I watched the Chancellors’ debate with interest last night. All three missed opportunities for killer blows – I guess everyone was nervous.
My favourite question was from an A&E doctor who asked which of the three could guarantee the maintenance of front-line services in his department. Cue lots of assurances from both the Tories and Labour about protecting the NHS at all costs.
However they all missed the opportunity to provide a much more progressive answer to that question. That is: of course we want to protect front-line hospital services for those who need them, but the real opportunity in health care reform must be to keep as many people out of acute care as possible and seek opportunities through a greater use of the third sector to further improve primary and community care. Services should be re-designed and re-prioritised so that fewer and fewer people end up in A&E, resulting in better more tailored services particularly for those with long term conditions, allowing people to stay in their homes, and delivering savings to the stretched public purse.
Consider the opportunities. Someone with diabetes can quite easily end up in A&E if they have not been able to administer their own medication. However support from a third sector organisation at a modest cost could prevent that admission and save the huge costs associated, as well as avoid the suffering for that individual.
Our recent manifesto published with sector partners showed the example of Age Concern South Staffordshire who run a support service for elderly people who have been discharged from hospital, supporting them in those first few vulnerable days. An investment of £0.5 million has saved over 8,000 hospital bed days at a cost of almost £2.5 million.
There are countless other examples but this debate is something of a taboo with the general public and particular with the press. The “reconfiguring” or closing on acute services is always met with great resistance from local campaigners, even when the money saved will be used on better primary care or where those hospitals have been deemed unsafe.
As third sector leaders it is time for us to lead on this debate. We must be bold and advocate for a better balance between acute and primary and community care, with a significantly bigger role for the third sector. This can dramatically improve outcomes for patients, but is can also save huge amounts of public money at the time when those savings are most needed.
This means some hospitals closing. We should celebrate this as a success for the third sector and those we exist to support. After all, no one actually wants to be in a hospital if they don't have to be. We have the potential to harness the voices of our service users to help lead the debate about how we reform health services. Image the power of thousands of diabetes suffers hailing the closure of a hospital because they are receiving better primary care. It would certainly be harder to resist than NHS managers talking about efficiencies.
This potential for reform is why our victory over Burnham’s disastrous preferred provider policy is so important. The third sector has so much to bring and we must be allowed the opportunity to do so. Rest assured there are other significant vested interests who will continue to fight against such reform but it’s time for the sector to champion this change. Service users know what they want and third sector leaders are ideally placed to help to convey that message.