Election 2019: Where Do the Parties Stand on Health?

Peter Russell

November 26, 2019

The UK goes to the polls on Thursday 12th December in what’s been widely dubbed as the 'Brexit election'.

But where do the parties stand on health and social care issues?

We round up the main commitments.

Conservative Party

The Conservatives were last to the table with their manifesto, launched two and a half weeks before polling day.

Much like an appliance bought to cook the party's 'oven-ready' Brexit deal, it came with a 'guarantee'.

Boris Johnson personally pledged to underwrite extra funding for the NHS, with 50,000 more nurses, and 50 million more GP surgery appointments a year.

The Conservatives have already pledged a £33.9 billion annual boost to the NHS by the end of the next parliament in 2023-24.

The party had already promised to upgrade six hospitals by 2025. The construction of new hospitals would be funded over the next decade, the manifesto said. 

At the heart of the party's promises on health was an NHS People Plan to focus on the workforce. That would involve:

  • Recruiting 50,000 more nurses, with students receiving a £5000-£8000 annual maintenance grant

  • 6000 more doctors in general practice, and 6000 more primary care professionals, such as physiotherapists and pharmacists

  • Improvements to NHS staff morale, with more funding for professional training, and more supportive hospital management

  • An 'NHS visa' to encourage trained health professionals from abroad to work in the UK with fast-track entry, reduced visa fees, and support for their families

  • A permanent solution to the pension 'taper problem' that discourages senior doctors from working extra shifts

The Conservatives also promised to enshrine in law a fully funded, long-term NHS plan.

One headline-grabbing initiative was a promise to scrap hospital car parking charges in England for NHS staff on night shifts, as well as some patients and family members. Hospital parking in Scotland and Wales is already free.

The British Medical Association said spending commitments were insufficient. "A boost to the GP workforce is long overdue and necessary," commented Dr Chaand Nagpaul, BMA council chair. "However, without details it's difficult to see how any government will achieve this – especially given the clear failure against the current target to recruit 5000 more GPs by 2020. Instead, we've lost almost 1000 GPs since 2015."

Plans to recruit an additional 50,000 nurses were "ambitious", he added.

Boris Johnson came under fire for a lack of ambition on reforming social care, having promised in his first speech after becoming Prime Minister to "fix the crisis in social care once and for all".

However, the Conservative manifesto only offered £5 billion in short-term funding alongside a vague pledge to work with opposition parties to "build a cross-party consensus to bring forward an answer that solves the problem".

"This manifesto contains some ambitious pledges on the NHS, but its failure to address social care threatens to undermine them," said Nigel Edwards, chief executive of the Nuffield Trust.

"After 2 decades of dither by both parties in government it seems we are no further forward," commented Paul Johnson, director of the Institute for Fiscal Studies.

Experts also commented on Conservative proposals to establish a reminder system for parents to have their children vaccinated. 

Jonathan Ball, professor of molecular virology at the University of Nottingham, said:

"It certainly wouldn’t hurt to establish a reminder system, but I doubt that alone would be sufficient to make a big impact.

"The evidence would suggest that the drivers leading to poor vaccine uptake in some parts of the UK are far more complex and will require a range of measures, such as more flexible delivery systems and improved education and stakeholder engagement."
 

Labour Party

Labour would "give the NHS the funding it needs, end privatisation, and never let our health service be up for grabs in any trade negotiation," said Jeremy Corbyn in a foreword to his party's election manifesto.

Free prescriptions in England, and free basic dentistry, would also be on offer, he said, echoing early ambitions of the health service's founders.

A Labour government would increase spending on health by an average of 4.3% each year to address hospital bed shortages and staffing issues.

It would enable 27 million more doctors' appointments each year.

An "urgent" priority was to reverse privatisation by ending a requirement on health authorities to put services out to competitive tender, and halting the sale of NHS land and assets.

Labour also reiterated its pledge to establish a publically owned generic drugs manufacturer to make medicines more affordable to the NHS.

In a statement, Labour said it was committed to bringing back the NHS bursary for nursing students which it said, unlike the promise made by the Conservatives, would include free tuition fees for nursing, midwifery, and allied health profession undergraduates.

A Labour government would strive to make the NHS environmentally friendly with a net zero carbon policy which included more efficient heating systems, greater reliance on renewable energy, and support for a million tree NHS Forest to increase access to green spaces near hospitals.

Labour promised to build a National Care Service for England to provide "community-based, person-centred support, underpinned by the principles of ethical care and independent living".

Free personal care for older people, and a lifetime cap on personal contributions, feature in the party's election promises.

An analysis by The King's Fund said that Labour's plans to recruit more staff in the NHS were welcome, but lacked detail on how this could happen when staff were leaving the profession due to work pressures.

Richard Murray, chief executive of The King's Fund, said: "Labour has pledged a comprehensive NHS funding offer, and they appear to be the only major English party willing to propose long-overdue reform of the ailing social care system.

