There are many lines in the Labour Party manifesto of 2024 with which I agree. This should not excite our news editor into thinking I’m crossing the floor however, nor is it anything I haven’t said publicly many times previously.
I say this because many ambitions in the winning party’s manifesto are so top-line they could mean almost anything. Perhaps that was the point.
In social care, still one of the biggest issues facing our country, it promises to “undertake a programme of reform to create a National Care Service”.
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This could literally mean the nationalisation of the entire social care sector – akin to how local voluntary hospitals were brought under national public ownership in the 1940’s – or it could mean, well, whatever you want it to.
In criminal justice policy it pledges to “intervene earlier to stop young people being drawn into crime, creating a new Young Futures programme with a network of hubs reaching every community”. Sounds good.
And in our area, we’re told “the principle of integrating health and care services will improve the treatment patients receive” and because “we know that more of this care needs to happen outside hospitals, we will trial Neighbourhood Health Centres.” OK, you’ve got my attention!
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So what might this mean for primary care and the pharmacy branch of the family?
We know planning for the Government’s new NHS Ten Year Plan is underway, and will formally launch very soon. Indeed, the Minister said in his recent C&D column, it will take the form of a “national conversation” about how we can come together to renewour health and care system.
We also know the team behind this plan are very much the band back together from the last time Labour were in power. Alan Milburn (watch this space!) is back, his former Special Advisor Paul Corrigan is there and, of course, Lord Darzi himself was brought in to diagnose what Wes Streeting meant when he said the “policy of this Department is the NHS is broken”.
What I know for sure when a band reforms is they’re all bit older, perhaps wiser, but they always play the greatest hits.
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We should remember, this is the first new Government to come to office in a very long time not pledging to reorganise the NHS. That is welcome and means those who need to ‘fix’ it are not distracted once again.
The challenge for Mr Streeting (and I was there helping to write the last ‘Long Term Plan’ for the NHS) is that it’s so big you get drawn into structural change when you very soon realise you can’t do one thing without the other and your manifesto has made some pretty grand promises.
To some extent it’s already happening. Just this week we learnt the way patient safety is regulated and monitored is to be completely overhauled in England.
And in the swoosh of a Minister’s pen; the CQC, the National Guardian’s Office, Healthwatch England and local Healthwatch services, the Health Services Safety Investigations Body, the Patient Safety Commissioner and NHS Resolution are to be reviewed!
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So when it comes to primary care, I wouldn’t be at all surprised if a relatively light line in the manifesto around ‘Neighbourhood Health Centres’ becomes something much more significant.
The reformed Blairite band may well put some form of Darzi Clinic 2.0 on the playlist and call them, let’s say, Neighbourhood Health Centres.
Could they bring together existing services such as family doctors, district nurses, care workers, physiotherapists, palliative care, mental health specialists – community pharmacists - under one roof? Stranger things have happened.
A National Care Service. A network of Young Futures hubs. An additional 3,000 nurseries on state primary school sites. Fits a pattern.
Neighbourhood Health Centres would face significant challenge of course. GPs like community pharmacists are not part of the state - they work under contract for the state – but I think back to what Wes Streeting (who always chooses his words very carefully) said in Opposition about the end of the partnership model for GP partners who want out.
And I look at the Government’s determination to press ahead with pure ‘hub & spoke’ knowing full well (as they surely do) the vast majority of community pharmacists still rely on volumes for the lion share of their income.
There is no question this is a Government of the left and, not unreasonably, they see things through a more statist lens than the last lot.
What remains to be seen is, how deep they want to dig in the pursuit of ‘change’ and what the actual response is to the “fourteen years of neglect and incompetence” (none taken!) the Pharmacy Minister obviously feels he’s inherited.
Whether it be in social care, crime and justice, early education – or primary care – we just don’t know yet how much it’s big words in a manifesto or big plans even they have yet to realise are on the cards.
