General Synod: NHS debate

Health and care public inquiry sought

PHOTOGRAPHY BY MARK WOODWARD AND DANIEL EASTON

The Bishop of Carlisle, the Rt Revd James Newcombe, introduces the debate on the sustainability of the NHS

The Bishop of Carlisle, the Rt Revd James Newcombe, introduces the debate on the sustainability of the NHS

THE General Synod has urged the Government to set up a Royal Commission on the UK’s health and social-care needs.

On Monday afternoon, introducing a debate on the long-term sustainability of the National Health Service, the Bishop of Carlisle, the Rt Revd James Newcome, a member of the Lords Select Committee on this theme, said that the Government had issued a response “with which we are entirely happy”.

The committee’s report had gained the impression that “very few people were looking ahead any further than the next election,” and that health had become “something of a political football”. The “simple answers” of more money, less or better management, technological innovation, and an emphasis on prevention were all “necessary and valuable”, though not sufficient.

The report had explored service transformation; a lack of adequate social-care provision; workforce and the need for an “evolution of roles”; funding — “I guess we’re all aware that even after we have left the EU, an extra £350 million per week will not be pouring into the NHS coffers” — innovation; public health; and “combating the culture of short-termism”.

It had made 34 specific recommendations, including a new Office for Health and Care Sustainability; the integration of health and social care into a new Department of Health and Care; “continuing to fund an NHS free at the point of use for everyone through taxation”; restoring funding for public health; and ensuring parity for physical and mental health.

“I haven’t mentioned the theological dimension of this report, basically because it hasn’t really got one. But it easily could have.” He outlined the perspective of every person as made in the image of God.

Dr Nick Land (York) had been medical director of a mental-health provider until recently. The NHS was “a mean of common grace to the people of this nation”. Yet he had had to find £10 million of cuts, against a backdrop of rise in demand for mental-health services of more than 100 per cent. Many staff had been under “significant pressure”; and there had been a struggle to recruit and retrain staff, outside the “golden triangle” of London, Oxford, and Cambridge. He supported the motion, and urged the Church to think about the 40,000 NHS staff in its churches. How could they be given the resilience to give leadership?

PHOTOGRAPHY BY MARK WOODWARD AND DANIEL EASTONThe Bishop of London, the Rt Revd Sarah Mullally

The Bishop of London, the Rt Revd Sarah Mullally, had worked for more than 30 years in the NHS and seen “some of the best care in the world”, despite its challenges. She paid tribute to those who had established it and to those who worked in it today. “The NHS reflects our compassion as a society caring for people regardless of their ability to pay at some of the most vulnerable moments in their life.” Over the coming years, it would come under more pressure, bringing hard decisions.

It was sustainable only if belief in the common good remained at the heart of society; if they were committed to solidarity of action. Churches held the potential to work alongside social care and health to promote health and well-being. She commended the work of the Cinnamon Network, which had explored how this could happen. She urged the Synod to support the motion: “Only as a common act of solidarity that we will be able to pass on to our children and grandchildren an NHS which is an inspiring act of empathy and not a despondent act of inhumanity.”

Alison Coulter (Winchester) moved her amendment. She had spent most of her working life in the NHS as a physiotherapist and manager and now worked with the King’s Fund, encouraging and supporting leaders in the NHS. This was an opportunity to “remember our call under God to care for those who care for our families”.

She cited figures from Professor Michael West: 35-40 per cent of NHS staff reported feeling unwell owing to stress — 50 per cent higher than in other workplaces. Only 40 per cent felt happy with the quality of care that they were able to deliver. The stress was partly due to the nature of the work, and also to the culture of the NHS: there were times when “proper performance and quality management by national bodies” slipped into “bullying”; this pressure was harmful. Finally, it was stressful because “we are making unreasonable demands of staff.”

She thanked churches for holding services to pray for the NHS, and urged people to keep praying, and to encourage staff. This was an opportunity to show appreciation for the dedication of staff.
The amendment — (b) in the motion below — was carried.