"Free personal care and a cap on personal contributions to care costs won’t solve all the challenges facing social care services, but the policy would represent a significant step towards a fairer system and bring it more in line with an NHS that is free at the point of use."

Liberal Democrats

The Liberal Democrats want to stop Brexit and invest what they called a £50 billion 'remain bonus' in public services, and to tackle inequality.

On health, the cornerstone of their manifesto was a commitment to delivering an extra £35 billion over 5 years to be spent on the NHS and social care. It said the funding would focus on relieving the crisis in social care, tackling urgent workforce shortages, and investing in mental health and prevention services.

Jo Swinson's party said it would raise a ring-fenced £7 billion a year additional revenue from a 1p rise on the basic, higher, and additional rates of income tax. The revenue would not be raised, nor spent, in Scotland.

The manifesto also proposes further developing a new, hypothecated health and care tax which would combine spending on the health and social care budget.

Other measures included:

  • A commitment to spend £10 billion in capital to make "necessary investments" in equipment, hospitals, community, ambulance, and mental health services buildings

  • Ensuring freedom of movement and mutual recognition of clinical qualifications

  • Measures to address workforce shortages, including bursaries for specialty roles where shortages are acute

  • Boosting mental health care, including reducing waiting times

In a briefing paper, the NHS Confederation said it was unclear how the Liberal Democrats would allocate funding between the NHS and social care, and that the spending plans relied heavily on economic performance which could not be guaranteed.         

Hugh Alderwick, assistant director of policy at the Health Foundation, commented: "The most obvious gap in the manifesto is on social care.

"NHS leaders can breathe a sigh of relief, as no major reorganisation of the health system is proposed. But much needed reform of social care is not one of the main priorities set out by the Liberal Democrats for this parliament."

Brexit Party

The Brexit Party launched a Contract with the People because in the words of its leader Nigel Farage, "the old mainstream parties have made 'manifesto' a dirty word".

Mr Farage previously said he thought the UK would have to move towards an insurance-based system of healthcare to take the burden off the NHS.

However, his contract states that the NHS must remain a publically-owned, comprehensive service that is free at the point of use.

Other major pledges for health in England include:

  • No privatisation of the NHS

  • Support for investment in medical research and development to "stop the taxpayer being ripped off by pharmaceutical companies"

  • Abolition of "politically imposed" hospital targets that "distort clinical priorities"

  • Re-opening nursing and midwifery recruitment to those without a degree, alongside a new nursing qualification in social care

  • Introduction of 24-hour GP surgeries to relieve the strain in A&E departments

There were no costings to underpin the party's aspirations on health, although its health spokesperson, Dr David Bull, told Medscape News UK this month that he wanted "a national conversation about what people expect from the NHS", and "what are we willing to pay for it".

Scottish National Party (SNP)

The Scottish National Party (SNP) only contests Scotland's 59 seats at Westminster.

Although health is a devolved matter, the party's leader, Nicola Sturgeon, has promised to try to protect the health service across the UK with an NHS Protection Bill.

If successful, the Bill would give a 'double lock' against the UK Government making the NHS a 'bargaining chip' in any future post-Brexit trade deal by requiring approval from the Scottish Parliament, and the Welsh and Northern Ireland assemblies.

In its manifesto, the SNP called for spending on the NHS across the UK to increase by billions of pounds.

The SNP was the third largest party at Westminster during the last parliament, and Nicola Sturgeon could wield significant influence in any coalition talks after 12th December.
 

Plaid Cymru

In common with the Liberal Democrats, Plaid Cymru backed remaining in the European Union and offered a second referendum.

The party, led by Adam Price, called for free social care for the elderly and vulnerable, and an additional 1000 doctors, 5000 nurses, and 100 NHS dentists.

Northern Ireland

The Democratic Unionist Party (DUP), which held 10 seats during the last parliament, has yet to publish its manifesto for the general election.

The second largest party in Northern Ireland, Sinn Fein, has also yet to set out its priorities. Its elected representatives have not traditionally taken their seats at Westminster.

Change UK

The independent faction at Westminster, Change UK, comprised of disaffected members of the Conservative and Labour parties, wants the UK to stay in the EU.

It warned of less money for the NHS in the event of Brexit.

On health matters, the grouping:

  • Backed the recruitment, retention, and valuing of nurses, doctors and healthcare professionals, including those from abroad

  • Supported UK citizens' right to healthcare when living and travelling in EU countries

  • Would campaign for the UK to be reinstated around the table as a full decision-maker in the European Medicines Agency

Green Party

The Green Party said it wanted to invest in public services and "support new technologies and approaches that will let us live longer, healthier lives".

It pledged to:

  • Treat problematic drug use as a health issue, not a crime

  • Make heroin available on prescription after a medical assessment by a doctor

  • Make cannabis, labelled according to laboratory-tested strength, available to adults from licensed small businesses

  • Prohibit commercial advertising of alcohol

The party called for an end to the sale of personal health data.

Editor's Note, 27th November 2019: This article was updated to include the SNP manifesto and the Conseratives' vaccine reminder system.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....