The Green Party argue that healthcare is not a commodity to be bought or sold. The National Health Service must provide healthcare, free at the point of need, funded through taxation. It must be a well financed, public service funded by, run by and accountable to local and national government and devoid of all privatisation, whether privatised administration, healthcare provision, support services or capital ownership. The NHS is concerned with healthcare provision and should not be subject to market forces either internal or external.
A publicly owned NHS
The Green Party seeks to repeal the 2012 Health and Social Care Act, and restore responsibility to the Minister of health to provide a comprehensive health service. It also seeks to repeal the right of the Minister of Health to close hospitals or hospital departments without effective public consultation.
The internal market
Market forces cannot allocate healthcare fairly, nor even efficiently. The internal market in the NHS has wasted badly needed resources on administration, and reduced the efficiency and morale of the whole system. The internal market opens the long-term possibility of further privatisation of the NHS. The internal market should be wound up and replaced with clear financial and service accountability of decentralised service units to regional assemblies within a single corporate whole.
Community Health Centres
The Green Party promotes diverting funding from centralised facilities towards community healthcare, illness prevention and health promotion. Community Health Centres will be the focal points for self-help and community-based initiatives and will also provide a wide range of services including primary healthcare, and health education and health promotion programmes. A variety of specialist services, in particular midwifery, obstetrics, family planning, counselling and psychiatry, will also be available. To permit the availability of the widest possible range of services and interventions, staff will be organised into multi-disciplinary teams. The public will be provided with easier direct access to nurse practitioners and other non-medical health and social care workers.
All women will be entitled to the care of a single midwife through prenatal care, birth and the first month of post-natal care, in line with the model of care currently provided by independent midwives. This will be made possible by increased numbers of training places and initiatives to improve the recruitment and retention of midwives. Maternity units should be sufficient in number and located so that all women are within reasonable reach of one. Funds allocated for maternity services should be ringfenced to ensure that they are used for the intended purpose.
Increased and protected funding of community services will enable healthcare as far as possible to be provided at home or in community-based facilities. Community services for frail elderly people and disabled people, including those with enduring mental and physical health problems or with learning difficulties will be increased to ensure everyone receives the support they need to live as independent and self-determined a life as possible based on their individual needs and circumstances.
Primary and hospital care will be more closely integrated. District staffing structures will be reviewed, with the aim of integrating hospital-based specialists into primary care and community health workers into hospital practice. The hospital programme will emphasise the development of appropriately sized district and community hospitals, with a reduced role for larger regional centres. However, some specialised services will continue to be provided on a regional or sub-regional basis.
Hospitals will focus on services for patients needing inpatient care. Accident and Emergency Departments will be for emergencies only with care for minor illnesses and injuries provided for by community health centres. We will require adequate night and weekend cover from consultants and diagnostic facilities in all hospitals dealing with emergency admissions.
The Green Party is opposed to the development of Foundation Hospitals which, although argued to be locally controlled, could actually result in reduced democratic accountability given that they will be unanswerable to parliament or local authorities. Foundation Hospitals are in fundamental opposition to the Green Party policy of the public health service remaining fully funded by public taxation, given that they are required to produce a profit and are able to seek commercial partnerships. This is likely to result in charging for ancillary services (disadvantaging the worse off), the reduction of medical education and training, the non-treatment of specialist or rare illnesses and early discharges. Foundation Hospitals risk undermining the principles of the NHS, creating a two- or multi-tier system of uneven provision. The Greens would abolish Foundation status, fully reintegrating any such hospitals into the NHS system.
The Green Party sees prescription and other charges as wrong in principle, unfair in practice, while generating little income for the Health Service. They will be abolished as soon as possible. The taxation system will require adjustment to compensate the Health Service for the revenue lost.
Essential dentistry, including check ups, is necessary basic healthcare, and should be provided free under the NHS.
Health spending in the UK needs to reflect the needs of the country and should be maintained at around the average in the European Union. The Green Party will continue to support the principle that the NHS is a national service, free at the point of entry and fully funded by taxation.
An NHS Tax, earmarked to increase direct funding of the NHS, shall be introduced as part of general income and other taxation. We believe this will have wide support.
Health Service spending will be reviewed regularly, with a view to increasing the resources invested in health promotion, illness prevention, community care and community development, relative to spending on curative interventions.
Workers in the NHS have been underpaid, undervalued and ignored. They remain some of the most overworked in our society despite the importance of their day-to-day decisions and actions. The multitude of local staff contracts and conditions will be simplified within a clear regional structure. Privatisation of ancillary services will cease and be reversed, so that all NHS workers of a particular grade can expect the same terms within the same region. Collective bargaining arrangements will be strengthened and honoured. A particularly urgent commitment will be to reduce all staff working hours to a maximum in line with the Working Time Directive.
The Green Party deplores the poaching of healthcare professionals from other less privileged countries. Conditions and wages of nurses, and also doctors, need to rise to encourage more British people to train as nurses and doctors. The NHS will not be allowed proactively to recruit non-British healthcare staff overseas by any means, including overseas advertising or direct approaches. The Green Party will actively seek ways of ensuring that healthcare skills are shared between countries including by offering exchange opportunities to students and qualified staff.
General Practices are predominantly run as small businesses and therefore are insufficiently accountable to local people and government. The Green Party will introduce a new model of General Practice to be adopted when new practices open. This new model will be based on practices being patient-owned co-operatives. Patients will be able to have a strong voice in their primary care provision and staff in the practices will be directly accountable to their patients. Primary care co-ops will be open to all potential patients to join and we will ensure that there are appropriate safeguards around membership, governance and provision.
Transatlantic Trade and Investment Partnership
The Green Party believes that the Transatlantic Trade and Investment Partnership (TTIP), which aims at removing the regulatory differences between the US and the EU, is an assault on democracy. It would likely lead to the weakening of EU social and environmental legislation and ensure that new European legislation does not stand in the way of corporate interests. The Green Party will make protection of the environment, workers’ rights, health (including the NHS) and animal welfare from TTIP a campaign issue.
For more details see http://policy.greenparty.org.uk/he.html