Scottish Labour Party Policy Review

2^nd Phase Consultation Document

June 2006

Health

Introduction

The Socialist Health Association Scotland welcomes the opportunity to respond to the Scottish Labour Party’s 2^nd phase consultation paper on Health. The SHA was founded in 1930 to campaign for a National Health Service. We are a socialist organisation that is affiliated to and actively supports the Scottish Labour Party.  

In our 1st phase submission we set out in some detail our views on how Scottish Labour’s health policy should be developed for the 2007 elections. In this submission we have therefore set out a summary of the key points that we would wish to see in the final report to conference.

 Tackling Inequalities

SHA Scotland believes that health should be tackled from a public health rather than a medical perspective so we welcome the emphasis the paper gives to tackling inequalities.  In particular we would support: 

§         An explicit recognition of the importance of addressing the vast economic divide as a key cause of ill health. This must be wider than just NHS resources and includes action in partnership with Westminster on reserved issues. 

§         Resource allocation in NHS and other devolved areas should be focussed on areas of deprivation. 

§         A Minister for Public Health to take action across a whole range of Scottish government departments.  

Health Improvement 

We are concerned that this section is too lifestyle focussed and there is some evidence that NHS health promotion activity is being directed on this aspect of health improvement at the expense of social inclusion. We would support a new focus on re-engaging with communities rather than being perceived as lecturing them. Specific health improvement measures should include:

• Fluoridation of the water supply
• In schools; free healthy meals, physical education, a full arts curriculum, ban on fizzy drinks and food advertising, healthy living including sex education as part of the curriculum.
• Promotion of healthy lifestyles and the means to achieve them
• Food labelling, salt, fat and sugar reduction and end agricultural subsidies for tobacco and sugar
• Build on the success of the smoking ban by tackling the next major cause of ill health – alcohol abuse.
• Open debate on drug policy including de-criminalisation

 Patient involvement and flexible care

 Introducing democracy and meaningful patient involvement is central to the Scottish NHS model. Reforms should include: 

§         Direct elections to health boards and later CHPs

 §         Develop Public Service Networks rather than constant reorganisation

 §         Deepen involvement of users through deliberative methods

 §         Recognising that bigger hospitals are not better. Learn from the ‘Keeping the NHS Local’ strategy to maintain local facilities wherever possible.

 §         Services should be responsive to user need. Reject the ‘choice’ agenda and develop genuine partnership with patients

 §         Scotland’s hospitals should be cleaner with better resourced in-house cleaners 

§         Grow capacity with service redesign to tackle waiting times 

§         Reject the use of private health care 

§         Improve hospital catering through the UNISON Food for Good Charter 

§         Abolish prescription charges and tackle the drug companies rising costs

§         Raise the status, pay and conditions of nurses. Cut agency nursing costs, pay students a proper wage and end discrimination against overseas nurses. 

§         Retain more of the doctors trained in Scotland. More salaried GPs and introduce specialist-generalist grades. 

§         Recognise the role of the rest of the health team 

§         Reject private finance including LIFT schemes and promote a level playing field with conventional borrowing. 

Keeping health care local 

Strengthen the emphasis on community care recognising that 90% of health and social care is delivered in the community. 

·         Greater use of salaried GPs and extended roles for other staff

·         Establish a comprehensive salaried community dental service, increase graduate numbers and require dentists to remain in the NHS after training 

·         Support Joint Future and strengthen the social work profession 

·         Flexible public sector care is preferable to Direct Payments

·         Greater funding for mental health and well being programmes

 

June 2006