Leadership Platform 6: Nick Clegg writes…

Like everyone, I owe a great debt of gratitude to our NHS. But these days it is struggling – with budget cuts, ward closures and superbugs. People are struggling, too – with cancelled operations, complex bureaucracy, and little sense of control over their own health.

I want an NHS ordinary people take charge of. But during the campaign, lots of people have been asking me exactly what that will mean. So here goes.

First, of course, I will devolve to locally elected people the power to develop the health service their community needs – not the health service Whitehall wants them to have. Local accountability of our health service is a vital first step in breaking it down, to human scale, and making it responsive. But it won’t be enough.

We need to put power back in the hands of nurses, doctors and everyone else who works at the sharp end in our health service – and into the hands of patients, too.

I want to see a bonfire of central targets. But that mustn’t for a second compromise the standards of people’s care. I want British citizens to have a charter of health rights – like citizens of Denmark do – a declaration of what everyone is entitled to. That should include a maximum waiting time, the right to information and confidential advice, the right to a GP and out of hours care and much more.

And we need to give people control over their health every day – not just on polling day. The vastness of the NHS is bewildering. It feels like the system’s in charge, not the people.

That must change. There’s an inspirational project called InControl, where patients in need of long-term social and health care get their own budget, and freedom to spend it how they like. So instead of having carers or therapists allocated by a faceless bureaucrat, they pick and choose what suits them – designing the care they need, instead of getting the care the system says they can have.

These pilot projects show satisfaction goes up, and costs go down, when people are given control in this way.

By putting all people, not just the privileged, in charge of their health care, by making sure they know and can get what they’re entitled to, we can end the unacceptable health inequalities in this country. I’m horrified that a child born in the poorest part of Sheffield, where I’m an MP, will live a full 14 years less than a child born in the wealthiest part.

I will lead the Liberal Democrats to be the champions of the NHS. I will stand up for small hospitals and local clinics and the people who work there. We will not be the defenders of the status quo, but rather believers in giving people the right they deserve to take control of their own health.

I will make the NHS human in scale and responsive to local needs. I want it to become, above all, a People’s Health Service.

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13 Comments

  • dreamingspire 2nd Dec '07 - 7:56pm

    Why does Nick keep talking as if he’s going to be PM in a year? Makes me sick (aagh – he would give me a pot of money to spend on it).

  • I quite agree Charlotte, the way Clegg has lifted these ideas from the Tories proves your point.

    But am I right in thinking there’s no actual policy here? Apart from scrapping targets and returning more control to doctors and nurses (well duh!), what does this return of control to the people actually consist of? I will admit I am not a Lib Dem supporter, but I do like the tone of what Clegg is saying, but there isn’t even the vaguest mustard seed of a policy here is there?

  • Grammar Police 3rd Dec '07 - 8:51am

    Simon, it’s not the leader’s job to dictate policy (unlike Labour and the Tories) – so I’m not surprised that at this stage Nick is setting out the themes of the direction that he’d like to see our health policy go in.

  • Matthew Huntbach 3rd Dec '07 - 12:30pm

    Some thoughts on this:

    What is the difference between say maximum waiting time imposed by a central target and maximum waiting time imposed by a charter of health rights? Is it that in the latter you have to call in a lawyer to get your rights?

    The InCare idea sounds good, and may be appropriate for some. But how many people requiring care are going to be in the position to take on the detailed management this requires – given that many of them will be frail in both mind and body? I rather think most people just want the right care to be provided with the minimum fuss without having to go through a whole lot of “choose your own options” paperwork.

    Life expectancy – this is hyperbole, how can any of us know how long a child born today will live? While there certainly is a link between life expectancy and poverty, I think we need to investigate a little more what these figures actually mean. If life expectancy really means “average age of death of all people currently dying in that locality”, the conclusion drawn here isn’t actually justified.

  • Matthew Huntbach 3rd Dec '07 - 4:11pm

    Joe,

    A Charter of Rights tells you what your entitled to expect. So what? If you’re not getting it, then what? We have had a bonfire of targets which might impose penalties for not meeting entitlements, haven’t we?

    As for life expectancy, is it really that hard to see if “average age of death in location A is X, and average age of death in location B is X+14”, that does NOT mean a child born in location A will live 14 years longer than a child born in location B?

    Consider if B is a place where everyone moves away by the age of 60, while A is a place where people only move to if they are aged over 60. As a consequence, the only people who ever die while living in B are people who die under 60, the only people who ever die while living in A is people who do over 60. If that is how “life expectancy is measured” (and I understand it is), then it does actually mean what one might expect it does, does it?

    I’d like a leader who is numerate enough to realise this.

  • Matthew Huntbach 3rd Dec '07 - 4:12pm

    Make that last but one line “does not”

  • Matthew Huntbach 3rd Dec '07 - 5:29pm

    I didn’t intend what I wrote to be “angry”, I just intended it to be points to think about.

    On the life expectancy thing, I actually agree with the point Nick was making – that the way poverty affects life chances even to the basic issue of its length, is a serious thing we should be concerned about. Nick has said enough things like that now to mean my earlier concerns that he didn’t know/care about poverty and equality issues have partly subsided. However, I think we need to be careful when using statistics, and in this case, to me he spoilt a good point by going on to make an unjustified conclusion. Sorry, the sort of training I have had and my professional work means I think of things like that.

    On the charter and direct payment issues, these have to quite a large extent been the centre of Nick’s campaign. So it is important actually to question what they mean in practice. I don’t think they are wrong things, let alone things to get angry about. I am, however sceptical as to whether they represent quite such a radical change Nick and his close supporters wish.

  • dreamingspire 4th Dec '07 - 12:02am

    Give power to locally elected people? So we get to choose, in that election, between groups of people who we do not trust? Or worse, between groups of people about whom we know that none of them are capable of doing the job? That is not what good management is about – it is first about creating an environment in which people will do it right, something that the public sector, elected or hired or (as with Nick) wanting to be elected, has in matters of public service largely lost track of. Get a grip, please, and work to stop our public sector being the joke of Europe. Having decided not to persuade Vince to stand, lets see Chris doing the job with Vince as his mentor.

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