Access to health services – article for the EU Chinese Journal

It’s Chinese New Year, and I’ve been invited to contribute an article to the Chinese Shadow Parliament’s EU Chinese Journal , on the NHS and access by overseas visitors to health services. The invitation came via Chinese LibDems Chair Merlene Emerson, and is in my capacity as a Parliamentary Candidate, and also as a former Vice-Chair of Hampstead Community Health Council, and a former member of the Islington Health Partnership Board.

The article will appear translated into Chinese – this is the original version.

The NHS is always an important topic in UK elections. We Brits love our NHS and are very proud of it. But when times are tough, some commentators do ask if we should allow immigrants to register with NHS doctors and use the health service.

In my view, talking about overseas migrants placing a stress on the NHS is a dangerous distraction from the real challenges facing our public health services.

Who is entitled to use the NHS? The origins of the welfare state were set up by the Liberal government a hundred years ago, with the first state pension. The benefits then were funded by contributions made by individuals through National Insurance; that principle also applied when the NHS was first set up in the 1940s. However, for decades now, the NHS has actually been funded from general taxation, not only National Insurance. So there is no reason to limit access to health services to people making National Insurance contributions. For example, people paying consumer taxes, including VAT, are also helping fund our NHS, even if they are not British citizens.

In a civilised society, we care for those among us in need, whatever their origin. In a globalised society, we accept that people will travel the world and may need health care wherever they go.

In fact the NHS would collapse tomorrow if migrant workers were to be excluded. Around a third of NHS staff, from consultants to cleaners, were born or trained outside the UK. What hypocrites we would be to say that migrants can help run our NHS services, yet cannot use them!

The real threat to the NHS is not from immigrants. Instead it is from bad policy choices from our own government. In my own area of Islington, north London, the Accident & Emergency unit at our local hospital, the Whittington, is under threat. This is as part of a wider reorganisation of hospital services; the plan is to encourage more patients to be treated at new polyclinics, which will replace traditional family doctors’ surgeries. That is fine for routine minor surgery but not for emergencies. If you have a heart attack at work or an accident in the street, then you need an Accident & Emergency Unit as nearby as possible.

I believe that a busy borough like Islington needs a 24 hour Accident & Emergency unit. If the Whittington is downgraded, local people face travelling further in an emergency. Last week a colleague and I raced to the Whittington and the next nearest hospital, the Royal Free in Hampstead. It took 30 minutes to get to the Whittington, nearly an hour to get to the Royal Free. No wonder our campaign to save the Whittington is so popular.

Meanwhile, elsewhere in Islington, the same NHS managers want to close Finsbury Health Centre. This is one of the original polyclinics, that has served its community well ever since the 1930s. It’s not surprising that local people are angry and confused.

As Liberal Democrats, we support local democratic control of our health services. At the moment, too many decisions are taken in Whitehall, with national targets imposed downwards. We believe that local communities should have more of a say in the priorities for the health services on which they depend.

We also want to protect front-line health services from cuts in this difficult economic climate. Instead, we would prefer to see a reduction in the bureaucracy and target culture; in particular we would abandon the plans for a single national health database, which seems to be more about documenting patients than treating them.

Keeping people out of hospital in the first place or reducing the length and expense of treatment by detecting serious illness sooner is also a priority for us. For example, ensuring that women have regular breast cancer screening and rapid referral where needed, is essential.

The NHS alone cannot guarantee our good health. The whole community, individuals and families have a role to play in promoting better health, through diet and active lifestyles. London has some of the worst air pollution in Europe. One of my campaign priorities is to improve air quality and help tackle respiratory diseases like COPD and asthma. And with many people in the UK suffering from the so-called ‘diseases of affluence’, such as heart disease or alcohol-related illness, we can all learn from the lifestyles of other communities among us.



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