It was a ‘badge of honour’ for some to remark ‘Never heard of him’ in response to Jon Ashworth MP’s elevation to Shadow Secretary of State for Health.
But if it’s any consolation – I doubt he’s heard of you either.
Whisper it gently, but there’s more to life in the health and social care services than the pages of the Health Services Journal or the lecture theatres of the King’s Fund.
His campaigning work on mental illness, breaking down stigma and prejudice, has been inspiring.
But he is no ‘yes man’ – he railed against the mischievous use of slogans (a campaigning strand for Owen Smith MP over the summer for the Labour leadership).
From this starting point, I think Jon has form in being able to speak his mind, but withstand having his political career assassinated. He potentially might act as an important bridge for Corbyn’s “socialism for the twenty first century” and the halyçon days of “New Labour”.
When Tim Farron MP, leader of the Liberal Democrats, says like the Stone Roses he prefers the earlier work of New Labour, he presumably is referring to how when Labour came to office and power in 1997 the NHS was on its knees. Radical surgery had to be taken to the NHS, including Milburn’s NHS Plan.
The aim was also to put in real investment to the NHS – which worked – and to tackle burning issues of poor infrastructure.
Alan Milburn himself has said the tendency when you first come to the post of Secretary of State for health is ‘to want to do everything’, but as time passes progress slows down.
Tragically, Jon Ashworth MP is inheriting the NHS in a state of chaos and turmoil, but there are huge problems bequeathed by the current leadership of Jeremy Hunt: viz, inadequate monies to run the services, backdoor insidious rationing of services, morale of NHS staff (excluding management) at rock bottom, crippling PFI debts, a small number of NHS Trusts in ‘special measures’, widespread financial deficits, social care funding on its knees, A&E targets comprehensively missed, an IT programme which is badly behind, problems in recruitment in some specialties of the NHS, drastic cuts in mental health services, leaders of the NHS who refuse to quit despite catastrophic performance, disasters of outsourcing where nobody appears to wish to take responsibility, junior doctors repeatedly on strike with an imposed contract officially seen as not ‘imposed’, problems in recruitment, retention and workload of general practitioners, and so on.
And yet despite this, Theresa May MP, in my opinion probably one of the most dangerous Conservative Prime Ministers ever, insists ‘nothing to see here’.
But, without pointing the finger of blame at the latter Blair years, the list of policy misfires is substantial, including unsafe staffing and rush to regulation which contributed to the Mid Staffs disaster, explosion in new PFI deals (PFI has continued under subsequent governments) with extremely poor value for the taxpayer, the consolidation of the market in the NHS and social care, the introduction of the ‘purchaser provider split’, moves to use of private sector due to failure in planning (termed euphemistically as ‘building capacity’) such as privatisation of NHS logistics, legislation such as the National Health Service Act 2006 and the Public Contracts Regulations 2006 which laid the foundations for the catastrophic Coalition Health and Social Care Act 2012. The 2012 Act saw turbo boosting of outsourcing and transfer of services to the private sector (aka “privatisation”). New Labour started to embed the notion that competition between providers would not only bring down costs but also improve quality, which was never borne out in other monopoly behaving industries such as the utilities – and this was a disastrous hangover for the Coalition Years 2010-2015 with the Conservatives and the Liberal Democrats finding synergy in free movement of capital. This all had paved the way for greater consolidation of competition economics governing the NHS from EU membership, as well as the threat of TTIP investor protector clauses.
And Ashworth needs to insist that the NHS and social care to run a decent service, when the current Government is using #Brexit as an all round ‘get out of gaol’ card. Without this money, Simon Stevens cherished ‘Five Year Forward View’ will run into deep problems. Governments and opposition parties have been shroud waving about integrating health and social care for decades, but progress on this has been generally poor apart from some islets of promise. Parity of esteem does not appear to be a reality, as even Andy Burnham MP had recently sloganised. Delayed discharges or delayed transfers of care, or ‘bed blocking’ as affectionately known in the predominantly right wing anti Corbyn media, have got worse under Jeremy Hunt’s watch too, breaking both the NHS and ASCOF outcomes for patient experience.
But Ashworth is an effective campaigner – and he needs to put those skills into good use, for example against the unconscionable poor value for money PFI deals, the catastrophic current operational performance of the NHS, and the disastrous funding situation of social care, the need for much better mental health services.
Simultaneously, Ashworth will have to convince the public of the long view of the need of a comprehensive, properly funded, NHS free at the point of use. A similar National Care Service has been the vision of many in the past, but never got off the drawing board. Maybe the Shadow Treasury will have some idea about prioritising this now, given the change in monetary policy from the current Government? Clinicians and patients/users converge on a desire for care planning and continuity of care. We know the Government has done its best to show wage restraint in some areas not others (e.g. of nurses but not of NHS managers), but addressing the funding gap will need to see an intelligent use of technology – not aggressive pimping and rent seeking to the private sector – and changing especially for the elderly, where polypharmacy and multi morbidity can be big issues, the direction of the supertanker towards being a ‘National Health and Care Service’ not a ‘Fragmented Health Service’.
Jon Ashworth MP definitely has his work cut out. It’s a monumental task where he does need to build up some momentum.
