Health

RESPONSE TO PARTNERSHIP IN POWER SECOND YEAR CONSULTATION:

1. CHRISTIAN SOCIALIST MOVEMENT (CSM)

1.1 CSM is a movement of Christians with a radical commitment to social justice, protecting the environment and fostering peace and reconciliation. CSM believes that ‘loving one’s neighbour’ in the fullest sense involves struggling for a fair and just society, one in which all can enjoy the ‘fullness of life’ Jesus came to announce.

1.2 CSM is proud to be affiliated to the Labour Party and engages fully with the Party at all levels. Members are active locally in their CLPs and CSM sends delegates to Party Conference each year. At the Party’s invitation we organise the official Conference service and we also run a high-profile fringe programme. We currently have some 50 members in the Lords and Commons, including current and former Cabinet members and the Prime Minister. CSM members pledge to work in prayer and political action for the values of Christian Socialism. Our values form the basis of our response to this consultation.

2. PREAMBLE

2.1 Because a person’s health is one of our greatest of all gifts, the NHS is possibly our most valued service. But it is also the most criticised, as expectations are high that it will serve people’s needs to the full. Labour has unquestionably put quality back into our health services, but perceptions lag behind reality. Surveys show that people believe that the NHS is getting worse, even though their personal experience of the NHS has been good. And inevitably, there is always more that can be done to maintain healthy lives, protect the most vulnerable, adapt to medical advances and ensure that all services fully meet individual needs.

2.2 CSM takes the holistic view that ‘health’ embraces the physical, mental, emotional, social and spiritual welfare of each person. These threads must be sewn into every service and be explicit in Labour Party policies.

3. MAINTAINING GOOD HEALTH

3.1 CSM welcomes the new emphasis on individuals taking responsibility to live healthy lives. Our faith stresses the value of human beings as created in the image of God, but we recognise that some will find it more difficult to assume this responsibility than others.

3.2 Among the ‘mainstays’ of healthy living are good housing and education. The state has a responsibility to ensure that these requirements are met. We welcome the emphasis on these in other policy papers but we believe that the links should be made explicit at every point.

3.3 The Labour Party has placed a welcome emphasis on healthier living, and its initiatives have influenced individual behaviour - for instance, the introduction of the smoking ban in public places. For those that need external drivers to change behaviour more needs to be done. We urge that the points made in this submission be incorporated into the policies adopted by the Party.

3.4 Life patterns are set at an early age, and parents have a responsibility to train their children well. However, some parents require direction and support, and intervention at the earliest stages of life may be valuable in helping all to promote good health throughout life. Encouraging parents to adopt healthier lifestyles during the ante-natal period will have a positive impact on the health of their baby when it is born. This support should continue into the post natal years. Recently it was mooted that health visiting services should be reduced, yet this overstretched service gives essential support to parents in the early years of a child’s life. Workforce planning must ensure that sufficient health visitors are accessible and able to deliver all that is necessary at these early stages of life.

3.5 Good integration into Sure Start is also essential, and these services should be reviewed to ensure that they are providing the best possible care. Some of the neediest families still do not connect into Sure Start. This should be remedied by liaison with families in their home setting.

3.6 Schools have a responsibility to assist both children and parents to live healthy lives. Extending the curriculum to provide cookery classes for parents could help achieve this. It is important that such provision reaches people on the margins.

3.7 Exercise improves physical, mental and social health, yet many do not engage at all. Low-level exercise and education should be freely available to all, through, for example, Sure Start or the extended schools or local sports centres. Just as lifelong learning helps people to acquire life skills such as numeracy, literacy and basic IT, so the value of healthy living and exercise could be taught. Churches and community centres should provide such services for the wider community. For those in most need, of whatever age, access to sports centres should be free, and we urge that a commitment be made to achieving this objective as soon as possible, possibly through staged implementation to a clear timetable.

3.8 Stronger rules are needed to govern food advertising and to restrict the public promotion of products which do not contribute to a healthy lifestyle.

