If we want good health we need to pay for it

norman-lamb

Norman Lamb was a first class Health Minister and Lib Dem Health Spokesperson. The policy he announced today shows courage and determination as well as a desire to bring people of all Parties and none together  to try and achieve a consensus on these vital issues

For the past two years it has been my privilege to be the Lib Dem Lead on Social Care & Health at the LGA. A particular pleasure of this has been to work alongside Norman Lamb the MP for North Norfolk and former Health Minister.

Norman is widely admired across parties and beyond for his determination to make the health and social care system work and to improve the status of mental health to that of physical health.

Norman has striven to try and forge a consensus about these issues. The NHS and social care is too important a sector to be left to political posturing and dissent. This is why he tried to get all three parties into the same room on this issue. Having failed to do that he then brought at least some MPs from all Parties together and went to see the PM about the problems that society faces.

He also established an independent commission on the funding of health and social care which I was asked to join. The Commission was composed of the great and good (except for me!). It included a former Chief Executive of NHS England, Dr Clare Gerarda the former Chair of the Royal College of GPs, A brace of professors, health economists, Patients etc. We were due to finish our work over the summer but fortunately produced an interim report which we published in time for the Lib Dem Spring Conference in March.

From that research and discussion the Lib Dems have today announced the following health policy which we will seek to introduce in the next parliament:

  • A 1 percent rise on the basic, higher, additional and dividend rates of income taxin the next financial year raising around £6bn per year, which will be ring-fenced to be spent on NHS and care services and public health.
  • To direct this additional investment into priority areas: social care, primary care (and other out of hospital care), mental health and public health which we know represent the most efficient and effective ways of spending extra resource
  • In the longer term, we will introducea dedicated Health and Care Tax, which will bring together spending on both services into a collective budget and set out transparently, on people’s payslips, what we spend on them.
  • Establish a cross-party health and care convention, working with patients, the public and NHS and care staff to review longer-term sustainability of health and care finances and workforce, and greater integration
  • Introduce a statutory independent budget monitoring agency for health and care. An Office of Health and Care Funding, similar to the Office for Budget Responsibility. This would report every three years on how much money the system needs based on meeting Government health targets and to fund new initiatives, while also covering projected increases in demand.

 

The Commission decided that whist money was not the answer to the NHS problems no answer could be found without more money. Crucially we agreed that the least effective place to spend the money was in our hospital service. The reason that hospital services are over-stretched is because there are too many people becoming needlessly ill and too many people left needlessly in hospital when they have recovered. We want more money therefore to be spent on Public Health and social care to ease up the pressures on acute services. We also examined the clear linkages between mental and physical health and found that mental health activities were cruelly underfunded.

You might think that there are two other solutions to the problems being faced:

  1. Should we not cut out waste in the NHS/social care sectors and in particular streamline them around patient and not organisational need? Yes we should. We know where some of the waste is. It is universally accepted, for example, that 40% of the drugs prescribed are wasted. Drugs are the second biggest item of expenditure in the NHS. If we reduced the waste to just 20% then £4 billion would be saved every year.
  2. Why not find the money instead from cracking down on tax dodging companies and individuals and very low rates of corporation tax? Every government for decades has promised to reduce tax dodging and make sure that Companies and individuals pay their taxes properly on profits raised in this Country. Their efforts have had few good consequences. The necessary changes are complex and far-reaching and would take time. The sector does not have time. It needs the money now.

 

50% of this taxation will come from the 5% wealthiest people in the community. 95% of this money will come from the wealthiest 50% of the population. The poorest with the greatest needs will pay nothing towards the costs.

10% of hospital beds are currently taken at any one time by people with diabetes II, 95%+ of which is entirely avoidable. Obesity costs us £6.1 billion every year. It leads to consequences for muscular skeletal development in the young which cannot be remedied in later life. It leads to reduced life spans as it causes problems with the heart, liver, kidneys and lungs. So much could be done to keep us fit. Some of it involves legislation and some involves education. That’s why we say that money alone is not the answer but only part of an answer. In some hospital trusts 30% of hospital beds are occupied by people with no clinical need. 15% is the norm across the NHS.

The job of a civilised society is not just to make people better if they are ill but to prevent them from becoming ill in the first place. The job of a civilised society is to get people back into their home and community instead of allowing them to languish in hospitals.

Today’s Lib Dem announcement is carefully thought through. It provides the short-term cash to keep the services going whilst the long term changes are made to our personal, civic and corporate behaviour on health. Read it well – think about. I can promise you this. No other Party will bring you as well a thought out set of policy proposals for health as Norman Lamb has put on the table today.

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About richardkemp

Leader of the Liberal Democrats in Liverpool. UK representative on UCLG Finance Committee, Executive Bureau and World Council. Deputy Chair and Lib Dem Spokesperon on the LGA Community Wellbeing Board. Married to the lovely Cllr Erica Kemp CBE with three children and three grandchildren.
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