State-Controlled, Free Health Care For All

When you are sick and need treatment, that is no time to be filling-out forms, discussing levels of cover and worrying about a possible massive future bill, yet that is the reality of the much-favoured insurance-based health care. For decades, Britons have enjoyed the security of professional health care that is guaranteed to be free no matter how much treatment is required and we will continue that tradition. State control of health care keeps all aspects of health care including the important details of waiting-lists, available treatments, etc both fair and democratically accountable to the public.

LONG-TERM AIM : All Major Infrastructure ( e.g. hospital buildings, expensive equipment) To Be Publicly-Owned

PFI contracts for hospital builds have been a very poor deal for the taxpayer, with payments for infrastructure costs over the very long term (30-years) of the contracts amounting to several times the original build-cost. To avoid this rip-off and to enable failing companies to be quickly replaced without the new company incurring prohibitive initial capital costs, our long-term goal is to take all major hospitals and health service infrastructure, including key items of expensive equipment (e.g. MRI and CAT scanners, etc) into state ownership.

All Existing Health Care Contracts and PFI Contracts Reviewed and Replaced With Short-term 2-year Contracts

We will not allow agreements made by previous governments to stand when those agreements have awarded a company unchallenged 30-year provision of services at unreasonably expensive rates. We will review all existing contracts for value for money and replace all long-term contracts running for short-term 2 year periods — from election-day to mid-term, and from mid-term to next election day. This would keep the service-providers constantly on their toes and enable a failing service-provider to be quickly replaced. And with contract start and finish dates in sync with the election calendar, a new administration would immediately be able to begin reshaping services and fulfilling its manifesto commitments.

The long-term aim is for all key national infrastructure to be owned by the state. In the short to medium-term the expense of this is prohibitive, so the private ownership of national infrastructure will be honoured for the lifetime of existing infrastructure assets, but with all existing PFI contracts renegotiated, such that each company is limited to only a moderate profit over the lifetime of their investment. Also, although the private company will retain ownership of their physical infrastructure asset, all peripheral services will be removed from their control and put out to tender by other private companies on short 2-year contracts.

All Existing Private General Hospitals and Health Care Providers Brought Within The State System

The experience of recent years has shown that growth of the private sector usually leads to staff shortages within the mainstream public sector services — as qualified doctors and nurses are quite understandably attracted to the higher pay and better conditions offered by the private sector. The NHS currently pays over the odds for agency nurses for precisely this reason.

We will therefore bring all private general health care providers within the state system either by compulsory purchase of their assets or by requiring the acceptance of NHS patients alone (for general medical treatments). Although certain to be unpopular within the medical professionals currently financially benefiting most from the present arrangements (indirectly at taxpayers expense), long-term this radical reform will spare all caring and qualified professionals the heart-rending life-long choice of whether to work in private sector for the money or public sector for 'the common good' and wider medical experience, making for a more settled career path for medical professionals as well as better value for the taxpayer..

All Health Services Privately Provided

— Whilst the service should be free to users and fully publicly controlled and accountable, health care services themselves should all be provided by private companies. There is simply no substitute for private enterprise as a galvanising naturally-motivating way of raising standards across the board. Apart from requiring minimum standards we will operate very much a hands-off approach, allowing private hospitals, private GPs surgeries and private health care centres to organise their internal structures, funding and staffing as they see fit. This will see an end to the current crazy internal market approach that requires artificial pricing of services and suffers from severe institution-overload, with Primary Care Trusts, Strategic Health Authorities and all the rest it is now so complicated even those working within the health service struggle to understand it.

A simple 'funding follows the patient' system will be put into effect, where the government pays each health service provider on the basis of the number and type of treatments provided to patients, with popular services allowed to expand, and unpopular services attracting insufficient patients allowed to fail. In keeping with a commitment to keeping markets competitive and not dominated by a few overly large companies, legislation will ensure that no single company has more than 5% of the national health care market in any area of provision.

To enable even very small health care companies to successfully win health care contracts, individual wards and services, such as porterage, laundry or meals provision will be available as separate contracts. It will also be made a simple matter for a small group of like-minded professionals to set-up their own GP surgery or health centre and begin offering services to the public — enabling a rapid expansion of services in areas of shortage and empowering health professionals to fulfil a dream of starting and running their own business.

