Andrew Lansley’s health reforms go before Parliament next week; a far-reaching upheaval, taking place against the background of the deepest cuts in public spending for 30 years. It is undoubtedly a gamble. But the prize is worth the risk.
The most exciting aspect of these changes is the opportunity for the Third Sector to play a far greater role in delivering health care and promoting the citizen's voice. There is great potential for the creation of new employee-owned organisations and social enterprises and expanding charity delivery of servcies.In 2007/08, the NHS spent just 0.05 per cent of its healthcare budget on voluntary organisations. It is, in other words, a virtually untapped resource waiting to be used. The third sector can compete against the private and statutory sectors, thereby freeing up NHS staff and delivering better care for the public.
But there are many vested interests – principally the health service unions – that will have none of this. They say the reforms are ideologically driven, essentially privatisation by another name. Competition, their argument goes, will benefit the shareholders of multinational private companies and should be opposed by anyone who cares about NHS patients and staff.Of course we all have an interest in arguing for proper funding for our NHS and for protecting it's essential core values of access for all , based on need not wealth. The third sector is a strong supporter of our NHS. We worry that the budgets for our health services ,set against rising demand will cause major problems for the many beneficiaries we serve. But these reforms,if carried out in a way that uses our third sector can make it stronger.
Competition in the NHS means British Red Cross volunteers being able to help more people adapt to life back at home after a lengthy spell in hospital, so preventing the need for readmission. Those who are supported in this way are often aged over 65 and have experienced a fall. Volunteers bring them home, settle them in, advise neighbours or relatives of their return, check on pets, help prepare a meal and make a further home visit the next day to ensure they are safe and well. Such schemes can save the typical NHS commissioner up to £1 million a year.
Competition means an environmental charity like BTCV running more "Green Gyms", which give people a physical work-out while taking part in environmental projects. So far, more than 10,000 people – often referred by their GPs – have taken part in this activity. An evaluation found that the positive impact on mental and physical health, not to mention the acquisition of new skills, means the state saves £153 for every £100 it invests. On top of that, it has a positive impact on local communities and the environment. Do we want less of this, or more? To me – and I suspect most of us – the answer is obvious. The people who rely most on the NHS are the vulnerable, the very people, indeed, who charities were set up to help precisely because they were let down by the status quo.
So if third sector organisations like the Red Cross and BTCV can do a better job then we should let them. We also need charities and community organisations to work more closely with GPs – who will be taking over responsibility for commissioning services - to ensure that they use the third sector more and are aware of what it can offer. These reforms could herald a new and dynamic relationship between local GPs and charities that both deliver good services and act as a powerful voice for patients.I spoke to a group of GPs lat week. They were enthusiastic to develop community leadership , to work with the many health charities and to commission services from us. But let's be c
Ear it will be along and difficult road in making that happen and it poses challenges for our sector and for GPs.
One of the crucial role that third sector bodies play is to represent the people who rely on public services, especially those whose voices are not otherwise heard – the elderly and isolated, the mentally ill, ethnic minority communities - and ensure that the NHS responds to their needs and not just those with sharp elbows. We can promote innovation and quality. The health service unions may ne on the wrong side of this argument; but to make the most of the opportunities Lansley must commit himself to bold and practical reform, He has outlined his plans for more competition to deliver NHS services; now he needs to make that competition fair, tackling hard issues like the distortions created by the tax and pensions systems. Furthermore, he needs to make sure that when GPs take over the commissioning of NHS care, they understand the enormous potential offered by the country’s charities and social enterprises.
These are the issues we need to deal with now to make the NHS properly responsive to the needs of the citizen. The obsession with “privatisation” is yesterday’s debate. Giving the third sector a bigger role is tomorrow's.
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