Liberals pioneered the National Health Service and are appalled at its present condition following the so-called reforms inflicted by successive governments.
Furthermore Liberals believe that New Labour’s current management of the National Health Service is being driven by target setting which has more to do with the health of political reputations than the health of the nation; we deplore the wasting of money on bogus public consultation surveys and the increasing dependence on private health care which we believe undermines the confidence of patients and health workers in the NHS.
Liberals say that the National Health Service should be firmly established on the Liberal principle of public funding sufficient to meet all the health needs of the nation, with the private sector being available as an additional choice for those who wish to pay over and above their taxation contribution to the NHS and not as an alternative form of health care.
However, financial resources are never infinite, even for the health service, and difficult decisions have to be made about priorities. In any case, throwing money indiscriminately at health provision can obscure good practice or be an excuse for avoiding important questions on medical ethics and effectiveness. An extension of the limited list for prescribing would, for example, benefit patients and save money. Public health, prevention and basic care services that benefit the many must generally take priority over technological advances which at best can help only the few. Pioneering work offering potential future benefits over a wider scale should be supported by trusts and charities.
Liberals recognise that the continuing development of medical technology is putting a great strain on the financial resources of the NHS, often at the expense of less newsworthy and less high-tech forms of medical treatment. We believe that such a moral dilemma is unlikely to be tackled by political parties, and therefore call for the setting up of a Royal Commission to investigate the impact of medical technology on ethics and medical funding.
The Liberal Party opposes the opting out of hospitals and other parts of the health service and call for the return of all NHS trusts to the mainstream NHS. The changes introduced by the Conservatives have led to a massive increase in bureaucracy, to the extent that accountancy is now the fastest growing specialism in the health service. The privatisation of sections of social work, hospital services and sheltered housing have led to a lack of co-ordination within the health service.
A New Structure
Liberals believe that, as a general principle, decision making should be devolved to the most local practical level. Local decision making allows communities to have a real say, avoids the errors so often caused by remote management and reduces bureaucracy. The Liberal Party therefore calls for:
- the work of health authorities to be brought under democratic control by being transferred to local councils;
- regional government, when established, to have a co-ordinating role;
- the transfer of responsibility for social services from county to district level in areas which retain the “two-tier” system of local government;
- the fullest possible co-operation within local authorities between health, social services and housing to provide a “seamless” service;
- training programmes to reflect the need for close co-operation between different professions and mutual understanding of their respective roles;
- continuing local consultations between health service professionals and the public on the manner in which services are provided;
- protected terms and conditions of employment for all staff;
- a supportive working environment for people working in the health service which we believe is more likely to achieve high standards than the present culture which seeks to apportion blame.
These Liberal measures represent a radical transformation of the NHS and we recognise that, in the short term, a real increase in funding is required to ensure equitable levels of pay (especially for ancillary staff), adequate resources for the provision of mainstream services, and a consequent restoration of morale in the NHS.
The objective of Liberal health policy is the promotion of positive health, with the NHS as the primary provider of medical care and advice available to all. Private practice cannot be outlawed but, with changing attitudes toward health and consequent improvements in the NHS, it ought only to supplement the NHS rather than provide an alternative for the better off.
Liberals recognise that prevention is better than cure and believe there is a need for more research into the links between diet and disease. We also support measures which encourage a healthy and balanced diet, reduced consumption of fats, sugar and salt, and increased consumption of fibre. Healthy eating is a vital step in a long line of public health initiatives which have included the provision of pure water, sewage treatment, clean air, and vaccination, which have transformed standards over the past century. It must be given a high priority and the dominance of food producers in the regulatory bodies must cease.
Liberals recognise the division between the cure of sickness and the promotion of good health. To ensure an adequate distribution of resources between these two aspects of the NHS, Liberals believe that the promotion of health should be separated from the NHS and given to environmental and educational agencies.
Liberals believe that an increasing number of people are suffering unknowingly from allergies caused in the main by environmental pollution and from consumption of inappropriate foodstuffs. As a result, many people suffer long periods of misery, a poor quality of life and ultimately long term illnesses. This in turn impacts on the National Health Service, with particular regard to expensive treatments and drugs, occupation of beds and long waiting lists.
Liberals envisage that a dramatic improvement in the nation’s health and a corresponding saving in NHS expenditure will result if the Government were to introduce a comprehensive and fully funded allergy testing service as part of the NHS primary care system, comprising a training scheme for allergy specialists, regional allergy centres and local allergy clinics.
Greater use should be made of the media in the promotion of a better understanding of health and diet matters, thereby relieving the workload of the NHS. The basis on which pharmacists are paid should be changed to fully recognise their important front-line role in the provision of health advice. Changes to the law are needed to give individuals more access to their medical records.
However, the Liberal Party is opposed to compulsory medication such as the fluoridation of water supplies and would seek to prohibit the addition of any substance to public water supplies for the purpose of affecting or influencing directly the development or functioning of any part of the human body, nervous system or mind.
Liberals call for a complete ban on all promotion of tobacco products and regular increases in duties to discourage consumption. Liberals also believe that, due to the effects of passive smoking, there should be a ban on smoking in those parts of any building to which a member of the public has the right of access except in areas set aside for smoking.
Liberals oppose compulsory HIV testing in principle as an infringement of civil liberty. We believe that HIV positive people should not be subject to any discrimination.
Genetic Research on Foetus’
Liberals oppose proposals to conduct genetic research upon the foetus in the womb and call for such research to be banned.
Care and the Community
Liberals support the concept of care in the community, as opposed to care in large institutions, but it is vital that such care is adequately funded. More funding is required for care of the elderly, disabled and mentally ill, and for the rehabilitation of the increasing numbers of those suffering from drug and alcohol abuse and their families. Liberals support greater partnership arrangements with the voluntary sector which can usually provide more diverse and flexible opportunities for individuals needing residential and day care.
We recognise that needs will vary from one community to another and that the best approach will involve a partnership of the statutory and voluntary groups to achieve care in the community. Looking after elderly, frail and disabled people in their own homes is the civilised, rather than the cheap, option – a lack of funding in this area is worse than institutionalisation, especially for those volunteers and relatives doing the caring.
Liberals support a Carers’ Charter in recognition of the invaluable work done by carers. Such a charter should specify the extent of community and backup support, including home help, meals on wheels and health services. Local Authorities should act to underpin individual and community effort which should not be substitutes for voluntary activity. Nor should people be abandoned to the crudity of market forces.
In addition, Liberals call for:
- citizens who are elderly or disabled and resident in homes, or in receipt of day care to have access to independent advocates with access to legal advice;
- reource led, caring and efficient social services able to respond to individual needs and restore dignity to the individual.
The separation of the power to tax from the power to spend is the chief single inhibition on the development of a better health service in each region and district. The existence of appointed authorities, responsible only for health provision, prevents a proper accountable assessment of priorities across the broader field of social provision, including housing, education and social services. The lack of a democratic base, with its attendant appeal to the electorate, means that powerful consultants in glamorous specialities inevitably exert too much influence. The lack of powers to raise income ensures subservience to the dictates of the Minister of Health.
Liberals call for the establishment of regional assemblies which would include health powers and would bring local health provision into government. This would solve the problem of the inherent weakness in Community Health Councils and greatly improve the rights of patients and other users within the health service and would improve grant aid facilities for self-help groups, such as “Well Women” clinics.