Labour’s plan to reform the NHS “offers a glimmer of hope”

The shadow health secretary, Wes Streeting, has recently announced Labour’s plans to reform the NHS, which include treating more patients in the community and freeing up GP time.

Mr Streeting says Labour wants to “fix the front door to the NHS”, enabling patients to be seen earlier and spot health problems sooner, so that fewer patients require emergency, life-saving care.

“The next Labour Government will shift the focus of health care out of the hospital and into the community. In this its 75th year, it is time to make the NHS as much a neighbourhood health service as it is a national health service. More health services should be available to you on your doorstep and from the comfort of your own home,” he said in a speech at the King’s Fund.

There are the three principles for Labour’s reform agenda, these are: healthcare on your doorstep, there for you when you need it, and patients in control. In his speech, Mr Streeting laid out what this would look like in practice.

Caring for more patients in the community

Labour wants to create a wealth of health hubs across communities. These hubs will be able to treat patients with minor injuries (such as sprains and cuts) and offer tests and scans, so that more patients can be treated outside of the hospital.

This plan is supported by a workforce plan which will see Labour double the number of district nurses qualifying every year and bring in 5,000 new health visitors to ensure that “every child has the best start in life”.

Labour has also pledged to create a mental health hub in every community and provide mental health support in every school. This will be paid for by abolishing tax loopholes for private equity fund managers and private schools, Mr Streeting said.

Women’s health is also a key focus for the Labour party, and Mr Streeting says health centres would act as a one-stop shop for women’s health, so they are able to easily discuss sensitive health issues with a specialist, close to home.

“If men were waiting an average of seven years for a diagnosis on a common condition as women are with endometriosis, we would hear a lot more about it,” Mr Streeting said.

Freeing up GP time

Mr Streeting says Labour is concerned about the “intolerable pressure” GPs are currently under, and how patients are often unable to get an appointment when they need one.

We have lost 2,000 GPs since 2015, and this means GPs are now forced to look after an extra 350 patients each.

“I know that GPs often feel that when Labour highlights waiting times for a GP appointment or face-to-face care, that we’re having a go at them. Actually, we’re having a go at the government for leaving general practice overstretched and under-funded,” Mr Streeting said.

Labour plans to publish a workforce plan which would see “the biggest expansion of medical training in history”. This would involve doubling the number of medical school places, so that an extra 7,500 doctors and 10,000 nurses and midwives would be trained every year.

This would be paid for by abolishing the non-dom tax status, which allows a person who was born in another country, or if their parent is from another country, to pay tax in the UK only on their UK income.

However, since training up staff takes time, Labour says it will create more “front doors” into the NHS so allow patients to access the health services they need when they need them.

This includes providing some forms of care (such as vaccinations) direct from pharmacies, and cutting out unnecessary GP appointments. For example, Labour would introduce a policy which would enable opticians to refer patients straight to an eye specialist without having to go back to their GP first. This would also apply for other specific conditions, where it is safe to do so.

Ultimately, Labour wants to give patients more autonomy and choice over their care. “There’s an assumption that greater choice for patients means more pressure on GPs, but actually, we believe the opposite is true. The right choice for patients can be more manageable workloads for GPs as well as healthier, happier patients,” Mr Streeting said.

Mr Streeting adds that Labour will not ‘structurally change’ the NHS, and they want to encourage an “entrepreneurial and innovative approach” that allows health leaders to decide for themselves how they will achieve a better service for patients. Integrated Care Boards are well-placed to drive this shift towards neighbourhood healthcare, he says.

Bold ideas for bold action

Mr Streeting says he is aware that Labour’s NHS proposals has “set the cat amongst the pigeons”, but this is deliberate.

“We are protesting bold ideas because the NHS crisis is going to require bold action,” he said. “I want to have the debate and the conversation with experts and those working in the health service now so that when the next election comes, we are ready to hit the ground running and it will take time to recover and reform the NHS so that it is fit for the future.”

“That is why we don’t have time to waste. After 15 years of conservative waste and failure. It falls to Labour, the party that created the National Health Service 75 years ago to build the neighbourhood health service our country will need for the next 75 years. And we will need your help to do it,” he concludes.

Labour’s plans have been welcomed by health leaders, but more needs to be done to address the immediate, short-term issues facing the NHS

Labour’s plans to reform the NHS have been welcomed by health leaders, but they warn that ideas only go so far, and the real challenge will be to make these plans a reality.

Beccy Baird, Senior Fellow at The King’s Fund said: “There has been a clear consensus for more than 30 years, under successive governments, that moving care from hospital to communities is the right thing to do. The challenge is making this actually happen. Previous attempts to do this have failed spectacularly, with levels of investment and workforce growing in hospitals, yet stagnating or falling in primary and community care services.

“There is much to welcome in the broad aims announced by the Shadow Secretary of State for Health and Social Care. However, translating these warm words into tangible change for patients will require radical reform across the whole health and care system. From social care reform, to fully engaging the voluntary sector, to improving NHS buildings.”

Ms Baird highlights that retaining staff should also be a key priority for the Labour party, as experienced GPs, doctors and other healthcare professionals are needed to train the new workforce.

Ruth Rankine director of primary care at the NHS Confederation has expressed similar concerns, and says investing in the current workforce is crucial so that we are not facing “a worse problem in the months ahead.”

However, she adds that health leaders “will recognise and be encouraged by the Shadow Health Secretary’s assessment that current investment in primary and community care, mental health services, and diagnostics is not comparable with other countries, and would urge that levelling up spending in these areas be made a priority.”

Dr Richard Van Mellaerts, deputy chair of GPC England at the BMA, says Mr Streeting’s speech “offers a glimmer of hope for what general practice could become”, and has urged the government to follow this example.

However, he warns that Labour’s plans to address the immediate short-term issues could go further. “Cutting back on red tape and granting greater autonomy to GPs are good ideas and may help to stem the flow of GPs leaving the profession, but do not go far enough. In addition, improving archaic NHS IT infrastructure, crumbling NHS premises, and scrapping the punitive imposition of the 2023/24 GP contract must also make the list.”