Editorial Monday 12 May 2014: Text of Ed Miliband's speech on Labour health policy
Commentary to follow: for the time being, here is the copy of Ed Miliband's speech today setting out the latest glimpse of Labour's health policy.
Ed Miliband MP, Leader of the Labour Party: A few weeks ago, I did something unusual for a politician.
I spent two nights with the staff and patients of an NHS hospital in Watford, a few miles outside London.
Sitting in on the clinics.
Spending time on the wards.
Going out with the paramedics.
Talking to the staff and to the patients.
Not a visit where you swoop in and out.
But where you get to understand what the NHS really looks like from the ground up.
I did it because you can’t change the NHS for the better if you don’t understand that.
David Cameron has proven that lesson.
It was one of the best things I have done in my time as leader of the Labour Party.
Every patient I met had one thing in common.
Every single one I spoke to told me that they had such belief, such pride, such faith in our National Health Service.
Pride in the achievement of our country after the War: coming together to build a service that is still the envy of the world.
Pride in the fundamental idea: health care free at the point of use, for every single citizen of this country.
Pride that, unlike in other countries, the service you get doesn’t depend on the size of your wallet.
People told me they thought it was one of the greatest things our country had ever done.
And they are right.
And that’s why the task of the next Labour government will be to protect the NHS, to improve the NHS and to nurture the NHS for generations to come.
There was something else people in the hospital had in common.
So many of them asked me: “where would we be without the NHS?”
“We don’t want to follow America, with a privatised health care system.”
And most people I spoke to, despite their pride in the NHS, also had an edge in their voice.
Because they all know these are hard times again for the NHS.
They fear that things are going backwards.
People remember the promises David Cameron made.
The airbrushed posters.
The three letters he said he cared most about: NHS.
But we all know the reality now too, don’t we?
The broken promises.
David Cameron toured the country promising not to close hospital services.
But he has taken on sweeping new powers to close services over the heads of local people.
He said there would be no return to people waiting for hours in A&E.
But last year almost a million people waited for over 4 hours in A&E, the highest for a decade.
He promised to protect frontline services.
But a quarter of walk-in centres have been closed since 2010.
He promised that people should be able to see their GP 24/7.
But a quarter of the British people now say they can’t get an appointment in the same week.
And, the biggest broken promise of all?
He said there would be no more of those top-down reorganisations that “promise change but instead bring chaos.”
And what did he do?
He spent billions of pounds on a top-down reorganisation that nobody wanted and nobody voted for.
And it has put the principles of markets and competition at the heart of the NHS like never before.
A boost for the private companies and competition lawyers.
A burden for everyone else.
That’s how the Tories see the future of our NHS.
That’s why it is going backwards.
Friends, they’re the wrong principles and the wrong priorities from the wrong government.
David Cameron has broken his bond of trust with the British people on the NHS.
He has proved the oldest truth in British politics.
You can’t trust the Tories with the NHS.
And if there is something even worse than the damage the Tories have done to our NHS, it is the wasted opportunities.
The lost time.
Because it has never been more important than now to have a proper plan for the future of our NHS.
When I was in the Watford hospital, a junior doctor came up to me at lunchtime on the second day I was there.
He had qualified several months earlier.
He liked his job.
But he had an edge in his voice too.
He said: “I’ve just started my career but I worry that the NHS may not be there in the years to come.”
“It is up to you to have a plan.”
He was right to be concerned about the challenges the NHS faces.
And he’s right that we need to plan for its future.
Let me tell you today what I learnt about those challenges.
The biggest of these is a growing elderly population in Britain today.
One of the greatest achievements of the NHS in the 20th century becoming one of the greatest challenges of the 21st century.
It is great that people are living longer.
But, I saw for myself in Watford, the NHS is having to cope with the difficulties facing people in their 80s and 90s that it never had to cope with before.
They don’t simply have medical needs.
But care needs.
Care needs which the NHS is not used to tackling.
This challenge of a growing elderly population means that there is more than ever a need for services to work together.
And it is true not just for the elderly but for the whole population.
I saw that a hospital can only be as good as the services around it.
Access to the GP.
Care in the home.
Prevention not just cure.
If those things aren’t right, all of the problems end up back at the hospital.
And they won’t be able to cope.
And the pressures of modern life make this more not less of an issue.
This came home to me as I was visiting one of the children’s wards.
As I was walking up the stairs one consultant said to me, you are visiting the wrong place.
Thankfully, so many childhood illnesses have either been eradicated or have cures.
You should be going to the schools instead.
Because kids are ending up in here because of the stresses they face.
The stresses of being a teenager.
Including from what goes on on-line.
It is another example of why a good health system isn’t just about hospitals.
And if these pressures weren’t enough throw in new medical technology and the higher expectations that people rightly have, and you can see why that junior doctor was worried about the challenges ahead.
Friends, we have to answer the question of that junior doctor.
And we can.
The Tories have no plan.
Apart from fragmentation and privatisation.
And then think about the others.
The Liberal Democrats have voted with the Tories every step of the way.
And UKIP say they want to charge for visiting the GP.
Maybe that’s what they mean by keeping the flame of Thatcherism alive?
It is up to us.
Up to a Labour government to make the changes we need to make sure the
NHS is there for the years and decades ahead.
We’ve done it before in the recent past, of course.
Some of you will remember what it felt like in the 1980s.
People were asking the same questions then about whether the NHS would still be there in the future.
Whether anyone could turn it round.
And that’s what we did after 1997.
When the last Labour government came to office, there were waiting time targets of 18 months that weren't being met.
When it left office, there were waiting time targets of 18 weeks that were being met.
There were more doctors and nurses than ever before.
And the highest public satisfaction on record.
That’s Labour’s record on the NHS.
