Maidstone Weald Labour Party

Since it's institution in 1948 the NHS has faced many challenges. Aneurin Bevan the Labour Health Secretary of the time said at the launch of the service that " We shall never have all we need. Expectations will always exceed capacity. The service must always be changing, growing and improving..."

How though can we alter the status quo that I have observed as a doctor having worked both in the community and in the secondary care hospital system?
I would propose that we move from a Government lead model to an NHS board. This would have the aim at looking at a more longer term approach to the NHS than that of trying to win the next election and the obvious pressures on ones jobs that this system delivers. This is really a work in progress and any comments would be much welcomed in a debate about healthcare.

There are two structures that I would propose:

1. A group that consists of the major representatives of those within the NHS structure. This would include (but not exclusively please feel free to suggest others) the heads of the following bodies:

British Medical Association, Unison, A patient advocate, Chief Medical Officer, NHS Chief Executive, the Head of the Accountancy firm, NHS Audit representative, the Secretary of State for Health, a prescribing expert.

A number of questions though would arise from this. A number of these positions are appointed by the Government so it could not be independent. Anyone that has also sat through meetings on committees would also though be aware that decision making could be a difficult process as rightly each group would be fighting the corner of it's members. Could this therefore be a working group, but again a major complaint is that the NHS already has too many levels of bureaucracy. Therefore I would propose a far more radical system.

2. The Supreme Court model - this would follow the model for the NHS that the Supreme Court has followed for judicial matters in many countries . It would consist of one chairperson and eight associates. The appointment of the members would be made initially by the Houses of Commons to be approved by the House of Lords and this would therefore be a cross party decision. The appointments would be made until retirement of the committee members. The Government of the time would then nominate a new member that would need to be approved by both Houses. This would therefore lead to a balanced committee given the vetoing powers of the Houses. Within this structure each position would have a defined expertise similar to those proposed for a working group, e.g. a patient advocate, a nursing expert, a physicians expert. The panel itself would be accountable to both Houses and they would have powers to take further action if needed.

At the Labour Party Conference Bill Clinton said that we needed to be in the "ideas game" and that we are the party of change. In 1946 under a Labour Government we introduced the National Health Service Act and now we should not be scared of it changing, growing and improving.