English GDP – to meet the needs of all elderly people with moderate care requirements

Regarding the costs of non personal social care i.e. the “hotel” costs of residential care homes or nursing homes, we agree with the recommendations of the 2011 Commission on Funding of Care and Support (Dilnot Commission) which recommended a lifetime cap on care costs of £35,000 and the means-tested threshold, above which people are liable for their full care costs, should be increased from £23,250 to £100,000.

Our policy

  • We will introduce free personal social care and increase funding to meet the needs of vulnerable elderly and disabled people
  • We call for implementation of the Dilnot Commission recommendations.

Care homes
The privatisation that threatens the NHS has been a reality in the care industry – for an industry is what it has become – since the 1980s.

Since the 1980s the provision of care in people’s homes or in residential care and nursing homes has become a for profit industry. The private and other non-public sectors currently own or run 86% of the elderly care homes sector. In the past 20 years the percentage of state funded services given to people in their own homes by private providers has risen from 5% to 89%.
As the market has developed more and more small care home operators have been replaced by giant private care operators run by private equity funds, hedge funds and conglomerates.

Because their primary motivation is profit, the pressure is on to keep fees high, wages low, and to close homes and evict residents at short notice if they no longer yield big enough returns. The regular scandals seen in the press and on TV about standards of care in homes have not come from nowhere; they have come from an ideologically driven privatisation. The Care Quality Commission (CQC) recently admitted that it faces problems upholding quality standards in its regulation of nursing and residential homes. It admitted to reluctance to intervene decisively because of fears of incurring legal action or triggering the collapse of providers.

Our policy

  • We support the provision of new local authority care homes to provide quality local care for those who need them.
  • We oppose the closure of existing local authority elderly care homes.
  • We will bring back into local authority ownership any care home that threatens closure and eviction of its residents.

Care staff
In a survey, John Kennedy of the Joseph Rowntree Foundation noted that 78% of frontline care staff earn an average of just £6.45 an hour: “The care home sector employs hundreds of thousands of low-paid workers, mainly women,” he said. “Care workers are the lowest-paid, lowest-status workforce in the economy.”

Good care workers do a vital, socially valuable and skilled job whether they are work in a care or nursing home or visit a number of people in their own homes during a single day. We may all come to rely on them for out health and well-being at some point in our lives.Though care home staff and domiciliary care providers are doing a vital, socially valuable and skilled job these workers are amongst the lowest paid in the country with little training and few qualifications, often working in situations where there are not enough staff and not enough support. Many have to provide care in 15 minute slots and are not paid for travel time between clients. This has an impact on care quality. Well motivated, well trained and well paid staff are likely to provide better standards of care.. “The cost of low investment in our social care system,” concluded John Kennedy, “is simply pushing higher cost on to the NHS.” Frail people stay in hospital longer than necessary if there is not adequate care waiting for them at home.

Our policy

  • We will improve the quality and provision of care through a transformation in the pay and conditions of care workers, with an end to enforced zero hours contracts; enforcement of minimum statutory staffing levels; and an end to 15-minute care slots for domiciliary care staff, who must be paid for their journey time between clients.
  • We will reverse the outsourcing of carers, taking them back into local authority provision to enable better standards, management, support and supervision.
  • We will invest in the pay, conditions, training and support of care staff, with statutory requirement a national qualification.

Welfare benefits
With the collusion or encouragement of this government, sick and disabled people have become the target of a campaign of vilification in the press. As with unemployment benefits, welfare benefits have been presented as people getting something for nothing. Assaults against disabled people have increased as a result.

The reality is that, while the majority of welfare benefit recipients are in work, their income is usually so low they depend on benefits for the basics of life. Nevertheless their benefits have been subjected to severe cuts to support and benefits, with even more severe cuts promised. People on employment support allowance (ESA) have been put through a computer-based Work Capability Assessment that was outsourced to a private company and roundly criticised by disabled charities as insensitive, cruel and not fit for purpose. Thousands of people have died within a few weeks of being declared “fit for work” by this assessment.

  • We will replace the Work Capability Assessment with a humane system based on a genuine assessment of people’s abilities and support needs, plus the resources to support them back to work where possible.
  • We support the abolition of the cruel and target driven “sanction” system which is driving many people to poverty. The “bedroom tax” (“spare room surcharge”) should be scrapped.

Reducing health inequity
There is incontrovertible evidence (e.g. Marmot report, Fair Society, Healthy Lives) that health inequity arises from social inequalities. To reduce such inequalities requires action across all determinants. Targeting the most disadvantaged alone will not improve health sufficiently. To reduce the social gradient in health, actions must be universal and with a scale and intensity that is proportionate to the level of disadvantage.

We therefore strongly support evidence based programmes to achieve the following 6 policy objectives

  1. Give every child the best start in life.
  2. Enable young people to achieve the maximum of their potential for healthy lives.
  3. Create fair employment and meaningful work for all.
  4. Ensure healthy standard of living for all.
  5. Create and develop healthy and sustainable communities.
  6. Take every opportunity to promote well-being and prevent ill-health.

We support the principle of respect for everyone whatever their race, ethnicity, gender, age, marital status, civil partnership status, religious belief or non-belief, sexual orientation, class, size, disability or other status.

We strongly believe in equal opportunities for all and support legislation and action that bolsters this, challenges and tackles evidence of institutionalised discrimination, and continues to train and educate staff at all levels on sensitivity to discriminatory behaviour.