Editorial June 2024 -Politics of Health & Social Care

What must we expect from the new Government?

Indranil Chakravorty MBE

We are fortunate to be in a democracy where (to a large extent) there is the power that the ‘people’ can wield over their political masters at least in some parts of the country where there is a real choice in electing who should represent them in forming the new government. In the cycle of governments changing, health and social care makes it into the top 5 issues that we the people care about. The others are the economy, immigration, crime, living standards and the environment. The 2024 general election is no different. However, the relative strengths of each of these top issues can vary between the different parties vying for popular votes and in different parts of the country, determined largely by demographics, impact of local issues and to some extent personalities of those who have national profiles. 

BAPIO and its members have cared for many different issues within healthcare and beyond in the larger social fabric that we live and work in. Over its more than quarter century of existence, BAPIO has stood for excellent care, justice, equality, tackling health inequalities, removing differential attainment and providing many charitable pursuits. 

BAPIO has represented the views of its members on how the NHS should transform its workforce, provide dignity in the workplace, tackle institutional racism and championed the cause of diversity and inclusion. It is therefore time that BAPIO members consider their choices while deciding which of the political parties offer the best solution for the NHS and its workforce, in a sustainable and just way. 

When one considers the present state of the health and social care one is faced with the challenging prospects of nearly 8 million people on waiting lists, often for urgent, life-changing care; the state of the hospital emergency care from queuing ambulances to people dying while waiting in inhospitable corridors; the demoralised primary care workforce unable to cope with providing care nearer to patients homes and the dire state of social care finances which makes discharging people from hospital or providing basic care in the community virtually impossible. Various political parties offer excuses from COVID-19 pandemic to industrial action by healthcare staff, for the state of the health and social care. Others blame it on the war in Ukraine, the cost of living crisis, BREXIT and the financial institutions, forcing us to consider austerity for a more stable future economy. 

If one were to consider the manifesto promises on offer from all the major political parties, there is not much to trust or believe that such half measures i.e a few hundred extra doctors/ nurses, buying capacity from the private sector would even scratch the surface of the challenges we face. There are a few common truths, if the political parties were to be believed – 

  • The one issue that most parties are fixated on is that somehow the net migration of 400,000 people into the UK contributing to the 1% (i.e. 6 million) annual population growth is to blame for the current state of everything that is ‘failing’ in the UK – health, social care, housing, unemployment, schools and the economy. If the net migration can be curtailed to a magic sustainable figure (from 300,000- zero) all will be well again. This argument appears to appeal to BREXIT voters and in the last few weeks we have seen the phenomenal rise of parties that swear by such zero migration policies. 
  • The second issue that appears to stem from the first, given the warped political logic, is health, social care, housing and education but these issues are not getting the attention that they deserve because the political limelight is on immigration. 
  • The issues that are not getting a look in are climate catastrophe, the pushing back of the net zero targets, and winding up of EDI as well as the frightening proposal to come away from the commitment to human rights. 

We as common citizens need to choose carefully which parties and hidden manifestoes we support. We need to educate ourselves and the patients we serve –  why abandonment of the lofty principles of universal health for all, enshrined in the NHS constitution would be a round catastrophe. There is no other system in the world that can provide for universal health at quarter the cost of the next best healthcare system. The public needs to decide if they wish to sacrifice universal health for a promise of broken systems, that will only drive up the gap between the haves and have-nots. BAPIO stands for excellent health for all, and this cannot be achieved without adequate investment. For adequate investment, it has to be paid for, and the only fair way of paying for health and social care is by a form of contribution to national insurance. Nothing else will do, or we face the real prospect of scrapping the national health service and piling on misery on the population. Like, all the major medical royal colleges and the BMA, BAPIO and all its alliance members need to talk about how the NHS can be funded, protected and enhanced. Nothing else will do. And we need to bring our patients with us on this quest.

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