Policies to save the NHS

John Lister, London Health Emergency Information Director, asks, "New Labour, new NHS?".

Seventeen years of Tory cuts and market-style "reforms" have brought crisis to the NHS and spread demoralisation through its 1 million strong workforce.

At the last count, the gap between government spending and the amount needed to keep pace with inflation, population pressures and new technology had topped 3 billion pounds a year.

To make matters worse, the 1991 reforms set up the ludicrously bureaucratic and costly "purchaser-provider split", fragmenting the NHS into a chaotic patchwork of quangos, with health authorities seeking to balance their books by screwing ever-greater "efficiency" out of increasingly desperate Trusts.

The result has been a massive proliferation of top managers, and a dangerous decline in the numbers of front-line staff.

And if the Tories get their way, the first NHS hospitals since 1948 to be built with private capital and run for profit will already be under construction, driving an even thicker wedge of privatisation into the heart of the service.

Already tens of thousands of frail elderly patients are carrying the costs of the "community-care" reforms designed to axe NHS continuing-care beds and force patients into private nursing homes, where they must pay means-tested charges.

To halt and reverse this decline, Labour must take urgent steps to dismantle the market system, scrap the community-care reforms and pump in the necessary cash to prevent further damaging cuts. An immediate injection of at least 2 billion pounds is needed to restore acute hospital services, mental health and care of the elderly.

In place of the network of docile quangos which control the 30 billion pounds NHS budget, Labour must set up elected health authorities. Opted-out Trusts and GP Fundholders must be brought back under NHS control.

All private contractors and companies providing support services to the NHS and private nursing-home chains must be nationalised, with staff offered NHS contracts.

And all charges for prescriptions, optical and dental checks, which contribute negligible amounts to the NHS budget at great bureaucratic cost while inflicting distress on the low paid, must be scrapped.

From this radical starting point, Labour could win the confidence and commitment of health staff and other public-sector workers and begin to lay the basis for a genuinely accountable, accessible and socialist health service.

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