DeHavilland has produced a health round-up from this week’s Labour Party conference.
- The mood throughout the conference was buoyant and busy, with health policy fringe events regularly at full capacity.
- Shadow Health and Social Care Secretary Wes Streeting was ideologically aligned with the rest of the front bench, embracing centre-left rhetoric and policy proposals. He repeatedly stressed the interplay between a healthy economy and a healthy population.
- A slow, steady and stable approach was promised by Mr Streeting, who stated his long-term vision would materialise over a decade, with rapid progress unrealistic.
- Mr Streeting outlined three shifts that would comprise his reform agenda: From hospitals to community care, from analogue to digital, and from treatment to prevention.
- Sector leaders welcomed these suggestions but pressed the shadow Secretary on funding and investment, which is widely considered necessary should the reforms be realised.
- A preventative approach to public health was backed by politicians and stakeholders from the private, voluntary and public sectors. So far, relevant policies pertain to smoking, vaping, obesity and dentistry, with a more comprehensive strategy yet to be seen.
Confidence without clarity
Imbued with optimism, self-assuredness and a dash of smugness, Labour’s 2023 party conference was a thinly veiled victory parade not just over the Conservatives, but the left-leaning wings of its own party.
Shadow Health and Social Care Secretary Wes Streeting occasionally let it slip that he “will”, rather than the conditional “would”, deliver for the NHS, which required he hasten “…if we win the next general election”. Sector leaders, policy wonks and other fringe event panellists also muttered implications that Labour is preparing for Government in the safe assumption that it will form one.
The simple and assertive conference slogan, “Britain First”, encapsulates this confidence but mirrors the absence of specifics behind much of Labour’s policy proposals. Every fringe event raised the question as to how measures will be funded without higher taxes. So far, the scrapping of the non-domiciled tax status and the introduction of VAT on private school fees appear to be doing a lot of the heavy lifting.
Growth and reform over investment
A thoroughly briefed and ideologically aligned front bench tethered their departmental policies to the national economic growth and fiscal responsibility promised by shadow Chancellor Rachel Reeves.
Mr Streeting argued that health policy is inextricable from economic growth and emphasised it would be woven through every department under a Labour government, with a mission delivery board holding Ministers to account. He pledged to improve the poor relationship between the Treasury, the Department for Health and Social Care and NHS England.
Repeatedly clarifying that Labour would not fund a “broken system”, Mr Streeting stressed that reform would be prioritised over investment. A victim of heavy criticism, the NHS was accused of inefficiency, waste and unnecessary cost. By targeting “wasted resources”, Mr Streeting declined to jettison the austerity rhetoric of the 2010s.
The three shifts
Instead, three shifts defined Mr Streeting’s “exciting and bold” reform agenda: From hospitals to community care, from analogue to digital, and from treatment to prevention.
Firstly, there was consensus that care should increasingly be delivered within communities and through primary care services. Conference delegates and speakers emphasised community pharmacies, GPs, social prescribing initiatives, local government, and improvements to the NHS hospital estate as key to this transition.
Secondly, digital and technological innovation made Mr Streeting positively giddy. He was careful to pledge basic IT delivery (working computers and systems that “talk to each other”) as well as more ambitious innovations such as genomics, robotic surgery, AI for diagnostics, and the use of patient data to create a “one-stop” app. Sector leaders within the life sciences and pharmaceutical industries welcomed the opportunity to work closely with a Labour government. Others, however, expressed scepticism and urged caution lest portions of the workforce and population be left behind.
Thirdly, “prevention” claimed the top prize for the word of the conference. Within the context of an ageing population, increasing multimorbidity and health inequalities associated with austerity and the cost of living crisis, there was a strong consensus that preventative approaches to public health are vital.
Following Prime Minister Rishi Sunak’s announcement of his aim to adopt a New Zealand smoking strategy, Mr Streeting reminded attendees that he had initially proposed the policy and said Labour would support it. Furthermore, he promised to “come down like a tonne of bricks” on the vaping industry for addicting a generation of children to nicotine. He pledged to investigate where and how vapes are being sold and ensure the industry “cleaned up their act”, deploying state regulation if necessary.
On obesity, he criticised the sugar tax and said he would prioritise alternative legislation during a cost of living crisis, such as banning junk food advertising targeted at children. Mr Streeting also reiterated plans to introduce supervised toothbrushing in schools and argued that shadow Education Secretary Bridget Phillipson’s breakfast clubs would provide children with a nutritious start to the day.
Generally, Labour’s “mission-driven” approach was praised by sector leaders. NHS Confederation CEO Matthew Taylor implied that this underlying justification made Labour’s health policy more comprehensive than the Conservatives’.
Shadow Minister for Social Care Andrew Gwynne also vowed to “make England a Marmot nation” that prioritises prevention, tackles health inequalities and delivers care “from the cradle to the grave”. Regarding social care, Mr Gwynne said he had been tasked with delivering a National Care Service within a decade and that this would include national terms and conditions delivered on the local level in collaboration with local leaders. In his Conference Hall speech, Mr Streeting announced he would work with shadow Levelling Up Secretary Angela Rayner to deliver a new deal for care workers.
New New Labour?
Labour’s political identity was clear. References to New Labour’s success littered Shadow Cabinet speeches. Mr Streeting explicitly shared how he took inspiration from the 1997 strategy to “under-promise and over-deliver”. He repeatedly emphasised that his was a long-term vision and not to expect immediate progress.
Meanwhile, Mr Streeting outlined how he would drive NHS innovation by working with the private sector, universities and charities. Eager questions came from social impact investors, pharmaceutical companies and charity representatives jostling for support, rather than trade unionists and activists.
When pressed about New Labour-era internal competition and targets, Mr Streeting claimed he was more inclined toward integration and collaboration. Details of this collaboration were not shared, aside from enabling private companies to roll out their products throughout the NHS, as opposed to implementing them trust by trust. Despite Mr Streeting vowing faithfulness to the founding NHS principles, such suggestions are likely to raise alarm amongst those concerned with backdoor privatisation.
Mr Streeting did, however, occasionally engage in some subtle code-switching. Speaking to Andrew Marr at a Policy Exchange fringe event, he boasted of his “centrist” principles. A couple of hours earlier, however, he expressed support for and negotiation with low-paid striking healthcare workers when on a panel with the BMA and RCN. And at an event hosted by the progressive think tank IPPR, he keenly focused on health inequalities and the social determinants of poor health.
Ultimately, it is no surprise that health policy was high on the agenda within the context of unprecedented industrial action, record waiting times, waiting lists and patient dissatisfaction, as well as wider health concerns contoured by poverty and inequality. Buoyed by poll leads of 21%, Wes Streeting appeared energetic and ambitious. His reform agenda was welcomed by those across the health and social care sector. But crucial specifics, notably around funding, must be outlined and scrutinised if dreams of an NHS “fit for the future” are to be a reality.