Return the NHS to its founding Principles

20151107_160347This day was a result of getting people who were passionate about the NHS from both ours and Keighley’s group to look at where we wanted to go. It took several meetings to decide that we needed to network as widely as possible and that we should focus on supporting the NHS Reinstatement Bill. We decided it should take the form of a talk and a workshop and Peter Roderick the barrister who drew up the Bill with Alison Pollock was invited to speak and Simon offered to do the workshop.

Article by Alison Pollock – The end of the NHS as we know it.

More info on the NHS via tab and in recent post.

20151107_145228

Peter Roderick explaining the Bill
See a summary in the Report at the end of this post (5. Address by Peter Roderick)

Add to circles

It was a full but very successful day for which we have had many thanks. It is we hope a beginning to strong liaisons with others and some purposeful action.

A great big thank you goes to Simon who prepared and provided all the materials, including a very detailed workshop and to his son Mat who provided these pictures and a comprehensive report.

 

The Report 

Return the NHS to its Founding Principles – a Planning Workshop to Support the NHS Reinstatement Bill

Report on Workshop 7th November 2015 Skipton & Keighley 38 Degrees Save Our NHS

Return the NHS to its Founding Principles

Report on the Workshop held in Saltaire, West Yorkshire 7th Nov ‘15

1. Workshop Background

The Keighley and Skipton ‘Save our NHS’ working groups, under the umbrella of 38 Degrees, discussed in early August how best to better engage the public in the campaign. The meetings agreed that the privatisation policies adopted by this and previous governments will lead to a fragmentation of services, a continued loss of the public service ethos necessary for an effective public health service, and greater costs to the public purse.

Further meetings agreed that a workshop should be held to build on the earlier experiences of the Save Our NHS campaigns in the area, and would look at how to enhance the impact of campaign activities.

The Workshop title would be …’Return the NHS to its Founding Principles’.

It would prioritise and design ‘how-to’ activities and invite people active in the campaign from all over Yorkshire to share experiences on what works in the campaign.

A further meeting in October agreed to support the Campaign for an NHS Reinstatement Bill and repeal the 2012 Health and Social Services Act that promotes and embodies the present privatisations. This will provide a clear focus for the Save Our NHS Campaign and a framework within which more local and immediate issues can be addressed.

Peter Roderick, who prepared the 2015 draft Reinstatement Bill, addressed the workshop.

This Workshop Report is based on the working material of the participants with edits only for clarity. The Workshop Programme & procedures are given in Annex A.

2. Workshop Design

The Workshop was designed with the following Focus Questions and steps:

Q1: Where are we now ?… what do we understand to be the guiding principles of the NHS?

Q2: What do we want to see?…what are the key values we want to see in the NHS Reinstatement Bill?

Q3: What do we do?…what are our Campaign options and preferences?

The Workshop Method ‘From Individual Creativity to Group Action’ provided the steps1.

1 Stanfield RB (2002) The Workshop Book. New Society Publishers. Return the NHS to its Founding Principles – a Planning Workshop to Support the NHS Reinstatement Bill

Report on Workshop 7th November 2015 Skipton & Keighley 38 Degrees Save Our NHS

3. Q1: Where Are We Now?

The Question addressed in this part of the Workshop was: what do we understand to be the guiding principles of the NHS?

‘Principles’…are the fundamental beliefs and values that provide a foundation for the law governing the NHS. The Bevan Commission (2008-11) was set up in 2008 to advise the then Minister for Health and Social Services on how the NHS is to remain loyal to the principles established by Nye Bevan in 19482.

2 http://www.1000livesplus.wales.nhs.uk/opendoc/179597

http://www.gov.wales/docs/dhss/publications/110606bevan1en.pdf

It considered whether these principles are still valid 60 years on or if they need to be updated, and what is required to establish world class health care. The Commission was concerned about how to:

o Support the developing health reforms

o Ensure primary health care is fully integrated into new ways of working

o Promote collaboration between healthcare and social care

o Meet the risks associated with decreases in public expenditure

It assumed that the future NHS will be about keeping people as fit and healthy as possible, successfully tackling inequities, alleviating suffering, – and bringing comfort, dignity and hope to people when they are at their most vulnerable. That is, more than just hospital care.

It also started from an understanding that societal inequalities are reflected in health inequalities.

The Commission was set up to look at the NHS in Wales (which has abandoned the internal market set up by the purchaser/provider split embodied in the 2012 Health and Social Care Act), but the findings and conclusions are equally applicable to the Campaign in England.

The Bevan Commission recommended that there are 11 Principles that should shape the future NHS and these are summarised in Annex B. The first three are those of Bevan in 1948, and the remainder are those of the Commission in 2011.

For this part of the workshop the groups reviewed each of these principles and assessed to what extent they are understood by: a) MPs, and b) the public. The results of this review are summarised in Annex C which suggests that MPs are assessed to have a clear understanding of the 1948 Bevan Principles but low understanding of the 2011 Commission’s principles.

The general public was assessed to have a generally low understanding of what the NHS is about and its values.

During the discussion several participants were very clear that MPs do understand very well what is required for the NHS in the 21st century but never disclose this in public. This applies to MPs from all the main parties. Return the NHS to its Founding Principles – a Planning Workshop to Support the NHS Reinstatement Bill

Report on Workshop 7th November 2015 Skipton & Keighley 38 Degrees Save Our NHS

Other participants considered that many MPs have financial interests in the privatisation of the NHS and will resist any efforts to enact the NHS Reinstatement Bill.

