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Posted by: John Brace | 14th May 2011

The issue of midwives (NHS) – Is Labour telling the voters two different things on the NHS?

I read Frank Field’s well balanced piece on midwives in the Wirral News with interest. However it reminds me of this question posed by a voter to me on the way to my local polling station and this story in the Wirral Globe with a quote from Cllr Foulkes.

So what do these two senior Labour politicians make of it?

Cllr Foulkes (in an article the day before the election) – “privatisation by the back door” and “It is a very dangerous move and we should be given more information about it.”

Frank Field (less than a week after the election) – “The reports are that it is extremely popular.” and “Likewise, if a private company can provide a genuine one-to-one service with a single midwife that sees the family through the birth, what is stopping the NHS doing the same? The overall aim of the service is to increase the number of healthy babies who will be able to live fulfilling lives. To do this I believe both approaches need to be combined in a way that midwives feel they can manage.”

So I must admit I’m a little confused on what Labour Party policy is? Is it one story one week which scares people into voting Labour followed by Frank Field’s more measured tones that seems (at least by the tone of the piece) that he acknowledges that private companies can do some things in the NHS?

I must admit having read both I am confused as to what Labour policy is or whether it was just hot air and posturing in the lead up to the elections. Comments from any political party members about their party’s policy on privatisation of the NHS welcome!

Myself and Leonora were two of the Lib Dems at the conference in Sheffield that voted (in the majority) against privatising the NHS, since then the Tory minister has had to have a rethink. Certainly Tory, privatisation and NHS aren’t vote winners. The policy motion finally agreed upon (which is now Lib Dem party policy) after two amendments and lines 9-15 being deleted is below:-

Conference believes that the NHS is an integral part of a liberal society, reflecting the social solidarity of shared access to collective healthcare, and a shared responsibility to use resources effectively to deliver better health.

Conference welcomes our Coalition Government’s commitment to the founding principles of the NHS: available to all, free at the point of use, and based on need, not the ability to pay.

Conference welcomes much of the vision for the NHS set out in the Government’s White Paper, Equity and Excellence: Liberating the NHS which commits the Government to an NHS that:

i) Is genuinely centred on patients and carers.

ii) Achieves quality and outcomes that are among the best in the world.

iii) Refuses to tolerate unsafe and substandard care.

iv) Puts clinicians in the driving seat and sets hospitals and providers free to innovate, with stronger incentives to adopt best practice.

v) Is more transparent, with clearer accountabilities for quality and results.

vi) Is more efficient and dynamic, with a radically smaller national, regional and local bureaucracy.

vii) Gives citizens a greater say in how the NHS is run.

Conference particularly welcomes the proposals to introduce real democratic legitimacy and local accountability into the NHS for the first time in almost forty years by:

a) Extending the powers of local authorities to enable effective scrutiny of any provider of any taxpayer funded health services.

b) Giving local authorities the role of leading on improving the strategic coordination of commissioning across the NHS, social care, and related childrens’ and public health services through councillor led Health and Wellbeing Boards.

c) Creating Health Watch to act as a local consumer champion for patients and to ensure that local patients are heard on a national level.

d) Returning public health duty to local government by ensuring that the majority of public health services will now be commissioned by Local Authorities from their ring-fenced public health budget.

Conference recognises however that all of the above policies and aspirations can be achieved without adopting the damaging and unjustified market-based approach that is proposed.

Conference regrets that some of the proposed reforms have never been Liberal Democrat policy, did not feature in our manifesto or in the agreed Coalition Programme, which instead called for an end to large-scale top-down reorganisations.

Conference therefore calls on Liberal Democrats in Parliament to amend the Health Bill to provide for:

I) More democratically accountable commissioning.

II) A much greater degree of co-terminously between local authorities and commissioning areas.

III) No decision about the spending of NHS funds to be made in private and without proper consultation, as can take place by the proposed GP consortia.

IV) The complete ruling out of any competition based on price to prevent loss-leading corporate providers under-cutting NHS tariffs, and to ensure that healthcare providers ‘compete’ on quality of care.

V) New private providers to be allowed only where there is no risk of ‘cherry picking’ which would destabilise or undermine the existing NHS service relied upon for emergencies and complex cases, and where the needs of equity, research and training are met.

VI) NHS commissioning being retained as a public function in full compliance with the Human Rights Act and Freedom of Information laws, using the skills and experience of existing NHS staff rather than the sub-contracting of commissioning to private companies.

VII) The continued separation of the commissioning and provision of services to prevent conflicts of interests.

VIII) An NHS, responsive to patients’ needs, based on co-operation rather than competition, and which promotes quality and equity not the market.

Conferences calls:

  1. On the Government to uphold the NHS Constitution and publish an audit of how well organisations are living by its letter and spirit.
  2. On Liberal Democrats in local government to establish local Health and Wellbeing Boards and make progress developing the new collaborative ways of working necessary to provide joined up services that are personalised and local.

  3. The government to seize fully the opportunity to reverse the scandalous lack of accountability of publicly-funded local health services which has grown up under decades of Conservative and Labour governments, by:

a) Ensuring full scrutiny, including the power to require attendance, by elected local authorities of all organisations in the local health economy funded by public money, including Foundation Trusts and any external support for commissioning consortia; ensuring that all such organisations are subject to Freedom of Information requirements.

b) Ensuring Health and Wellbeing Boards (HWBs) are a strong voice for accountable local people in setting the strategic direction for and co-ordinating provision of health and social care services locally by containing substantial representation from elected local councillors; and by requiring GP Commissioning Boards to construct their Annual Plans in conjunction with the HWBs; to monitor their implementation at meetings with the HWBs not less than once each quarter; and to review the implementation of the Annual Plan with the HWBs at the end of the year prior to the construction of the Annual Plan for the forthcoming year.

c) Ensuring commissioning of health services has some degree of accountability by requiring about half of the members of the board of commissioning consortia, alongside GPs, to be local councillors appointed as non-executive directors.

d) Offering additional freedoms only to Foundation Trusts that successfully engage substantial proportions of their local populations as active members.


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