Socialism and Health The journal of the Socialist Health Association
Autumn 2004
2/2004
SLOGAN OF CHOICE “Choice” for patients is the new buzzword, the slogan around which the Labour and Conservative parties will joust on the health battlefield in the forthcoming General Election. Strategists for both parties claim that “choice” in health care is what the public wants.
groups – “pro-active” choice that better off from the taxes that everyone invests time and effort in explaining pays for the NHS. options and helping people to make decisions. Patient choice is intended It is, however, also difficult to accept also as the stimulus that will ensure Labour’s argument that choice is that providers put a proper emphasis intrinsic to equity. On the contrary, on the needs and preferences of users. more patient choice may mean less At the same time it will reduce the equity. likelihood that better off people will opt out of the NHS and then question Some people are more able to take why they should be taxed to pay for advantage of choice than others. The the NHS. middle classes, for example, may turn
Labour’s intention is to introduce “choice” within a programme of expanding NHS capacity that provides a greater range of health to the independent sector if a waiting care options for patients. Labour The Tories plan to give every patient list is too long. They are not limited argues that this will be the first time the right to treatment at any NHS by the resource limitations of the in the context of health care that hospital in the country. This choice NHS. The choice now being promoted everyone will have the ability to will be “unrestricted and immediate”.by our government is a well-meaning choose. A start is already being made Alternatively, every patient will have attempt to build more equity into this for those who have been on a waiting the right to treatment at any system so that poorer people are also list for more than 6 months - they now independent hospital that can treatnot limited by NHS resource have “choice”. patients at the standard NHS tariff. constraints. So to an extent choice = increased capacity. The intention is that universal choice But then comes the fundamental will give poorer people some of the inequity. Any patient who chooses an This is achieved in a number of ways, same options presently available only independent or private hospital that including care in the private sector to the middle classes. It will redress charges more than the standard NHS that is paid for by the NHS, importing the current imbalance whereby only tariff will be given half that NHS tariff teams of foreign practitioners to the wealthy can choose to avoid to spend on their treatment – thus undertake specific procedures – such under-performing providers. To do reducing the amount they, or their as cataract operations, sending this, special effort will go in to insurers, pay. This is of course just patients abroad to be treated and designing choice mechanisms so that queue jumping in a new guise, a bringing new facilities into the NHS. they can be used by socially excluded subsidy for private care payable to the One such example was the purchase
2 of the Royal Masonic Hospital in West London, which is now the Ravenscourt Park Hospital that carries out uncomplicated hip and knee replacements. Through these measures, the ability that hospital consultants have to control capacity – by limiting the amount of work they do within the NHS - can be undermined. But it is also the extent to which people are able to exercise choice that will largely decide who gets what – and this will depend on knowing what the choice is and then being able to make the right choice. This is where knowledge and information come in, so in fact choice = increased capacity + knowledge and information. And this is where inequality can re-enter the system, with some people being better able to take advantage of choice than others. For example, I can opt to go to a hospital anywhere in England for my operation; my neighbour Mrs. Said will opt for a hospital that can provide an Arabic interpreter and culturally appropriate care, so her choice is already more limited than mine.
A VIEW FROM THE CHAIR
In my last piece I suggested that there was a strong case for the legalisation of the supply and use of drugs as a means of improving public health and reducing crime; and I asked for comments from members in order to gauge the level of support for what on the face of it looks like a pretty radical policy. I proposed further that if there was a reasonable level of support for it, we might consider organising a conference, possibly in conjunction with the UKPHA and other interested organisations, with a view to quality-assuring our case for the policy and setting up the necessary machinery for organising a viable campaign that would stand a chance of influencing government thinking.
but I see no evidence of any effective action. Experience of trying to promote partnership working at national and local level calls to mind the situation in the voluntary sector where the sheer number of separate organisations militates against their ability to lobby effectively; and where suggestions that they should merge or establish some form of empowered umbrella organisation are greeted with stony antipathy or worse. It seems to me that working closely with other socialist societies to promote socialist principles is self evidently a good thing. But more than this, now that we understand that a whole range of disparate factors apart from healthcare have an impact on health and well-being, surely we need to work with those socialist societies with an interest in education, housing, the environment and crime, to name but a few, in order to further our avowed mission of promoting health and well-being through socialism? On issues of healthcare and the NHS we in the SHA have, more or less, a monopoly of interest and expertise and we must use this to good effect. But on the broader canvas of health and well-being we clearly don’t and we can only hope to be effective by working with other socialist societies.