4. Q2: What do We Want to See?

The Question addressed in this part of the Workshop was: what are the key values we want to see in the NHS Reinstatement Bill?

The groups in the workshop considered again the Bevan Commission’s 2011 Principles and prioritised nine concerns for the future of the NHS. Using the Consensus Workshop Method these concerns were clustered into like areas by the participants and given a label. The outcomes of this are given in Annex D which indicates that ‘Stop the Privatisation of the NHS’ was the highest priority concern, followed by the importance maintaining universal access to both health and social care.

The photo below presents the key values identified by participants grouped under 8 thematic headings (highlighted with red boxes).

Political awareness of the role of health care in addressing social inequalities was also considered a priority. This includes initiatives focussed around educating the general public (and school children in particular) as to the history and role of the NHS, the importance of self-care and an individual’s responsibility to look pro-actively after their own health.

The purpose of this part of the workshop was to encourage participants to dig deep into both their rational and intuitive understanding of the NHS and what they want to see in the future. Return the NHS to its Founding Principles – a Planning Workshop to Support the NHS Reinstatement Bill

Report on Workshop 7th November 2015 Skipton & Keighley 38 Degrees Save Our NHS

These understandings, together with the explanation on the purposes of the draft NHS Reinstatement Bill, provided the make-up of the practical Campaign options that participants elaborated in answering Q3.

5. Address by Peter Roderick

Peter Roderick then summarised the main changes brought in by the Health and Social Care Act 2012 and the implications for the NHS. In particular the 2012 Act:

o abolished the Secretary of State’s duty to provide key NHS services throughout England, and replaced it with a duty on individual clinical commissioning groups (CCGs) to contract for the provision of services for persons for whom they were responsible;

o made all trusts 51% NHS and 49% non-NHS, by prospectively abolishing NHS Trusts with the intention of them becoming NHS Foundation Trusts and then stipulating that Foundation Trusts would not fulfil their principal purpose unless most of their income was from the NHS. He explained how the list of services that FTs must currently provide would be amended after April 2016, and that Monitor has said this list is expected to be reduced;

o made the tendering of services virtually compulsory; and

o took public health out of the NHS, splitting it between the Secretary of State (Public Health England) and local authorities.

He also explained how the 2012 changes were the latest in a series of changes that began with the introduction of the internal market in 1990 (NHS Trusts and the purchaser/provider split) and the creation of more commercially-oriented Foundation Trusts in 2003. Return the NHS to its Founding Principles – a Planning Workshop to Support the NHS Reinstatement Bill

Report on Workshop 7th November 2015 Skipton & Keighley 38 Degrees Save Our NHS

He outlined some of the main proposals of the NHS Reinstatement Bill to reverse 25 years of marketisation, which has support from Green, Labour, Lib Dem, SNP and Plaid Cymru MPs – including Jeremy Corbyn and John McDonnell.

The NHS Reinstatement Bill would:

o re-establish the legal duty of central government to provide services throughout England,

o create Health Boards from the bottom-up,

o end the purchaser-provider split,

o abolish NHS Trusts, Foundation Trusts, Monitor and CCGs,

o end competitive tendering and assert Parliament’s control over treaties (such as the Trans-Atlantic Treaty on Investment and Trade) that could allow international companies to

provide NHS services.

He said that the Bill is scheduled to have its second reading in the House of Commons on 11th March 2016, although this might not happen and the likelihood of it having the support of a majority of MPs is very small.

But the immediately important thing is to build parliamentary support for the Bill especially amongst Labour MPs as the party revises its health policy after the leadership election.

Successful legislation will probably have to wait for a change of government, but we can work now to raise awareness of the Bill amongst the public, as well as getting support from local Labour parties and trade unions and monitoring the activities of local CCGs and Trusts.

6. Q3: What do we Do?

The Question addressed in this part of the Workshop was: what are our Campaign options and preferences?

Participants considered their main concerns and also their experiences in the campaign and put forward options for discussion by the workshop groups. Each preferred option was summarised in the form of a Terms of Reference. Return the NHS to its Founding Principles – a Planning Workshop to Support the NHS Reinstatement Bill

Report on Workshop 7th November 2015 Skipton & Keighley 38 Degrees Save Our NHS

These were prioritised and presented on flip charts on the Workshop front wall. Participants then reviewed these and, using the three red stickies provided, placed their ‘votes’ on their preferred options. The Outcomes of this exercise are presented in Annex E and summarised below in order of numbers of ‘votes’: Option for Campaign Projects

‘Votes’

Promote NHS Reinstatement Bill amongst Organisations and Groups

20

Petition for NHS Reinstatement Bill

13

Opposition MPs Support the Bill

13

Monitor Clinical Commissioning Groups

12

Educate General Public on Bill

12

Mock Auction outside private Providers Offices

6

Punch & Judy Show

5

Yorkshire for the NHS – Street Campaign

4

A&E Emergency Care Networks

2

NHS Logo is not the NHS

1

Education about the Bill

1

Win Hearts and Minds of Medical Professionals

0

Pyramid Selling of the Truth

0

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s