Below you can the speech which Liz Kendall MP delivered in Ilford today on the choice between Labour and the Tories on health and social care.
As we meet here in Ilford, we're exactly nine months away from the general election.
It's voters in marginal seats like Ilford North who will decide whether Ed Miliband enters 10 Downing Street as our Prime Minister next May.
I'm really pleased to be back here today supporting our brilliant MP, Mike Gapes - and our fantastic candidate, Wes Streeting.
Mike, Wes – you and the local Labour team are running a brilliant campaign. You’re rejuvenating the local party with more members, activists and councillors. In May, Labour took control of Redbridge Council for the first time, and you did it by focusing on the issues that matter most to local people, with clear and specific pledges, based on strong Labour values.
I was here a few months ago, because Wes asked me to come to a meeting of local residents who need care and support and who look after their elderly and disabled relatives.
They told us about the desperate daily struggles they face to try and get the support they need, how they have to battle different services, and that the system really isn’t working for them.
It’s an all too familiar story that I’ve heard right across the country.
Today, I want to talk about how the NHS and social care is going backwards under the Tories, and the risk they pose if they get back into Government again. I also want to set out Labour’s alternative to improve services for the people that use them, the families that support them and the taxpayers that fund them.
The Tory failure
We all remember when David Cameron used to say his priorities could be summed up in three letters: N.H.S.
On his 2010 General Election poster he promised to “cut the deficit, not the NHS”.
He also promised that under the Tories “there will be no more of the tiresome, meddlesome, top-down restructures”.
Four years on, these promises have been broken.
Vital local services have been cut and care is going backwards.
There are now 2,400 fewer district nurses and community matrons than there were in May 2010.
Labour’s walk-in-centres have been closed. The Tories scrapped our 48 hour GP waiting guarantee, now two thirds of patients say they can’t see their doctor within two days and 1 in 6 have to wait more than a week.
£3.5 billion has been cut from local council care budgets. A quarter of a million fewer older and disabled people are now getting vital services like home care visits, which help them get up, washed, dressed and fed.
And today I’ve published new figures, which show that 5,500 fewer people are getting home adaptations like handrails, ramps and stair lifts.
These adaptations are a lifeline for older and disabled people, helping them to stay living independently at home and preventing painful falls and fractures.
Fewer home adaptations, alongside the lack of other services in the community, means increasing numbers of frail, elderly people are ending up in A&E and getting stuck in hospital when they don’t need to be there.
This causes huge distress for them and their families and it’s a false economy because taxpayers end up paying extra for more expensive hospital care.
The Tories promised to protect the NHS. But hospital A&Es have now failed to meet this Government’s lower 4 hour waiting target in every single week of the last year. Over the last 12 months, a million more people have waited for more than four hours in casualty departments.
Delayed discharges from hospital have soared. These delays cost taxpayers £250 million in the last year alone – money which could have paid for 37,000 home adaptations or 18 million hours of home care. Where on earth is the sense in that?
Rising emergency admissions and delayed discharges mean planned operations are going backwards too.
Three million people are now on the waiting list. Figures out today show the 18 week wait target was missed in June and more than 32,500 people waited over 18 weeks – the highest in six years. Average waits for operations are increasing too and the NHS has missed the maximum 62 day wait for cancer treatment for the first time ever.
The Tories failure to keep people out of hospital, and keep waiting lists under control, means the NHS also faces a growing financial crisis.
Trusts ended the year in deficit - for the first time in eight years. A third of hospitals are now in the red, piling on further pressure to make even more cuts in future.
So David Cameron has broken his promise to protect the NHS.
And he’s broken his promise of no more top-down reorganisations too.
Forcing through the biggest backroom reorganisation in the history of the NHS, when it faced the biggest financial challenge of its life, was David Cameron’s single biggest mistake.
A triumph of dogma over common sense that’s wasted three years of time, effort and energy - and £3 billion of taxpayers’ money - which should have gone on improving patient care.
Cameron claimed his re-organisation would cut bureaucracy and put clinicians in charge. But instead, it’s created even more layers of management and chaos and confusion in the system.
There’s not only 221 Clinical Commissioning Groups, 152 Health and Wellbeing Boards and the huge new national quango NHS England, but four new regional NHS England teams, 27 Local Area Teams and 19 Specialist Commissioning Units.
Alongside Public Health England, Health Education England, Monitor and the Care Quality Commission, the NHS is now so complicated and fragmented that no-one knows who is responsible or accountable for leading the real changes to frontline services that patients and taxpayers desperately need.
This is David Cameron’s true record on the NHS: cuts to vital services, which he promised to protect, and a wasteful reorganisation that he promised not to do.
As the NHS and social care go backwards, and with a looming funding crisis, it falls once again to Labour to protect and renew the local services we all rely on.
Dealing with the current crisis, and preparing our care system for the future, means reforming frontline services to meet the challenges of our ageing population, the increase in long-term health conditions and changing public expectations.
And we must do all this when there is far less money around. As Ed Miliband and Ed Balls have made clear: we need big reforms, not big spending to ensure our economy and public services work for everyone - not just the privileged few.
Four changes are now essential.
First, NHS and social care services must be fully joined up so people don’t have to battle different parts of the system and to reduce waste and inefficiency.