The government hopes that carefully structured choice mechanisms will give providers the incentive to Disappointingly, the response was expand their services and make them notable only by its paucity. more responsive to patients. But the consequence will still be that the Nevertheless, I have interpreted better-educated, more empowered BUT how can we do this in a way that people will get more benefits from the silence as at least a lack of violent is not seen as threatening or opposition; and on the strength of this system. presumptuous by the other societies; we are currently in discussion with and which does not distract us too UKPHA about a jointly sponsored The services they choose will attract much from our other business? And event to explore the proposal in resources and flourish; and the how do we promote this through the detail. This won’t happen before next services that patients like Mrs. Said, Socialist Societies Executive? year; so watch this space. whose options are more limited, choose may ultimately be forced to Paul Walker Changing tack completely, I have for close because they are not chosen SHA Chair often enough. Mrs. Said would then some time worried about the seeming lack of interaction and partnership have no alternative but to use a working between the various Socialist service that she would not have chosen and which will give her poorerSocieties, the result of which is that we socialists have little influence on care. Choice could thus ultimately Party or government and the drift harm those who are worst off. towards the right continues Judith Blakeman unchecked. I am of course aware that Please let us know by writing to: there is a Socialist Societies Executive, The Editor which is meant to have relevant role,
WHAT DO YOU THINK?
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3 Socialism & Health 50 Wesley Square London W11 1TS or by e-mail to: jm@jblakeman.fsnet.co.uk
detain thousands of people and compel them to take treatments that do not benefit them.”
where they are treated and much better information to support that choice. For people with chronic conditions, it will mean closer Minister of State Rosie Winterton MP personal attention and support in claims that the Bill puts a new focus the community and at home. on the needs of the individual patient, There will also be a much stronger providing clear procedures, new support for patients and strengthened emphasis on prevention.
safeguards. Patients will be able to This is underpinned by new targets choose their own representative to help them and clarify their views to for hospital services: by 2008 the maximum wait from referral to the clinical team. For the first time completed operation will be no more both patients and their than 18 weeks, with an average of 9 or representatives will have statutory 10 weeks; and the private sector may The government has just published its access to specialist independent eagerly-awaited revised Mental Health advocacy to ensure that their voice is provide up to 15% of operations and a growing number of diagnostic Bill. Campaigners were hoping that, heard and their views taken into procedures to NHS patients. following the outcry against the account. The use of compulsory government’s original proposals, it powers beyond 28 days must be would have addressed those independently authorised by a new People will be given greater choice criticisms. Sadly this is not the case. Tribunal or the courts, following about the time and place of their care. This is underpinned by new targets: independent advice from a new The Mental Health Alliance has Expert Panel. The Tribunal’s power by the end of 2005 patients should be voiced the concerns about the new will be limited by regulations only “to able to choose between 4 and 5 hospitals chosen by their Primary Bill. Chair of the Alliance, Paul the small number of patients who Farmer, said “we are deeply pose a significant risk of causing harm Care Trust; and by 2008 every patient disappointed that the government has to others. We think these powers are who needs a specialist outpatient still not listened to professionals, necessary to aid decision making in consultation will have the choice of carers or people using services. these difficult cases, rather than the any NHS or private provider, or any Despite receiving 2,000 responses responsibility falling on an individual one of the new – possibly public/private - treatment centres. opposing its original plans, the clinical supervisor”. government has pressed ahead with many of its most disturbing proposals In this regard, Alliance campaigners All treatments, whether NHS or … we have a Bill that is rooted in an believe that the proposals are private, will be paid the same - a out-dated, false stereotype that people incompatible with the government’s "money following patient" system of with mental health problems are a fixed national tariffs. new choice agenda. The proposals danger to society and are unable to lead many people to believe that it is make their own decisions about care the Home Office and the criminal Will this increase choice? and treatment.” justice system that is behind the Bill rather than the Department of Health. The theory is that where money The feeling is that the new Bill follows the patient, providers of acute stigmatises and marginalises people care will improve the quality of their with mental health problems. It risks service, reduce waiting times, use introducing fear and coercion into resources more efficiently, give what should be a purely therapeutic patients more say in their own relationship and risks driving away treatment and provide more those who most need care and personalised and responsive services. treatment. The additional workforce The NHS Improvement Plan is the But for many patients a choice of requirements to implement the Bill’s Department of Health’s vision for the hospital may not be practical, proposals are also most unlikely to be next phase of The NHS Plan and the particularly people with chronic NHS priorities to 2008. These will met. conditions, those who need ensure that “a drive for responsive, emergency care and those who cannot convenient and personalised services Angela Greatley of the Sainsbury very travel far. takes root across the whole of the Centre for Mental Health said: “the NHS … for all patients”. For hospital government has once again proposed How will it work in practice? a law that will place psychiatrists and services, this means a lot more choice for patients about how, when and social workers under pressure to
Here we go again!