Gavin Oldham (Oxford) said that he took no issue with the core principles of the NHS: to meet the needs of all, free at point of delivery, based on clinical need, not ability to pay. Universal participation lay at the heart of the NHS and was its great strength, but nothing in these principles stipulated the method of funding. The assumption had been that it all had to come from general taxation, and, at £125 billion per year, with 100 per cent of funding coming from general taxation, this had become its “greatest weakness”.

He contrasted the recommendations for funding health, set out in the House of Lords report, with those for social care: one tax-funded, the other underpinned by means-tested insurance. “What is the logic for this? I would suggest none.” The Bible taught that the Christian focus should be on the poor, and yet the use of tax to pay for universal services had meant cuts to benefits for the poor. His amendment urged the Government to introduce mandatory insurance for higher and top-rate taxpayers to pay for their use of the health service.

PHOTOGRAPHY BY MARK WOODWARD AND DANIEL EASTONCarl Hughes (Southwark)

Carl Hughes (Southwark) spoke of the “complex and significant” challenges facing health and social care. There was a need to call on the Government to establish a Royal Commission to consider how needs could be financed over the period to 2040. It would enable the subject to be explored outside partisan politics. The NHS was “creaking at the seams”, and social care had yet to be fully integrated. Health and social-care funding would need to increase to nearly 13 per cent of GDP over the next 50 years: a “truly enormous adjustment”, and no single government or party was able to address these issues.

Bishop Newcome had no objection to Mr Oldham’s amendment, but it was “specific and slightly contentious”, which went “in the face” of the kind of recommendations put forward by the House of Lords committee and motion. The amendment fell.

Mr Hughes’s amendment was carried.

Jane Patterson (Sheffield) moved her amendment. She had worked in the NHS for 33 years, 20 of them as a consultant surgeon in a deprived area in Nottinghamshire. The House of Lords report was the best analysis that she had read. Many who worked in the NHS felt that, as the funding and provision failed, they were “standing on the edge of an abyss into which the elderly and vulnerable are falling”.

She urged the Synod to “celebrate what God’s people with a much longer history of caring for the elderly poor and vulnerable” were doing: “let’s unashamedly reclaim the initiative.” Many churches were already playing their part, offering pastoral care. Her church was about to employ a counsellor. Surely the Church’s 16,000 parishes could do “what the state will never be able to do”.

Bishop James accepted the amendment, which was carried — paragraph (e) below.

Resuming debate on the main motion, as amended, the Revd Dr Jason Roach (London) had worked in the NHS as a hospital doctor. The problem, he said, was not simply “enough cash, but not enough community that cares for the common good”. He quoted the World Health Organization, which had argued that factors including the state of our environment, and how many family, friends, and community people, had had a “considerable impact on our health — more so than access to health care”. It was in the Church that such community could be found.

Edward Cox (C of E Youth Council) spoke of the things being taken away from young people. The NHS gave them hope, “embodying egalitarian morals”. It was not just vital for them as consumers, “but for those who use the space to live out their God-given vocation”. He wanted to look forward to celebrating 140 years of the NHS. It was “a mark of our character, our morals, a space to be salt and light”.

The amended motion was carried by 267 nem. con. It read:

That this Synod:

(a) welcome and commend the report The Long-term Sustainability of the NHS and Adult Social Care published in April 2017 by the House of Lords Select Committee on the Long-term Sustainability of the NHS;

(b) express its heartfelt gratitude for the dedication of NHS and social care staff, and call on local churches to support those working in the NHS and social care, and to pray for them regularly publicly and privately;

(c) call upon Her Majesty’s Government to implement the recommendations made by the Select Committee, giving particular consideration to:

(i) the problems arising from the use of urban models of strategic care in the rural context;
(ii) whether social care is being adequately funded in the context of an ageing population; and
(iii) whether sufficient resources are being given to the recruitment, outside larger urban centres, of experienced and highly qualified health professionals;

(d) call upon Her Majesty’s Government to establish a Royal Commission to consider how the United Kingdom’s health and social care needs might best be delivered and financed in the period to 2040, taking into account expected changes in life expectancy, demography and medical technology; and

(e) call upon local churches to lead by example in showing Christian compassion and care to the elderly and vulnerable in our local communities, as we have done historically and is now especially needed, given the shortfall in the funding of social care.


Read a report of every General Synod presentation and debate from York 2018, here

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