By Deborah Harrington
Labour’s Mission driven government: building an NHS fit for the future outlines precisely the kind of population health management approach which is at the heart of US Integrated Care.
It says it’s a ‘new’ kind of reform. It’s nothing of the kind. It’s already been set out by NHS England. They even have a Population Health Management Academy. It uses exactly the same language as the Tories, describing the NHS as designed ‘for 1948’ and not being fit for modern medicine. It entirely ignores decades of innovation and change. This is the argument consistently used for hospital closures and increasing the involvement of corporate digital giants.
To look at some of the detail in the Starmer/Streeting plan: “To make our health and care services sustainable, we must deliver a ‘prevention first’ revolution. In our reinvented system, patients will get rapid access to a seamless, personalised service from a multidisciplinary team of professionals, who care for them at home where possible.” (“sustainable” means keeping costs down).
Anyone can see that the current system is buckling from an existing absence of staff. Hospitals are designed to allow relatively low staffing levels to cover a large number of patients by having them in one place. ‘Multidisciplinary teams of professionals’ caring for you at home needs far higher staffing levels.
“People will have the power and information to stay well, supported by a proactive government that recognises the value of good health.” This is echoing neoliberal values about ‘personal responsibility’ to stay well. It’s not ‘power and information’ people need it’s good education, decent housing, full employment at liveable wages, a social security system that actually offers security. We know this stuff. No one needs to ‘reinvent’ it. They just need the political will to commit to implementing it.
Meaningless verbiage instead of concrete answers
“And care will be powered by groundbreaking technology, like the genomics revolution – so we are working towards a system where every baby can be screened for rare diseases or predisposition to the deadliest diseases, allowing the NHS to work out who is most at risk and to intervene before they become unwell.
“The more we know about our risk of future disease, the more important the NHS’s principle of universal coverage becomes. A system where we share those risks as a society, where health is promoted and protected, where free at the point of use is the foundation, is the only system that can be fit for the future. That is our NHS.”
Our health data is already being given away to US corporations. It is an immeasurably valuable resource. In population health management data is used to identify people with the potential to be expensive patients in the future.
It’s really mentally draining to try to unravel stuff like this: “The more we know about our risk of future disease, the more important the NHS’s principle of universal coverage becomes. A system where we share those risks as a society, where health is promoted and protected, where free at the point of use is the foundation, is the only system that can be fit for the future” – because it just doesn’t actually mean anything.
Or at least it doesn’t really mean anything different from the principles of 1948, but they can’t and won’t say that. Nor will they implement the reconstruction and maintenance of the Welfare State which would actually turn rhetoric into substance. Instead, they will plough on with dismantling what could and should be the most cost effective and efficient system in the world.