Those “Choice” Proposals in Detail
Promoting health and well-being through socialism
4 Choice of outpatient department may range of needs, even those of very not incorporate choice of inpatient dependent people and will provide a The aim is to help people manage care. Will patients get a second chance these conditions in a way that suits realistic and attractive option. to choose the hospital once they know them, avoiding complications, they have to be admitted? maximising their health and helping Social care providers will be them to live longer lives. Specialist encouraged to integrate with Choice must include patient nurses and GPs with specific expertise providers like integrated mental empowerment and a more will provide improved care closer to health provider trusts to exploit the collaborative approach between home and reduce the need for potential of integrated care; and PCTs patient and professional so that emergency hospital admissions. The will be encouraged to use their meaningful decisions can be made. Expert Patient Programme that enables leverage to achieve more effective This has practical implications: patients to manage their own integration of care between primary patients will need information to help healthcare will be rolled out and secondary care and between them judge quality; they will have to nationally, backed up by cash health and social care. be able to understand the choices incentives to GPs who support the available; they may need effective programme. Choice in primary care advocacy and other support to help them choose. Some patients may not Social care In primary care the NHS will develop want choice - others may suffer undue new ways of meeting patients’ needs pressure, stress and anxiety as a result The NHS Improvement Plan sets out closer to home and work. New of the requirement to choose. flexibilities will enable PCTs to some essential principles to ensure
that health and social care services commission care from a wider range The NHS Improvement Plan stresses work together to meet the needs of of providers, including independent that where patients choose to go will people with long-term conditions, sector organisations, to enhance the be important since this will affect enable people to live more range and quality of services. where the resources go and which independently and provide them with providers prosper. This could lead to the support that they need. Social Greater flexibility in the way services the development of fewer centres of services, like health services, will need are provided will be matched by excellence, spread thinly across the to become more person-centred increases in NHS staff and new ways country and hence less accessible. tailoring services to a client’s assessed of working to meet patients’ needs. In Unpopular units may have to close, needs and also involving them and primary care GPs will increasingly the number of generalist units may their families in the design and work with more diverse teams, reduce and more specialist units may delivery of services. including GPs with a special interests be created. Alternatively, the power of and community matrons, to meet patient choice may be muted – poorly Social care commissioning and patients’ needs in new ways in the performing hospitals may not be provision will be further integrated community rather than in hospital. allowed to close, popular hospitals with healthcare to deliver a better The target set for 2010 is that the may need to ration their services and experience for the individual. Patients majority of care of older people with patients may be forced to go to will not have to communicate long-term conditions will be provided hospitals that they did not choose. between different services. That will in primary care in the community and And suppose too many patients opt be the job of local health and local will cut emergency hospital inpatient for home care? This could cause authority services. More emphasis days by 10%. intense pressure on costs and the will be put on preventive services to availability of health care keep people out of hospital. Otherwise, there will be far fewer professionals, leading to reduced national NHS targets. Local services capacity elsewhere. The move towards improved choice will set their own stretch targets to could have major implications for reflect the local circumstances, The government is not promoting a both social services and housing over ethnicity and health inequalities in free-for-all free market to drive the coming years. The provision of their own communities to meet the change. It will continue to rely on care in people’s own homes is priorities of the people whom they other ways to improve performance - growing rapidly, particularly very serve. such as central standards and targets, intensive home care services. The continued investment in money and government is also promoting newer Information systems staff, more regulation, and a different forms of care, such as extra care mix of incentives. housing that provides specially All this will be under-pinned by designed housing with an in situ care information technology designed and Helping people with long term team. This model can cater for a wide delivered around the needs of
and chronic conditions
Promoting health and well-being through socialism
5 patients and service users. By 2005 electronic booking will enable patients to arrange appointments to suit themselves, and electronic prescribing will make it easier to obtain repeat prescriptions. An individual personal care record will give health professionals easy access to their patients’ medical histories at any time of the day. The new technology will also give patients more influence over how they are treated and a new personal facility called HealthSpace will enable them to record their care preferences.
