Exclusive: Labour’s shadow health secretary warns of two-tier healthcare system emerging as waiting lists grow
The government’s levelling-up agenda will be meaningless without a sustained focus on and investment in improving the nation’s health, Labour’s shadow health secretary has warned.
In an interview with The Independent ahead of his speech at the party’s annual conference on Tuesday, Jonathan Ashworth said a new vision for the NHS, and for wider public health, was needed if the country was to tackle inequalities that had been made worse by the pandemic.
This should include tackling heart disease and focusing on nutrition and exercise in what he labelled an “obesogenic society”, in an effort to concentrate on the overall “wellness” of the nation.
During his speech on Tuesday, Mr Ashworth will also outline his concerns over the increasing use of private providers, particularly in mental health care, and his fears over the emergence of a “two-tier” health system that benefits those who can afford to pay.
“I have been thinking about what we need to do for the future of the NHS, the challenge of how we reduce the waiting lists, and it’s not good enough to reduce them only back to where they were pre-pandemic,” he said.
“People who are desperate to get care are waiting an unacceptable amount of time. Sajid Javid has described some NHS targets as nonsense, but for cancer patients that’s not nonsense, it is a matter of life and death.”
He continued: “In this age where more people are developing long-term conditions, we need to get better at preventing ill health.
“We need a big push on overall wellness. It’s about health creation. It’s not just about what the NHS does, but how we care for people from the moment they are born to their last breath.”
He cited the book by former NHS chief executive Lord Nigel Crisp, which describes health as being “made at home” and says that “hospitals are for repairs”.
Mr Ashworth pointed to key statistics on heart disease as a major example of why more effort was needed. Around twice as many people have heart disease in the UK as the combined number of those with cancer and those with Alzheimer’s disease.
Similarly, half of people with high blood pressure aren’t getting proper treatment or a diagnosis. The British Heart Foundation has warned that the effects of the pandemic could result in at least 12,000 extra heart attacks and strokes over the next five years.
Mr Ashworth said a major push was needed on all major public health problems, including what he described as our “obesogenic society”.
He said the government’s plan to level up the country wouldn’t work “unless you level up on heart disease, and keep people well at every stage of life”.
Labour believes the government’s Health and Care Bill, which is currently going through parliament and provides for a major reorganisation of the NHS into 42 regional bodies, is a mistake, and that it will create a two-tier system with the increasing use of private providers.
Research for Labour by the House of Commons Library has found that almost half of independent mental health services are currently rated inadequate, or as requiring improvement for safety, by the care watchdog, the Care Quality Commission (CQC). Almost 4 out of 5 specialist eating disorder beds for children and young people are provided by the private sector.
He said: “Years of mental health care cuts and neglect see the NHS forced to use the private sector for poor quality care and beds.
“Quality, safe care must be a priority, and making use of these private institutions, which we know from the regulator are inadequate, is a disgraceful failure [to protect] some of the most vulnerable in society.”
His comments come after a series of scandals in private mental health hospitals, including staff at a Cygnet hospital in Essex being found to have slapped and kicked patients last year. A Suffolk mental health hospital was rated inadequate by the CQC after “elements of abuse” were found in the services provided by the hospital, which was part of the Priory Group.
Mr Ashworth said: “We think this is the wrong bill at the wrong time, and I would rather see this bill pulled and different legislation brought forward.
“We know the scale of the backlog is enormous, and we know NHS staff are exhausted after the past 18 months. The NHS has been in crisis all summer, and only this week we’ve seen chemotherapy services in Nottingham start to be rationed.
“I am not convinced a reorganisation of the NHS at this particular moment is sensible.”
The party has specific concerns about the role of private sector organisations in the new regional integrated care boards, as private companies could have a role in developing local health plans.
“That in itself has a direct implication for patient safety,” Mr Ashworth warned, adding: “We know that at the moment the waiting list is at such a scale that people, out of desperation, are turning to the private sector to pay for operations, and we know anecdotally that some people are taking out loans and even remortgaging their house.
“That is a two-tier system opening up before our eyes at a time when recommendations from the [inquiry into rogue breast surgeon Ian Patterson] haven’t been implemented.”