A public NHS for all? Labour delegates vs the old guard

The NHS holds a special place in the consciousness and hearts of Labour members but, of all the sections of the 2017 Labour manifesto, the section on the NHS was the weakest.

NHS article2016 Shadow health secretary Diane Abbott meets Peter Roderick, NHS Bill co-author.

The manifesto’s only concession to the passionate commitment of Labour members to a publicly owned and run health service was to make the NHS the ‘preferred provider’ for health care contracts in England. The manifesto completely ignored the commitment at party conference in 2016 made by Diane Abbott, then shadow Health Secretary, to the NHS Reinstatement Bill* which is also supported by Jeremy Corbyn and John McDonnell:

The NHS Bill is a detailed but flexible plan for the complete renationalisation of the NHS in England, restoring it to its founding principles as a comprehensive and universal health service. This powerful bill is necessary.

The 2012 Health and Social Care Act effectively abolished the NHS in England: it is now just a logo and a funding stream. The 2012 Act accelerated an Americanisation process that had been decades in the making.

The NHS Bill will bring all services back into public ownership and control, eliminate the internal and external market, and establish the legal framework that will protect the NHS from privatisation in the future.

Abbott had begun working through the bill line by line with its authors, Professor of Public Health Research and Policy at Newcastle University Allyson Pollock and barrister Peter Roderick, to formulate policy that is faithful to the bill.

That process ended with Abbott’s appointment as shadow Home Secretary and was not continued by new shadow Health Secretary Jonathan Ashworth. Since Ashworth’s appointment, there has been no mention of the NHS Bill from the shadow health team.

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This was the situation when 40 contemporary motions on the NHS were submitted to the 2017 conference. 25 of them were based on the motion submitted by the Socialist Health Association, authored by its new chair Alex Scott- Samuel, and explicitly called on the Labour Party to formulate its health policy as per the NHS Bill. Indeed these 25 motions all contained precisely the same paragraph making this call.

The 40 NHS motions went to the compositing process. The first stage was the production by Ashworth and his team of a draft composite that contained no mention of the NHS Bill. The paragraph common to the majority of the CLP motions was simply missing, though democracy demanded its inclusion.

The second stage was an exhausting three-hour compositing meeting at which the shadow health team’s representative, Lord Philip Hunt, doggedly attempted to keep mention of the NHS Bill out of the motion. One delegate pointed out, more than once, that Lord Hunt’s role was to help the delegates put their motions together, not to suggest or push for any position of his own. However, Lord Hunt continued to argue for the omission of any commitment to the NHS Bill — it was “tying their hands”, the NHS “doesn’t need another top down reorganisation” — until the chair finally acceded to delegates’ unyielding demands for a vote on the paragraph. This was carried easily.

Another common feature of the majority of the contemporary motions was an explicit rejection of the Five Year Forward View (FYFV) a massive top-down reorganisation which reflects healthcare multinationals’ global aims. This rejection of the FYFV was missing from the draft composite, again Lord Hunt tried to keep it out, and again the delegates prevailed and it was reinstated. The composite NHS motion passed unanimously at conference.

Running parallel to this, a section of the Health and Social Care National Policy Forum report was referred back by conference because, as powerfully argued by delegate Charlotte Paterson of Bristol West CLP, it did not commit Labour to full renationalisation of the NHS but merely contained that inadequate manifesto pledge on preferred providers:

It was in this context that, at the Health and Social Care Policy meeting at conference the next morning, a delegate asked Ashworth when he would meet with Pollock and Roderick to work on the NHS Bill. Ashworth ignored the question, was reminded of it, twice, and eventually made the weak statement, “I am happy to talk to academics.” Pollock and Roderick are not just random academics but the authors of draft legislation that is the basis of Labour policy, if Diane Abbott’s commitment and the sovereign will of conference are to be honoured.

All Labour members need to be aware of the situation. If party members want the NHS to survive its 70th birthday next year, they must apply immediate and strong pressure to Ashworth and the shadow health team to start working with Pollock and Roderick to formulate the powerful legislation needed.

And because the destruction of the NHS is happening now, Ashworth and the shadow health team must immediately start implementing the other aspects of the NHS composite motion, including working with Labour councils to give them the help they need to work together in blocking the Sustainability and Transformation Plans.

Ashworth should either honour the will of conference or step aside for someone who will.

* The name varies with versions introduced in different sessions — the last version tabled was called the ‘NHS Bill 2016/17’ (the name includes the dates).

A version of this article originally appeared in the November 2017 issue of Labour Briefing, which you can subscribe to here.

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