favour of banning smoking in fronts to ensure that school all workplaces; meals provide a healthy and nutritious diet and it shows that 89% supported a ban in where imaginative policies have been offices; and 79% supported a ban in introduced, the quality and take up of school meals has improved. public areas.
CPAG's Chief Executive Kate Green said: "school meals play an important role in promoting healthy eating and tackling disadvantage. Recipe for A report published in the British change is the first time that good Medical Journal by Prof. Konrad practice has been brought together to Jamrozik of Imperial College sets out show that unless real changes in strategies to prevent smoking aimed policy are introduced by the at the population rather than the government, school meals will individual. It considered the effect of continue to fail children." Performance assessment banning smoking in public places and in the workplace, the impact of these Hull City Council, which has The Department will devolve the measures on persuading individual introduced free school meals for all annual star ratings assessments to the smokers to give up and the effects of primary school children, has independent inspectorates and ensure increased tobacco price. The research contributed to the report, as has a that star-ratings reflect its aims for shows that smoke free policies would school in Sunderland that is both health and social care. have no adverse economic impact. overcoming the stigma associated Prof Jamrozik’s research also shows with school meals. A piece on that passive smoking causes 49 deaths regeneration programmes in East Championing public a year among those employed in the London reports the involvement of a hospitality industry, that an estimated whole local community in making a health … surveys and real and lasting difference. research endorse SHA 700 people a year are killed by environmental smoke in the policies workplace and 4,000 by passive The editors’ recommendation that smoking at home. food and nutrition should be a part of the national curriculum concurs with The government will be spelling out measures to tackle obesity, sexually Other research, reported in the BMJ the SHA’s Choosing Health? response. transmitted infections and smoking in by Pechacek and Babb, examined the The report says that all schools should risk of coronary heart disease from have a 'food policy' and a school the public health White Paper to be second hand smoke. A study in meals plan, with minimum published before the end of the year. Montana in the USA showed that a requirements for the take up of school The SHA sent a detailed response to six-month smoking ban in public meals. It also argues that the the Choosing Health? consultation that government should make grants will underpin this White Paper. In the places resulted in a 40% decline in available for schools to enable them to meantime, a number of reports and hospital admissions for acute myocardial infarction; and that even a introduce new systems to improve the surveys have validated and take up of meals. And it argues for strengthened many of the arguments small exposure to tobacco smoke rapidly increases the risk of coronary schools’ catering staff to be more that the Association put to highly valued in terms of both pay heart disease. government. and conditions.
The smoking ban
Population strategies to prevent smoking
Better health requires changes … and a strange synergy in school meals
An Evening Standard poll of 1,517 Londoners carried out on 7-8 June by The Child Poverty Action Group has YouGov shows that: just published Recipe for change - a good practice guide to school meals, there are around 13 million edited by Carrieanne Hurley and Ashley Riley, the first study of its adult smokers in London; kind to draw together practical 85% of smokers and nonexamples from across the country. smokers surveyed were in The report argues that government should intervene on a number of
A key proposal in the SHA’s response to Choosing Health? is that the government should appoint a Cabinet Member with cross-departmental responsibility for public health, rather than leaving the brief with a junior minister of state. It therefore came as some surprise to learn that a Conservative government would
Promoting health and well-being through socialism
6 establish a public health commission and take public health from ministerial to secretary of state level! This proposal was announced by the Tories’ public health spokesman at the recent conference of the Chartered Institute of Environmental Health.
