Conservative Policy Forum: Health & Social Care – BCiP Response 3/2018

Group name: British Conservatives in Paris

1.  How has your experience of access and care in the NHS changed in recent years?  
One of our members with recent direct experience of hospital services was full of praise for response time & general professionalism encountered.
Another suggested discharge of patients from hospital could take place too quickly.

2. Given the profoundly different landscape of 21st-century healthcare compared to when the NHS was founded 70 years ago, what should the role of the state be?
“The state role should be to ensure a better synergy between the public and private sector, encouraging the development of a deeper and, therefore, cheaper complementary insurance market for private healthcare to enable more companies and individuals to choose this option.”
A major overhaul in the way the NHS is funded is necessary.

3. What more could be done to support individuals and families to take more control of their own health and wellbeing? How might we shift from a system based on treatment to prevention of disease?
Health issues should be included in the curriculum of all pupils.
Parents should be encouraged to bring up their offspring with a healthy lifestyle (cf diet, sports).
One member: families should be required to “invest more in the care of the elderly”.
Public awareness of health issues should be heightened through recourse to various media as well as through actions in hospitals, schools, employers (eg distribution of leaflets).

4. How might we help people to use the NHS responsibly, e.g. not attending A&E for issues that a GP or pharmacy can clearly resolve? How might we reduce the costs associated with the 1-in-15 patients who miss their appointments?
“Larger and combined GP and pharmacy practices could allow 7 days a week working, and more opportunity for people to secure appointments rather than being forced to go to A & E.”
“Operating an on-line appointments service would allow maintenance of a blacklist for serial cases of missing appointments and introduction of a refundable financial penalty when booking future appointments.”
Raise awareness of the sort of problems that can be resolved through a GP or pharmacy.
One member: make the first “port of call” an online advisory system.

5. How could we further raise awareness and tackle the stigma associated with mental ill health?
Inform the public including re recent developments in practice & understanding (eg re depression) – including through television, social media, educational institutions, even employers.
… also re the (significant) numbers of people involved; and cases of successful treatment/overcoming of problems.

6. What kinds of NHS services do you think could be put online/digital rather than traditional face-to-face?
Initial sorting exercises?
Appointments, repeat subscriptions?
One member expressed reservations about recourse to the digital – out of a concern that failures of communication on important items might occur.

7. What more could the NHS do to encourage people to want to work for it? What sorts of practices do you associate with really good employers in other sectors, which the NHS should adopt?
Try to provide for flexible & reasonable working hours at least for those for whom these considerations are important.
Work to develop a professional ethos including through encouragement of suggestions, & through better remuneration (not to mention ensuring professional conduct & due mutual respect eg between doctors & nurses).
Address practical concerns such as the cost of transport/parking/accommodation as related to the location of the hospital etc in question.

8. How might we continue to fund sustainably a growing NHS?
A separate & clearly NHS-labelled tax
More recourse to private insurance complementary coverage: reference to the French model would be instructive & helpful in this regard.

9. As the NHS budget grows, what health services or treatment areas should be prioritised?
More time should be devoted to initial point of entry visits to the NHS to ensure issues are identified up front.
To provide relief to the system, tasks which can properly be assigned to nurses/social care workers should be so allocated.
Preventive medicine should be developed & accentuated.

10. What could be done to raise awareness among working age adults about the risks of future care costs? How should we fund the need for increased social care?
An explicit separate (“ring-fenced”) tax would help.
Similarly a local “ring-fenced” tax for social care would draw attention to these issues.

11. What should be the guiding principles for Conservatives in making these decisions?
Be lucid & rigorous: eg benchmark against other comparable countries/systems.
Respect for the inherent dignity & worth of each human bein.g
Accessibility.
Openness to innovation.
Openness to a role for non-state actors.

12. Is there any other question you think should have been asked or observation you would like to make?
More in the way of comparisons to other countries would have been both interesting & illuminating.
The importance of cross-party thinking/consensus-building on such fundamental issues would have deserved some attention.
Pharmaceutical product pricing issues could have usefully been addressed.
The needs of certain specific groups (eg the homeless) might also have been addressed.

FEEDBACK ON PAPER

What did you find useful?
The international overall ranking chart
Indications on the evolution of the health situation (eg improvements wrt youth smoking, drinking, unwanted pregnancies).

What did you not find helpful?
Overly broad and optimistic policy declamations not particularly helpful in coming to grips with the issues.

Do you have any suggestions for how we might improve future briefings?
This brief was of good quality.
More and more in-depth comparisons with other countries –elsewhere in Europe, elsewhere in the “Anglosphere” or anywhere else– would be both stimulating and relevant from a policy assessment perspective – & this would apply for many different subjects.

CPF 18-3 Response – BCiP

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