Given the persistent push from the Labour Party on the NHS over the past year as the Party looked to capitalise on its poll lead on the issue, it was a little surprising that it that the health manifesto was launched by Ed Miliband and Andy Burnham on a Saturday – seemingly in response to the Chancellor’s promise to meet Simon Stevens’ £8bn funding uplift in the next Parliament. Incidentally this pledge from the Chancellor has come under scrutiny, with commentators speculating as to how it would be funded. Given the cuts in other public services due to be central to Conservative plans, one would expect much of the funding to come from these savings. But such cuts will have a knock-on effect to the NHS and may negate the effectiveness of any funding uplift.
As with Labour’s education manifesto that was published last week, the policies in the briefing are predominantly a reiteration of commitments made in the past year, with the only new announcement being that Labour would fund 3,000 new midwives.
What is most striking is that Labour still hasn’t committed to the necessary £8bn uplift, instead continuing to claim that it would find £2.5 billion of extra money to recruit 20,000 new nurses, 3,000 new midwives, 8,000 new GPs and 5,000 new care staff by 2020 funded by the mansion tax, bankers bonus tax and the much-discussed crackdown on tax avoidance.
There are also a number of pledges within the manifesto that are light on detail or practicality, including the proposed profit cap for independent sector providers and how exactly commissioning will be structured for integrated health and social care. Despite promises to legislate in the first Queen’s Speech for much of the plans in the manifesto, it is clear that there will be continued uncertainty following a Labour victory for the NHS as it irons out the details of its plans in the light of a fragile parliamentary base.
A full breakdown of the policies can be found below:
Integrating health and social care
- Better integrated health and social care with support in place to care for people with long-term conditions at home under the ‘whole person care’ banner
- Introduce new year of care budgets, replacing the current payment by procedure model, give all people with complex needs a personalised care plan covering their needs and a single point of contact for their care
- Health and Wellbeing Boards will be “supported to become a vehicle for system leadership” suggesting that in the short term at least commissioning systems will remain unchanged.
- The Secretary of State’s direct responsibility for the NHS would be restored, following the decision in the Health and Social Care Act to transfer this to NHS England.
Access to primary care and diagnostics
- Introduce a 48 hour GP target and give patients the “right to choose the GP of their choice”
- Introduce a goal of a one-week wait for all urgent diagnostic tests by 2025, investing £150 million a year in diagnostic capacity
- Create a new Cancer Treatments Fund to improve access to not only new drugs but also the latest forms of radiotherapy and surgery
- Improve cancer services to make Britain the best place for cancer survival in Europe, and publish a new cancer strategy within six months of entering government
Competition and the role of the private sector
- Repeal section 75 regulations governing competition law
- The NHS will be installed as the “preferred provider” of NHS services”
- A profit cap would be imposed on independent sector providers, however a “limited role” in providing services to fill gaps within the NHS would still be available to the sector
- Remove the role of Monitor and the CMA as economic regulators. Monitor would have a role in driving integration of health and social care across health economies and not only overseeing individual providers
- Save £100m from competition and “red tape” to invest in GP services
Access to mental health services
- Increase the proportion of the budget spent on children’s mental health
- Create a new right to talking therapies in the NHS constitution
- Ensure that teachers have training in mental health
- Introduce a 28-day waiting time target for talk therapies and adults and children
- Set limits on the amount of sugar, fat and salt in food marketed substantially to children
- Ensure public health is embedded throughout the licensing system
- Reinstate the goal of all children doing a minimum of 2 hours PE a week
- Crack down on high-strength, low cost, alcohol products
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