SHA seminar sets 10point action plan on obesity On 11 September the SHA held a seminar on obesity in Liverpool. The main speakers were Andy Burnham, MP for Leigh and Robin Ireland from the Heart of Mersey. Participants included public health workers, researchers, GPs, councillors and members of Patient Forums. Participants at the event produced a 10-point plan for action on obesity:
3. Demonising or blaming people who are overweight, or are the parents of overweight children, is not helpful.
4. Supplies of healthy food at
affordable prices are not available everywhere. Some subsidy in food deserts may be necessary at least temporarily, although experience demonstrates that small independent suppliers of fresh food can flourish in areas with deprived populations if there is sufficient demand. If there is to be subsidy, then it may have to operate at EU level and will need to consider the need for sustainable local food production.
1. Obesity is an important factor
5. The new government
2. Food has a cultural and
6. Children should be permitted
in health inequalities that affects poor and deprived communities more than people who are better off. Most health problems arise from weight gain, rather than obesity per se. Although it is easy to see that people need to eat less and be more active, it is very difficult to understand why this is not happening, and more research is needed.
psychological significance quite apart from its nutritional function. The social norms that underlie eating behaviour are very deeply rooted. There are important considerations of ethnic diversity, since eating and exercise patterns vary between different cultures. These are problems of affluence. Traditional guidance on the importance of people getting enough nutrients is now largely superfluous.
emphasis on competitive sport is welcome but not sufficient, because those with the worst problems are the least likely to take advantage. A new and widespread emphasis on physical activity is needed – walking, dancing, swimming and other activities that people who are unfit can enjoy. The sedentary life must not become accepted as normal.
and encouraged to engage in active play. Great publicity is given to the tiny risk of children being abducted from public areas. Much less is given to the far greater risk of children being killed or injured by vehicles; and almost no publicity is given to the huge risk children have of developing diabetes and many other diseases as a result of long term inactivity. Parks and public areas must be safe and perceived as safe if parents are to be persuaded
to let their children loose in them.
7. Transport policy has a very significant part to play. There must be a substantial shift away from the dominant position of the car so that people can walk and cycle safely. Regular activity in the course of daily life is more likely to have a sustained beneficial effect than expensive trips to the gym.
8. Schools also have a very
significant part to play in teaching children to cook, to eat sensibly, to manage a budget and to understand the problems of obesity. School dinners should be a free and important part of the curriculum. Children must not be permitted to choose a diet of unhealthy food. School dinners could be much healthier. Teaching physical skills to the many and fostering competitive sport for the few both have an important role to play, and it is clear that teachers cannot be expected to do this important work in their spare time without payment. Primary school teachers will need support and training; and schools must be protected from the culture of litigation if they are to protect children from the dangers of obesity.
9. Obesity is a major threat to
health care services and to the economic well-being of the country. The cost of increased diabetes and other problems associated with obesity in lost economic activity, increased health care needs and incapacity benefits for those unfit for work far exceed the cost of the measures proposed to address obesity. In addition, these measures will
Promoting health and well-being through socialism
7 make a substantial contribution to reducing health inequalities and improving social cohesion.