The Government claims this is what their “Better Care Fund” will do. But hospitals warn that simply taking money out of their services to plug the gaps in social care will put patient care at risk. Now councils have been told they’ll have to give the money back if their local hospitals struggle.
This isn’t true integration: it’s a recipe for yet more chaos and uncertainty.
We have got to end the false divide between the NHS and social care once and for all.
Places like Torbay and Greenwich have shown that properly integrating health and social care stops people having to deal with lots of different services and telling their story time and time again. It also cuts the number of emergency bed days, decreases delayed transfers from hospital and reduces the number of people requiring nursing care homes.
Joining up local NHS and care budgets in every area would create the potential for truly integrated care, including one point of contact, one care co-ordinator and one team to meet all of a person’s care and support needs.
Second, there must be a fundamental shift in the focus of services out of hospitals, into the community and towards prevention.
This is essential to improving patient care and getting better value for taxpayers’ money.
Take just one area: diabetes. More than 3 million people already live with diabetes and spending on the condition is set to increase from £10 billion to £17 billion over the next 25 years.
80% of these costs go on treating complications, including amputations, many of which could be prevented with better health checks and help for patients to manage their condition to reduce the risk of it getting worse.
Making sure everyone focuses on prevention means changing the way money flows around the system.
The NHS is constantly urged to join up services and treat more people in the community. Yet the focus is predominantly on paying for patients to be treated for each of their separate health conditions in hospitals.
A new ‘year of care’ budget covering the whole of a person’s physical, mental and social care needs would switch this focus, giving a powerful incentive to provide more preventive care in the community and at home.
Third, we’ve got to do more to help people to help themselves and to support family carers.
For most of the time, people with long-term illnesses manage their own conditions and families provide the vast majority of care for elderly and disabled relatives.
Training and education must ensure NHS and care staff have the knowledge and skills they need to better support patients and carers in future.
Stronger networks of local support can also make a big difference. Initiatives like the Neighbourhood Networks in Leeds and the Sandwell Friends and Neighbours project identify volunteers to help older and disabled people and their carers, alongside statutory services.
These volunteers provide practical and emotional support, such as going shopping, organising social events or just being available to talk – things that make a real difference to people’s lives but aren’t currently being provided.
Fourth, services must be truly personalised and designed around the needs of individuals and families, rather than those of service providers and their staff.
That’s why Labour will give patients new rights in the NHS Constitution including the right to have an appointment at their local surgery on the same day if they need to be seen quickly, a guaranteed appointment within 48 hours and the right to book an appointment more than 48 hours ahead with the GP of their choice.
We’ll invest an extra £100 million a year to help GP surgeries achieve these new standards, with money saved from cutting back on the costs of bureaucracy and competition created by the Tories Health and Social Care Act: a terrible piece of legislation which Labour will repeal in our first Queens Speech if we’re elected in 2015.
Achieving truly personalised care for the 15 million people with long-term conditions means giving them much greater power and control.
Living day in, day out with a condition means patients often know best how to prevent it from getting worse. They also care more about getting the right help than which service or organisation provides it.
Personalised care planning, where individuals and their families play an active part in determining their own care and support, is essential for people with long-term conditions.
Personal budgets also have an important role to play. Personal budgets in social care, which Labour introduced in Government, have helped transform the lives of thousands of disabled people and their families.
Pilots of personal health budgets for people with long-term conditions show they can improve patients’ quality of life and reduce their use of more expensive hospital care.
Of course there are many aspects of NHS care where personal budgets aren’t suitable, like emergency and inpatient care.
But for the growing number of people with long-term health conditions, they are an important way of ensuring a publicly funded health system can do the things that people really want.
The Choice in 2015
The NHS is a part of all our lives from the moment we are born, to the time we die and often many times in between.
But the NHS is even more than this. It is an expression of our values: our belief in the power of collective action to change people’s lives for the better, by ensuring care is available to each of us according to our needs, not our ability to pay.
At the next election there will be a real choice about whether these values will be protected for future generations.
It’s a choice between care going backwards, with fragmented services and money wasted under the Tories – or Labour’s plans to fully join-up the NHS and social care so we get the best results for patients and the best value for taxpayers’ money.
A choice between the Tories, who used to promise a ‘bare knuckle fight’ over hospitals but now force through financially driven changes, ignoring the views of local people.
Or Labour, which will be straight with you when hospital services need to change to improve the quality of care, and give clinicians and the public the power to make these changes happen.
And it will be a choice between a Tory Government, which has thrown the system into chaos, then blamed NHS staff for not coping and left patients and families to struggle on their own.
Or a Labour Government, which will make the real reforms we need so everyone gets the right care, in the right place, at the right time.
And when people ask whether these huge changes are possible, let’s remind them: in 1997, the NHS was on its knees and many people questioned whether it could even survive. But through investment and reform, Labour transformed patient care and left patient satisfaction at an all-time high.
Next year, voters will face a real choice about which party can protect and renew the NHS once again.
Labour is proud of our record on the NHS. We’re determined to put right David Cameron’s mistakes. And we are confident that our alternative will ensure the health and care services we all rely on can be sustained for future generations.
That’s what’s at stake when we go to the ballot box in May next year. And it’s what we’ll be fighting for in the months to come.
Below you can the speech which Liz Kendall MP delivered in Ilford today on the choice between Labour and the Tories on health and social care. As we...