Non-Essential Cosmetic Surgery To Continue To Be Available At Specialist Private Hospitals and Clinics

Patients wanting cosmetic surgery of a kind not normally covered by the NHS should still be able to access treatment at specialist hospitals and clinics on a private paying basis. However, these clinics should not be allowed to perform any other medical or sugical procedures at all (to avoid any inevitable sector growth and the re-emergence of an unfair 2-tier system for essential medical and health services).

Places On Waiting Lists To Be Allocated Strictly On A Needs Basis

We will bring forward proposals that will see an end to the 2-tier health system that we currently have — with the better-off, after initial diagnosis, able to queue-jump to receive treatment. This inequality is unacceptable. Responsible, democratic government should seek to create a united country, where everyone is treated fairly. Legislation should require strict needs-based waiting lists — with no advantage from wealth and no disadvantage through being overweight or a smoker/drinker etc.

All Health Services Subject To A Strict Inspection Regime Controlled By A Single Health Inspectorate

All hospitals and clinics should be subject to a strict and unannounced inspection regime. Inspectors would have the power to impose heavy fines, alterations to service and, ultimately, termination of contract for any service-provider consistently failing to meet minimum standards.

An End To The Postcode Lottery

The government should end the divisive and unfair postcode lottery that currently means some treatments are only available in certain parts of the country. The government should organise the health service as the national service it is supposed to be and ensure uniformity of drug and treatment availability across the country.

New Patients' Rights — The Right To A Second Opinion and Flexible Treatment Options

Doctors are amongst the most capable people in the whole of society, yet they are human and make mistakes like the rest of us. A mistake in either diagnosis or treatment can have serious consequences and people shouldn't have to argue and fight the system just to have genuine concerns allayed over misdiagnosis or inappropriate treatment options at a time when they are already ill. Legislation should therefore grant patients the automatic right to a second opinion from a comparably qualified doctor who is completely unconnected to the original doctor and surgery or hospital — for more minor conditions and for dental treatments/diagnosis walk-in 2nd-opinion clinics could be trialled.

Patients should also be allowed a more proactive role in their treatment options — too often patients are made to undergo unpleasant only semi-necessary diagnostic tests or treatments known to be of little clinical benefit for a high proportion of patients. This may be either because the doctor or their employing hospital is guarding against possible future litigation for professional negligence by doing absolutely everything to diagnose correctly and treat fully, or sometimes because a consultant is conducting their own little experiment with a relatively new treatment and is just dabbling to see whether it works in certain cases. Either way, when discomfort or negative side-effects are inflicted upon patients, patients have the fundamental right to be fully informed about what is taking place and given the choice of whether or not to allow the professional to proceed with the procedure — if necessary, signing a disclaimer explicitly stating that they have decided to forgo the procedure against the professional's advice.

Patients Allowed To Choose The Gender of Those Providing Intimate Care

For many women, receiving care procedures of an intimate nature from a male carer — no matter what the personal qualities of the male carer and no matter how professional their approach — can be deeply distressing. And this at a time of great emotional vulnerability. Today, in this era of 'creative modern lifestyles' — and the inevitable impact this has on the expression of a 'personal vibe' — a not insignificant proportion of male patients too, would probably much prefer to only receive intimate care from a member of the opposite sex. We will therefore look to progressively implement changes to recruitment, care delivery and staffing schedules within the health sector to enable this increased quality of care to be offered to everyone that wants it.

New Investigative Branch of Medicine Established

It is sadly a commonplace of patient experience that to suffer with symptoms, feelings, sensations or reactions that are not readily recognised by doctors or consultants is often to have that very real suffering belittled and be dismissed as some kind of crank with fanciful tales of imaginary woes. This dismissive attitude by care professionals seems to afflict most branches of medicine and is often just as widespread amongst consultants, who, in theory, are supposed to take a broader medical view.

Rather than attempt to change attitudes across the entire medical profession, we will provide for the establishment of a new investigative branch within medical practise—a branch that will naturally attract those professionals willing and able to properly listen to their patients and explore their odd experiences and unusual combination of symptoms to truly endeavour to identify any obscure underlying causes. It is hoped that such cases would also quite naturally provide both an early warning system for previously unidentified problems with current treatments and a ready-made set of stimulating and practical problems for further potentially fruitful investigation by medial research teams.