NHS is awash with "pen-pushers" not only mislead the public but also damage the morale of hard-working staff. Foundation
Letters to the Editor
democratic
trusts are
Dave Prentis, UNISON’s General Secretary points out that no one wants play in regulating the Good on Martin Rathfelder, sending labelling and advertising of nurses and doctors to waste their the latest Socialist Health Association food and drink. Weight gain valuable time and training doing paperwork. They should be out on the info, but the BMJ article [Low turnout is clearly related to market wards looking after patients, but an in (foundation trust) elections sends a forces. There are many unscrupulous companies that organisation the size of the NHS that warning signal] is appalling. Highly do their best to confuse and treats millions of patients a year must selective, or what? also have effective managerial, clerical mislead consumers. The average voting turnout for the and administrative staff. He Labelling has to be simple foundation trusts has been in excess cautioned both Labour and the Tories and clear. The more of 50% so far. to stop trying to out-tough each other complicated the message, the harder it is for those most at over the number of support jobs they How many people get to vote for the stewards of National Health Service risk to understand what they will cut in the NHS, stressing that bodies now? Zero. And that's the way need to know. Consideration these are real jobs, done by real people, with real benefits to patients. that some self-styled socialists (let should be given to the alone the Tories and many "liberals") regulation of prepared meals, would like to keep it. Heaven forbid which could be monitored by that ordinary folk should have a say Environmental Health Men at Risk! as to who gets to stuff their wallets Officers. Bans can be (sorry, serve the public) around the unpopular and sometimes board tables of "our" far-too-many A survey conducted for Cancer counter productive, but quangos. Research UK's second Man Alive people need to be able to make healthy choices. There campaign has found that: Neither Rome nor the Rochdale is no shortage of healthy Society of Equitable Pioneers was bowel cancer is the most food. What is needed is a built in a day. This is just as well, 'cos common cancer affecting reduction in the prevalence of they'd have fallen down on account of men, followed by testicular unhealthy food. insufficiently attended work. From 28 and prostate cancer; members (Rochdale) to a multi more than half of men would million membership movement (the Stop bashing the not immediately see a doctor modern co-operative movement) bureaucrats! if they discovered a symptom takes time, and rightly so. of cancer; An ICM poll commissioned jointly by one third of men only sought By the way, the no-doubt well UNISON and the NHS Confederation advice when forced to by intended Professor Small also shows that people believe only half of their partners; rubbished the entire United Kingdom all NHS staff are directly involved in and survival rates were consumer co-operative movement in a patient care, when the real figure is 84 significantly improved by previous piece (reference 4 in the per cent. Exaggeration and political early detection. latest predictable drivel, I think). His criticism have created a reality gap in source: an academic textbook written people's minds over the number of Men are notoriously the most hard to in the 1960s. With progressive support staff employed in the health reach group so far as accessing health commentators like this we could do service. care is concerned. The SHA hopes with advocating laws to prevent the that its own members are not as Common People from having any UNISON and the Confederation have reticent as the majority about seeking opinions at all - and abolish the therefore published a new report healthcare advice at the earliest Socialist Health Association to boot Completing the Picture - that explains moment that they suspect that (heaven forfend that other than the the roles and responsibilities of something may be wrong. Great, the Good and the patronising managers and support staff. It is should be allowed to have a say as to based on real-life staff profiles and our great organs of State). shows the contribution they make to the health service and to the quality of Want a debate?! I'm up for it, and I patient care. Suggestions that the
10. Government has a part to
Promoting health and well-being through socialism
8 imagine many other co-operative socialists would be too.
up by the Association of CHCs for England and Wales under the chairmanship of Will Hutton and the Very best wishes. report of the Department of Health’s Geraint Day Transition Advisory Group, coSHA member ordinated by Christine Hogg – both set blueprints for modernised patient PS. Perhaps we should also abolish and public involvement (PPI) voting altogether and hand the entire arrangements in the NHS. Sadly, process of government over to such however, once CPPIH was set up it bodies as the NHS Appointments seems as if it consigned these two Commission and the Electoral excellent reports to the dustbin. The Commission ... a quango appointing result was a top heavy CPPIH people to other quangos. Wonderful. bureaucracy that used most of the It'll save us all from having to waste available resources and hindered time expressing opinions. rather than helped the PPIFs to flourish.
and complementary work programme that utilised all their combined skills. Now we hear that CPPIH is to be abolished – and this has brought a huge sigh of relief from many. Can we now hope that the resources allocated to the Commission will be released to fund the impoverished PPI Forums and their support staff? Can we also hope that, free from the dead hand of CPPIH, the Forums will be able to publicise their members, their accessibility and their local accountability
Good riddance to Chippie?
