Beyond the Bill

Below is the text of an article which was first published here on the Progress website. 

Ed Miliband has made clear that a key reason to vote Labour in local elections this May is because Labour councillors will protect local NHS services. This is a real opportunity for us to demonstrate Labour values in practice.

Like local Labour parties across the country, we in Tower Hamlets campaigned hard against the health and social care bill. We were more unusual in that our GPs also spoke out against the bill, with the chair of our clinical commissioning group Sam Everington writing to David Cameron to express the group’s opposition to the legislation. Having united in opposition to the bill, we are now finding a way through this new environment. 

One of the first local challenges was to keep as much as possible of the well-respected expertise of the Tower Hamlets PCT. The East London and the City cluster commissioning support organisation retains strong Tower Hamlets links, and our GPs are working together, with a democratic structure for the CCG and a determination to maintain a public service ethos in commissioning.  This structure is more fragile than the previous PCT and trust and collaboration across Hackney, Newham, Tower Hamlets and the City will be necessary to maintain it successfully. 

Trust and collaboration will also now be needed to fill the gaps left as the Tories dismantle our local NHS institutions. One example of this is in Bart’s and the London NHS Trust, where consultants are moving beyond the limits of their formal roles in hospitals to take a lead in tackling public health issues across the borough. 

The health and wellbeing boards, hosted by local authorities with membership from local government, acute trusts and GPs, are the formal structure around which new relationships will develop. One of their first major tasks will be to oversee the move of public health functions into local government. 

Tower Hamlets’ educational attainment rose dramatically over the period of Labour government, as increases in investment were matched by increases in aspiration and commitment from families and schools. Our children are brilliant and so are our schools – we should be among the best in the country. One reason we’re not is poor health and lifestyle. If local councillors, parents and governors had school by school health outcome statistics and some good examples of where healthy meals, exercise, early immunisation and other interventions had had an impact, we might start to see change. The Marmot review tells us that tackling inequalities doesn’t mean putting all resource where there is the greatest need – improving health outcomes in all our schools is the best way of tackling the worst symptoms of poverty and housing overcrowding. 

This period of change is an opportunity to inject greater local democracy into health structures. The late amendments to the health and social care bill, weakening the role of HealthWatch, are a major concern, and it is down to local authorities to commission in a way that supports a strong coherent local voice. Our CCG is organised democratically, and councillors will be organising democratically to influence its decisions. 

Cuts and the unnecessary top-down reorganisation imposed by David Cameron mean that we are having to spend significant time and energy on steadying structures which would be better spent improving services. The challenge now is how we as councillors work with GPs and health professionals to deliver a stronger, more responsive health service. In Tower Hamlets we have an excellent starting point – our GPs and other health professionals choose to continue to base their work on cooperation, goodwill and equality, despite this Tory-led government.

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