3.9 Alcohol misuse is a growing concern and we urge the Labour Party to include a comprehensive package of measures in the policy document. This should include education measures to encourage lifestyle changes. As with smoking, a ban on advertising should now be considered, alongside a hard-hitting public education campaign. Restrictions on the quantity of alcohol sold by publicans, off licenses and supermarkets should be considered, with a promise of faster intervention on shops that fail to stick to the rules. By-laws relating to drinking in public places should be strengthened. And the targeted approach of the Cardiff Violence Reduction strategy should be extended to all NHS Trusts, Local Authorities and Police Forces.

3.10 The impact of drug use on mental and physical health can be devastating, so the classification and controls on the use of recreational drugs should be strengthened. We urge that a policy commitment be made now to greater use of community sentences and quicker access to rehabilitation for all offenders.

3.11 The second year document raises concerns about sexual health, particularly that of young people. CSM believes that the model upheld in the Bible of sexual intimacy within marriage is not only morally right but has clear social and public health benefits. Education in school and through public health information is needed to provide a better understanding of the dangers to health of casual or recreational sexual activity. This should extend beyond physical health to embrace the emotional, social and mental impact of such behaviour. The current level of abortions reflects the fact that termination is still often seen as the solution to an unwanted pregnancy. We urge the Labour Party to make a commitment on integrating the work of organisations that offer alternative advice to women into public services. Postnatal support packages should be guaranteed to reassure young women in particular that they will be fully supported with their child.

3.12 Workplaces can help to promote healthier lifestyles, for example through the food served in canteens. People in the UK work some of the longest hours in Europe and many employees have little time to exercise. Employers should be encouraged to invest in the welfare of their staff, and government should introduce a tax-free voucher scheme or equivalent redeemable against gym membership or at sport centres and sports clubs.

3.13 Too many people remain on sick leave or leave employment because occupational health support is not effective at quickly addressing the needs of individuals. Employers should make it easier for staff to enjoy the benefits of screening. Employers need to address issues such as stress and bullying in the workplace as these are major causes of ill health. Health and safety legislation needs reviewing to address these rapidly growing concerns, and appropriate legislation should be put in place, including a limit on working time, as under the European Working Time Regulations. Dignity at Work legislation should be introduced to address levels of bullying.

3.14 Health care is as vital for older people as for young, and the wellbeing of retired people must be promoted. Good health in older people affects the level of hospital admissions and demands on support services, as well as being a moral imperative. Loneliness is a major issue for elderly people, yet there are few services reaching those behind closed doors. Services focusing on social interaction impact on health as much as those dedicated to fitness. Access to screening is important for older people. Pro-active measures can keep people out of hospital for far longer.

3.15 Too many people fall through the net of the support services. We would like to see link-workers introduced to work with all in our society, particularly the most vulnerable. Health services are still viewed as relevant only when things go wrong, yet a truly holistic service would address physical, mental, emotional, social and spiritual welfare in a far more proactive way. In the way that many sector skills councils are currently introducing ‘skills passports’, we ask the Labour Party to propose ‘healthy living passports’, supervised by a link person, in order to promote good health and achieve healthier lifestyles. Link workers would help ensure that care is appropriate, and could act as an intermediary between a patient and a consultant where the former is uncomfortable asking certain questions and the latter lacks the time and inclination or the training in interpersonal skills. A link worker could also act as an advocate and provide access to information for a patient. This will become increasingly important with the setting up of personalised care. The work of carers generally needs greater recognition and carers need more respite facilities.

3.16 The Christian church and other faith traditions place great emphasis on healing and good health, yet faith communities are only on the fringes of our health services. We need far better understanding and integration of all services, including those with a spiritual dimension, to meet the needs of individuals. A link worker allocated to each child and adult can help assess the holistic needs of individuals and signpost and support them to make lifestyle adjustments. As the most vulnerable are the least likely to seek out support, support coming to individuals is crucial. For instance, an elderly person alone at home, though not ‘ill’, will usually welcome a visit once a week. The not-for-profit and faith sectors are excellent at providing such services, though they need to be supported and enabled to co-ordinate their work to ensure that they benefit everyone. Such levels of support have the capacity to transform society.

