Friday, 11 February 2011

Health, me and the PM

Great to see the article I'd written on the role of charities in health published this morning. It reads well (he says modestly!). Here it is in case you missed it;

Charities can offer better service than the NHS

Stop arguing over private or public delivery on health and choose what is best for patients

St John’s Hospital in Bath was established in 1180 to provide healing and homes by the bubbling spa springs for the poor and infirm. The charity is still there 830 years later: a much valued health and care service for the elderly.

This demonstrates our country’s great charitable tradition in health. The Government’s desire to put citizens and patients first is both core to the current health reforms and a guiding mission for the country’s great charities and social enterprises. The words of the Health Secretary, Andrew Lansley, “no decision about me, without me”, are our driving passion.

We have a dual role: to deliver health services, undertake research and provide care and compassion to those most in need; and to act as an advocate and adviser. We are sometimes a challenger of the health establishment and always a doughty champion for patients.

For these reforms to be a success we must ensure a much stronger role for the third sector. That is why we strongly support the policy of “any willing provider”. The previous Government was profoundly mistaken in pursuing a policy of the NHS as “preferred provider”, which implied that services from our sector were less valued than the State’s. In fact, through a big expansion of the role of charities and social enterprises in providing care, we can provide more cost-effective and citizen-focused services.

This is not about privatisation. What matters is what is delivered, not who delivers it. This must be at the heart of health service reform.

Charities can offer a better deal in so many ways. In 2008 the NHS spent just over 0.05 per cent of its healthcare budget through charities. In other words this is a virtually untapped resource waiting to be used.

To me, competition in the NHS means British Red Cross volunteers being able to help more people to adapt to life at home after a lengthy spell in hospital, so preventing the need for readmission. Those who get this support 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 to prepare a meal and make a further visit to ensure that they are safe and well. Such schemes can save the typical NHS commissioner up to £1 million a year.

Competition in the NHS would also mean an environmental charity such as BTCV running more “green gyms”, which give people a physical workout while taking part in environmental projects. So far, more than 10,000 people — often referred by GPs — have taken part. An evaluation found that the positive impact on mental and physical health, not to mention the acquisition of new skills, means that 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? I suspect that for most of us the answer is obvious.

Those who rely most on the NHS are the vulnerable, the very people charities were set up to help, precisely because they were being let down by the status quo. If groups such as the Red Cross and BTCV can do a better job than the NHS, we should let them.

Promoting wellbeing and preventing ill health have for too long been neglected aspects of the NHS’s role. These reforms rightly put emphasis on public health. Giving a role in health back to local councils is long overdue. The new health and wellbeing boards may provide the opportunity to get more resources behind public health as well as, for the first time, giving elected councillors the chance to scrutinise NHS resources. Preventing diabetes through better education, diet and exercise is always a better approach than picking up the costs of a growing number of people with diabetes. Charities such as Diabetes UK, working with councils and GPs, are critical to achieving that.

Of course there are challenges in introducing reforms. Of course proper funding is crucial. We want to ensure that there is a strategic approach to commissioning, including national guidelines. We want the new GP consortia to take full advantage of the opportunity to expand their work with our sector.

The challenge we face as a country is to build on the sure foundations of our NHS to provide service that recognises and expands the work of charities, promotes partnerships between State, third and private sectors and moves on from arcane arguments over privatisation.

And The Times also had a brilliant summary of the problems of Big Society and how to solve them by Phil Collins and a great letter from my Chair in response to the Francis Maude MP article.

I'm blogging from H M Treasury where the Prime Minister has been announcing new procurement and commissioning arrangements to free up the process for SMEs and charities and social enterprises. He was clear that we are part of the SME community and contracting has to be changed so that we can bid easier and better. He must have mentioned charities some 10 times in his speech and even referred to me directly. Then shook my hand on the way out! I made the point to him that we welcome the initiatives and I referred to Chris White MP's Social Clause Bill and how important that is.

And now the weekend beckons. Though I'm spending Sunday morning on Sky News. There you go; no rest for the wicked!

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