This article is part of a series covering the Fabian New Year Conference , written by Dave Baldock and Sue Watson

Panel consisted of: – Abena Oppong-Asare MP, Shadow Minister for Mental Health.

                                 Anita Charlesworth CBE, Director of Research and the REAL Centre at the Health Foundation.

                                 Dr Sonia Adesara, NHS Doctor and Activist

                                 Andrew Harrop, General Secretary of the Fabian Society.

                                 Chair: Cathleen Clarke Business Manager at Labour List.

Abena opened the session by stating previously the Fabians made it clear poverty is not a choice and called for socialized medicine and a national service. Fabians drafted the NHS Bill in 1945 that led the Labour Government of Attlee, to introducing our NHS. A medical service based on clinical need not payment, a medical service free at the point of delivery and this needs to be fought for. However, she acknowledged the NHS needs radical reform with prevention as the watchword.

The Wanless report details how prevention not only would increase the health outcomes for individuals/groups, but would potentially save the NHS significant amounts of money and add to the economy with less days lost to sickness. An additional factor could be satisfaction with the NHS. 2001-2010 it stood at 70%, today it stands at 29%.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC194071

Approximately 1million people have died prematurely in the last decade due to poverty, covid and the inequality that poverty brings. Abena informed the meeting Labour will address health inequalities and look to increase life expectancy. This will feature in their manifesto as in 1945.

A further issue was why Labour will introduce supervised teeth brushing at school, with one of the benefits being fewer hospital appointments for children to have teeth removed. This is a prevention better than cure initiative.

Mental health is now a national emergency. The Fabians understand health cannot be treated in isolation from all the impacts on and of society. Labour has asked Luciana Berger to ensure mental health is included in all policies. Labour will cut waiting lists for mental health support, introduce specialist support in schools and develop mental health hubs to provide advice and support.

Abena referenced the Black report in that poverty is the chief cause of disease. The example of black maternal health outcomes, particularly in childbirth, where mortality is higher than other ethnic groups. Labour plan on recruiting more midwives and health care workers, along with reviewing training.

https://pubmed.ncbi.nlm.nih.gov/7118327

Andrew informed the meeting Wes Streeting, Shadow Health and Social Care minister, asked the Fabians to review the care sector and think through a National Care Service. Issues explored include a new national workforce settlement, a national service type approach with. national responsibilities and a responsibility for finance and standards within the care workforce. It was felt the geographic disparity had to be ended and a move from a market-based fragmentary system to a National Care Service would help here. It should be for everyone and not as currently with the public sector ‘holding the hands’ of those that need care. It was also recognised a long-term financial commitment would be needed.

Anita shared concerns around rising obesity levels and the rise of those with mental health needs. She also pointed out how women’s health is falling in inner cities. The importance of prevention in improving the health of the nation along with potential positive impacts for the NHS explored. However, Anita pointed out spending on prevention has been cut by a quarter over the last 10years. She was clear that prevention is a form of investment and that it may be necessary to legislate for a spending commitment. Anita felt spending on primary care is critical as an economic, social justice and equality issue. Reviewing this area of spending was seen as a priority as 2.5million more are living with chronic illnesses in the UK. The need to modernize the NHS by investing in the buildings, facilities and new technologies would further drive improvements in the NHS.

Sonia pointed out the UK has one of the highest asthma mortality rates in the young in Europe. Poverty, damp housing and malnourishment can lead to a young person being 2 ½ times more likely to be admitted with asthma to hospital. She called for Labour to be bold and look at legislation to improve the social drivers of health inequality She called on Labour to make hope possible rather than despair a reality.

Points from the floor included the need for wellbeing to run cross government and through all policies. Labour looking at deals struck with pharmaceutical companies to maximize best deals. Look at Sure Start type provisions as part of preventative work linked to a child health action plan that has tangible positive outcomes. The importance of resilience within the NHS is seen as part of eradicating health inequalities.

SW