and get on with the work they are I know that in my own part of supposed to be doing? London the PPIFs are floundering. I have spent time observing the They have excellent support from Some issues remain about the demise of the community health their Forum Support Organisation but Forums’ relationships with the councils (CHCs) and their replacement by Patient Advice and they have no money, no premises, no growing band of foundation trusts, equipment and few links with their their relationships with the OSCs, Liaison Services (PALS), Overview and Scrutiny Committees (OSCs), the local communities. Their work was ICAS and PALS and how the patient Independent Complaints Advocacy also hampered by the strange decision view can be championed at national taken by the Commission that the (in England) level and at regional Service (ICAS) and the Patient and Public Involvement Forums (PPIFs) – names of Forum members could not level in places like London where a together with the establishment of the be made public – for spurious “data strong regional voice is desperately protection” reasons. So how we, as needed. So I hope that the SHA will Commission for Patient and Public members of the public, were be able to influence the development Involvement in Health (CPPIH). of patient and public involvement in Former CHC activists promoted the supposed to know who would be pressing our interests with our local England to ensure that the PPI Commission vigorously because they health services remained a complete Forums become – and remain – the recognised the need for an mystery. truly independent, accountable and overarching body to champion the effective voice of the patient. interests of patients (well, at least in The OSCs were similarly hampered England) to the government, the Department of Health and the public and so they set their work plans in isolation. How much better it would Mary Bartle in general. have been if the OSCs and the PPIFs London The first Hutton Report – New Life for had been able to meet up, divide out Health, the report of a commission set the work and set a comprehensive
Prof. Allyson Pollock NHS plc: the privatisation of our health care. Prof. Allyson Pollock has published a book that draws together many strands of her research and that of her colleagues in the Public Health Policy Unit at University College, London. In it she demonstrates how, in her view, the NHS is being handed over to the private sector. "This is a shocking story, brilliantly told, by one of the leading thinkers in the field of public health policy … No one who cares about the health of the nation should ignore NHS plc." Prof Raymond Tallis, author of Hippocratic Oath - Medicine and its Discontents.
Promoting health and well-being through socialism
9
FORTHCOMING SHA EVENTS OBESITY Cambridge, Saturday 6th November 2004, 10.30 a.m. to 3.30 p.m. Venue: Alex Wood Hall, Norfolk Street, Cambridge. Jointly with the Co-operative Party and the Cambridge Cycling Campaign Dr. Tony Jewell, Director of Public Health Norfolk, Suffolk and Cambridgeshire Anne Campbell, MP for Cambridge Healthy lunch provided. £20 with reduction to £10 for SHA members/Co-op party members/Students. Free for people on means tested benefits. The intention of this meeting is to produce some policy proposals for national government, to be taken through the Labour Party policy process, or for local government and others to take forward.
PUBLIC INVOLVEMENT AFTER CPPIH London, Friday 3rd December 2004, 10.00 a.m. – 4.00 p.m. Venue: The Resource Centre, 356 Holloway Road, London N7 6PA Malcolm Alexander, formerly of ACHCEW Fiona Campbell, Democratic Health Network Lunch provided. £90 for statutory and commercial organisations £45 for voluntary organisations, CHCs and PPIFs £22.50 for individuals. Some free places for people on means tested benefits
SHA BRANCH CONTACTS Greater London: Greater Manchester: North East: Scotland: Wales: West of England: West Midlands: 0
Huw Davies Martin Rathfelder Rita Stringfellow Ali Syed Anthea Symonds Paul Walker John Charlton
020-8748-7284 0161-286-1926 0191-200-6672 0141-942-8804 01792-295313 0117-968-2205 0121-475-770
Promoting health and well-being through socialism
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CONTACT THE SHA Do you have a point of view? The pages of Socialism & Health are open to everyone. All letters and articles will be considered for publication. And the SHA welcomes any other expertise or help you can offer to ensure that the SHA remains a dynamic and respected campaigning pressure group in the 21 st Century.
Promoting health and well-being through socialism
Socialist Health Association 22 Blair Road Manchester M16 8NS Tel: 0870-013-0065 E-mail: admin@sochealth.co.uk Website: www:sochealth.co.uk Editor: Judith Blakeman The views expressed in this journal are not necessarily those of the SHA