But this time the challenges will be even harder.
Because when the next Labour government comes to office, it will need to deal with the deficit.
Money will still be tight in the NHS.
The last Labour government was able to deliver some very big increases in health service spending.
The next government won’t be able to match that scale of increase.
And yet we know how big the demands will be on the NHS.
And that means we will have to do things in a new way.
To make things better.
To save money where we can.
And to make sure that every single penny is well spent.
That’s the work we are doing as part of our zero-based spending review.
And here’s how we can make the resources of the NHS go further and make it a better service.
Our plan for the future of the NHS starts by making sure that services that have stood apart for too long work together.
Physical health, mental health and social care.
In Watford, I talked to a sister who was responsible for a 64-person ward for the elderly.
She told me about one frail lady who was there.
She had nowhere to go.
Even though she had been physically strong enough to leave for two weeks.
It wasn’t good for her.
And it wasn’t a good use of the hospital’s resources.
We can rise to it by ensuring that each and every frail older person has a personal care plan.
Bringing together care workers, medical specialists and GPs.
With the patient and their relatives having a single, point-of-contact within that team.
Someone who isn’t just responsible for this appointment or that.
But who is there to make sure all of their needs are addressed.
So that lady wouldn’t be waiting for weeks on the ward with nowhere to go.
And if we do that, just think of the difference it could make.
If a simple grab rail is placed in someone’s home that can stop a fall that could lead to that person being seriously injured.
Keeping them out of hospital.
Saving them the pain and the suffering.
And saving the NHS thousands of pounds.
That simple grab rail costs just £50.
A fracture can cost about £14,000 to put right.
Falls cost the NHS £2 billion ever year.
That’s why the next Labour government will integrate services across our NHS.
That’s how we can help the NHS to meet the challenges of our ageing population.
That’s how we can help make sure it’s there for the next generation too.
Second, we need to act to sort out people’s problems as quickly and as early as we can.
Before problems get too bad.
Before people end up in hospital.
In the NHS, again and again nurses and doctors tell me: “we work in the hospital but we want to see better services helping people closer to where they live.”
“To get people the care they need as swiftly as they need it.”
Why is there such pressure on our A&E services?
Because services outside hospital aren’t there.
GPs are under such strain.
And too many people feel the only place they can go is to A&E.
If you’re a parent with a sick child, there can be nothing worse than waiting anxiously to get in to see a GP.
Phoning early in the morning, only to be told you will have to wait days, even more than a week, to get the help you need.
That is why the last Labour government transformed GP opening hours and GP access.
David Cameron has changed all that.
Scrapping the guarantee of a GP appointment.
Cutting funding for extended opening hours.
The government said it just wasn't their priority.
And we all know the results.
People just can’t get in to see a doctor as quickly as they need to.
Storing up problems for them and for the health service down the line.
Today only 40 per cent of people get a GP appointment within 48 hours.
We have to change that.
We will change that.
Today I can announce that the next Labour government will put in place a new set of standards.
Everyone will be entitled to a same-day consultation with their GP surgery.
A guarantee of a GP appointment if you need it that day.
And a guaranteed GP appointment for all within 48 hours.
Because your family deserves an NHS there when you need it.
With a new right to book further ahead if you want a guarantee that you can see your own doctor.
All this will be:
Better for patients, because they have better access to their GP surgery.
Better for the NHS, because it will save money currently spent having to treat people in hospital.
And better for Britain, because it is the kind of preventive health service we need.
The third part of our plan will help us pay for this improved access.
And it's about more than that too.
It's about restoring the fundamental values of the NHS.
The basic principles.
It's about ending David Cameron’s dogmatic obsession with bringing competition and privatisation into the heart of the NHS.
And reducing the huge costs that have come about because of that terrible Bill.
The last Labour government showed how private companies can sometimes help bring down waiting lists or provide specialist services that the NHS can’t.
So, of course, there is some role for the private sector in our health service.
But this government doesn’t just want to do that.
It thinks competition and privatisation should be at the core of the way the NHS works.
As the government says itself: if it worked for the privatised utility companies why shouldn’t it work for the NHS?
Doesn’t that say it all?
Well, not under my government.
We'll go back to the right principles.
To the right values.
Why should a hospital have to spend money on competition lawyers instead of patient care?
We’ll stop that happening.
We’ll stop the regulators from spending their time on free-market competition in the NHS.
We’ll cut back on the consultancy costs caused by the Tories’ reorganisation.
We’ll reduce the number of very senior managers who cost too much at a time when resources are so scarce.
We’ll stop the threat of European competition law forcing the privatisation of services.
And, friends, we’ll repeal their terrible NHS and Social Care Bill.
This will save money.
At least £100 million.
And we’ll put all of this money straight back into improving GP care.
Labour will have the right priorities.
This is how we plan to improve the NHS.
A comprehensive service based on the needs of the whole person.
Prevention not just cure.
Co-operation not privatisation.
The NHS is so important to Britain.
Especially in tough times like this, when so many people are struggling under the pressures of the cost-of-living crisis.
People need to know it is going to be there for them.
And for their children.
And for their children’s children too.
When I was at Watford General, I met a lady who was 99 years old.
She remembered how Britain pulled together as a country in the darkest of days to create the greatest of institutions.
Just imagine that kind of courage.
A country recovering from war.
But determined to better itself.
And then compare it with this government we have today.
A government that has the wrong approach.
That has no plan.
That cannot be trusted with our NHS.
That’s why we have to raise our sights once again.
Only One Nation Labour will make the changes that we need for our NHS.
Planning for the long-term
Care there when you need it.
Patients before profit.
Britain loves the NHS.
Britain needs the NHS.
And working together we can and we will protect and improve the NHS for the future.