Fundamental Review of Intrusive Diagnostic Tests, Treatments and Surgical Procedures

In consultation with medical professional bodies we will also conduct a root and branch review of all standard diagnostic tests, treatments and surgical procedures to try and identify less intrusive ways of diagnosing and treating illness. For e.g. many men die of testicular cancer each year through delaying a visit to the doctor through concern about all the embarrassment and intrusion involved, and many patients perhaps die from bowel cancer due to similar concerns. And diagnostically, in the 21st century is their really no better way of diagnosing many ailments for men than the 'rubber glove' treatment — repeated several times as the hapless patient is passed from GP to consultant to consultant's side-kick. And why are doctors (and opticians) still all-but 'snogging' patients just to view the back of the eye — when many people find this deeply intrusive and inexpensive optical screens make such intrusions completely unnecessary. We will conduct a thorough review and require changes where it is medically possible to do so.

We will also conduct a thorough review of surgical procedures that many believe to be overused by the medical profession — performed perhaps as a form of medical 'defensive paperwork' against potential lawsuits (for e.g. hysterectomies and caesarean section). If changes to surgeons' potential legal liabilities are needed to make this possible, then changes to the law will be made.

Drugs Procurement — Drugs Companies Confronted Over High Prices and Only Treatments With Proof Of Definite, Significant Effectiveness Continued

The price of many drugs, particularly the newer treatments, is in many cases far too high (e.g. DDT substitute too expensive). This means the NHS paying a fortune in drugs bills and means that cures that are available physically, being unavailable to the often desperately ill people that need them, simply because of the marketing policies and, frankly, greed of the drugs companies. This situation is not acceptable.

Whilst drugs companies need to recoup their considerable investment on the long-term expenses associated with the development of new drugs, due to the vast quantities needed by the NHS they will still be able to make £'000,000s profit when supplying drugs at much-reduced prices. We will therefore confront the major drug companies with an ultimatum : either charge the NHS a fair price or lose the right to supply the NHS with so much as an aspirin for the next 4 years. If the drugs companies refuse to co-operate then we will consider sourcing from license-infringing and generic-product suppliers from across the globe. The drugs bill MUST be reduced. New, effective treatments must be made available to patients as soon as they are available.

We will also conduct a thorough review of all currently prescribed medications — many of which have dubious effectiveness and potentially very significant side-effects. In the absence of very clear evidence of significant and definite effectiveness (from INDEPENDENT medical research, not by the drugs manufacturers themselves!!), the presumption will be that the 'treatment' will be stopped.

New Medical Devices and Treatments Assessed By An Independent Branch of The NHS

The current widespread practise of NHS Drs and surgeons being paid by medical supply companies to trial and use their latest (often largely untested) products must be ended. If a new product has something to offer then it must establish the fact from 3-years clinical trials and by passing rigorous screening and assessment by an independent team of medical professionals.

Intrusive Questioning Abolished

The obligatory avalanche of intrusive questions encountered when seeking to access many health services must be made a thing of the past — for e.g. hospitals asking about people's religion when just attending as a day-patient for minor surgery and new patients registering with GPs practices being presented with detailed questionnaires about lifestyle issues, such as smoking and drinking habits, exercise etc. Even NHS direct, the extremely useful NHS online advice service, demands a contact name or telephone no. or email address, just to report an error with their website — the government and the NHS need to be made to just plain 'mind their own business'.

Chronic Staff Shortages

At present, it is often a shortage of staff, and not of funds, beds or equipment, that is limiting the provision of health care — beds and entire wards, often recently built, and even MRI scanners worth £'000,000s, often bought thanks to great efforts by League of Friends groups, lie unused across the country.

Merging all private health care with the state-controlled sector would significantly reduce the loss of qualified staff, but government should also try and address the shortage by allowing for rolling, modular qualification for doctors and nurses and permitting a reduced period of training before qualification. We will also consult with professional medical bodies to identify the key frustrations of the jobs and take steps to overcome them where possible. The profile of nursing also needs to be raised in careers literature, presenting it as the invaluable and rewarding career for women that it has always been and as a real and practical alternative to office work.

Prescription Charges — All Prescription Charges Abolished

— These don't raise much money anyway, yet can be quite expensive for less well-off people with long-term conditions. Their abolition will spare Drs, dentists and opticians the need to act as unofficial tax collectors — fiddling about with HC2/HC3 claim forms many times each day — and claimants themselves will be spared the indignity of regularly declaring themselves 'social pariah' in front of large queues of people.

The identity-verification procedure for the collection of prescriptions will also be changed so that people are no longer unnecessarily required to openly and publicly state their name and home address in front of nosey (potentially malicious) hearers.