Politics out of health – The impossible dream?

Introduction by Professor Marcus Longley, Director of WIHSC and Professor of Applied Health Policy

Our series of ’20 blogs for 20 years’, marking the Institute’s 20th anniversary, concluded last week with Jeff Collins’ blog, ‘Words’. But the debate on health and social care policy is, of course, far from over… So, without a pause, we continue to publish blogs written by WIHSC’s friends and collaborators. This week, Mike Ponton, one of our Visiting Professors, goes back to a question raised by Jack Evershed in Blog 13 – is there a better, more timely way of making tricky decisions in healthcare than the current arrangements? Mike has worked in health policy all his working life, rising from basic administrative roles at the start of his career, to being a Chief Executive and senior civil servant, and currently Independent Member of Hywel Dda University Health Board.

Politics out of health – The impossible dream?

According to Dr Alan Rees, Vice President Royal College of Physicians for Wales, health policy will clearly play a central role in the campaigns of all political parties in the forthcoming National Assembly for Wales elections. He believes the debate should be depoliticised and asks all political parties to support the RCP’s Future Hospital model.[i]

Professor Frank Dunn, President of the Royal College of Physicians and Surgeons of Glasgow has also called for the removal of politics from NHS in Scotland and suggests running it by an executive body including members of different political parties.[ii] He believes there remains a substantial political dimension to the NHS and the resultant conflicting information undermines the confidence of the public, patients and staff in the NHS. He suggests that even when NHS Plans are well thought through and have professional support – they will be mothballed if there is any electoral risk.

But will it ever be possible to take politics out of health in Wales when many see such debate as an essential part of democracy? Bambra et al have pointed out in the past that health is political because power is exercised over it as part of a wider economic, social and political system. In their view, changing this system requires political awareness and political struggle[iii]. As a fundamental component in our modern complex society, unsurprisingly the NHS has become a major political and election issue.

Local Health Boards, which have regularly faced awkward and high profile political criticism or opposition to their plans, have been told to work closely and more effectively with politicians in order to win their support. That may be easier said than done, particularly in view of the generic fickleness of politics and the pendulum nature of political opinion.

Depoliticising health has become a fashionable theme. It is understandable that thoughts are turning to ways of curing the blight of the apparent aversion of politicians to making courageous, difficult, yet necessary decisions on health futures. The Welsh Government’s recent Green Paper[iv] seeks to provoke a discussion on taking the heat out of difficult decisions.

The NHS is in deep trouble. Whatever approach we adopt, if we are to avoid its continuing decline we need to find more effective and pragmatic ways of speeding up the decision making process.

 By Mike Ponton, Visiting Professor

[i] Focus on the Future – Our action plan for the next Welsh Government, Royal College of Physicians, 2015

[ii] Agenda: Time to take the politics out of healthcare, Professor Frank Dunn CBE is President of the Royal College of Physicians and Surgeons of Glasgow, 2015

[iii] Towards a politics of health, Bambra et al, Health Promotion International, Vol. 20 No. 2, 2005

[iv] Welsh Government Green Paper – Our Health, Our Health Service, 2015

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