4. The NHS

4.1 There is evidence that the ‘choice’ agenda only benefits some people, while, others are unable to gain access to the information they need. Practitioners should ensure that everybody is empowered to make informed decisions about their health and treatment and that patients and relatives have access to the best providers. We have to ensure that inequalities are not the unintended consequences of Labour’s efforts to improve our services.

4.2 Standard setting has led to improvements, for example in the area of waiting times in England and in public health in Wales. Often the best judges of standards are the service users themselves. The NHS should ensure that patients are aware of the standard they should expect when they use the NHS (an example would be cleaning in wards, which still has not gained the public confidence regardless of standards attained). A charter would help the public to understand the standard of care they should expect from the NHS and assist them to highlight shortfalls.

4.3 Post-discharge from hospital can be a very challenging time for patients, socially, mentally, emotionally and physically. Post-discharge care may focus on the rehabilitative elements of a patient’s treatment, but there should be a greater emphasis on wider care.

4.4 Some hospital chaplaincy services have been threatened – this is blamed on overall constraints on budgets - but the spiritual well-being of patients is as important as all other elements of their care. Maintenance of chaplaincy services should be a standard requirement and should continue with the patient post-discharge. The spiritual aspects of mental health and wellbeing should also be given more attention.

4.5 The end of life is a difficult time for patients and their relatives, and the best support needs to be provided at this time. The hospice movement has shown that dignity can be achieved in death, yet many people still die in very clinical settings. Whilst some will choose to die in a ward, there should be provision for patients to transfer into a special unit within the hospital which is totally geared to supporting the patient and the family in the final days. In these times the spiritual and emotional needs of a patient often become more important than the physical, and a properly designed unit would be equipped to deal with this. Such a unit could serve both those who transfer to it and those who remain on the wards. We also commend the ground-breaking work of charities like Marie Curie in supporting those – including terminally ill young people – whose wish is to die at home. We urge that the Labour Party make a specific policy commitment to the development of comprehensive support for these services

5. SERVICE PROVIDERS

5.1 CSM supports mixed provision of services but calls for an assurance in Labour Party policy that services will remain seamless and that the fundamental spirit that holds the NHS together will not be lost through ‘fragmentation’. There is concern that, with the increased use of contracting of services, those bidding to run services are being pitched against each other. Greater collaboration should be considered wherever possible instead of straight competition. There is also concern that a competition model will leave niche organisations, such as those providing spiritual support, out of care provision. Small faith-based organisations may not have the capacity to engage in the commissioning process, yet what they offer could be vital for the well-being of service users. Faith-based organisations should be encouraged to bid for services, with their faith element affirmed. Involvement of the third sector in service provision must be about adding value not about commissioning services “on the cheap”. We call on the Labour Party to make a specific commitment to strengthening the role of the Compact Commissioner in respect of the NHS .

6. Workforce

6.1 People employed in the NHS are among the most dedicated workers in the economy, yet at times they can feel undervalued. While many positive steps have been taken to support NHS staff, more can be done – for example, the introduction of greater flexibility in working hours. This is important as many employees also have caring responsibilities. There is a massive role for volunteers in the provision of holistic care, a valuable addition to services. Again we ask the Labour Party to make a clear commitment to strengthening the role of volunteers in the NHS, to provide mainstream resources for their training and support, and to recognise explicitly that they provide “added value” rather than being the source of cheap labour.

7. Medical advances

7.1 CSM welcomes advances in health research but urges the Labour Party to take great care in balancing the need for the fast development of new forms of treatment with the need to deal sensitively with the concerns about the use of embryos in research expressed by those who believe that life begins at conception.