UK: The Future Of The NHS – Mirror, Mirror On The Wall Whose Are The Safest Hands Of All?

Last Updated: 12 May 2015
Article by Karen Taylor

Most Read Contributor in UK, August 2017

Whatever your political persuasion, the NHS continues to be a high priority for all parties, and if the promises of increased investment are to be believed its future, at least for next five years, is safe whatever the outcome of the election. The only difference is what constitutes safe, and how much additional money and staff might be available to deliver the various commitments. As people wake up to the results of the election, this week's blog looks back at the various commitments made.

Unlike the 2010 election, any attempts to de-politicise the NHS failed spectacularly, with all parties competing on their ambitions for the NHS. However, despite the combative stances taken, there is actually a lot of consensus. Specifically, that the NHS needs to maintain and improve quality, transform the way care is delivered and achieve financial balance. Furthermore, that additional funding and more clinical staff will be needed. The differences however are in how much funding is being pledged and the source of this additional money and staff.

While all major parties are offering additional funding for the NHS, some fall well short of the resources needed to deliver the NHS's Five Year Forward View (5YFV) –given the consensus suggests at least £8 billion by 2020/21 will be needed and likely much more. Nevertheless, the different funding commitments and other commitments promised by the main English parties are as follows:

  • Conservatives – a commitment to increase NHS spending in real terms by a minimum of £8 billion over the next five years to fully fund the 5YFV (made possible because of their long term economic plan). Specific promises include better funding for mental health services (particularly for women to have access to mental health support pre and post pregnancy and for cognitive behaviour therapies to be available in everywhere). There is also a commitment to fund a 'truly 7 day NHS' involving changes to the way services are delivered. The party also commits to train 5,000 more GPs by 2020 and ensure same day appointment to a GP for over 75s.
  • Labour –would provide a time to Care Fund of some £2.5 billion a year, recruit an extra 20,000 nurses, 8,000 doctors, 5,000 more care workers and 3,000 more midwives. It promises to provide more mental health services to children and guarantee access to a GP within 48 hours. Funded by a mansion tax on properties over £2 million, taxes on tobacco and clamping down on tax avoidance. Its manifesto commits to repealing the Health Act but promises to keep inherited structures and avoid top-down reorganisation. Labour plans a 'whole person care' approach and to increase the scale and pace of integration.
  • Liberal Democrats – would aim to commit at least £8 billion more a year in real terms, by 2020, with mental health services receiving an extra £500 million a year. In order to improve access to GPs, it would encourage telephone and Skype consultations and repeal any parts of the Health Act that make NHS services vulnerable to "forced privatisations" including removing the Competition and Markets Authority's role in health. With full pooling of budgets between the NHS and care services by 2018.
  • Greens – would increase NHS funding immediately by £12 billion and continue to provide additional money so that by 2020 the healthcare budget will be some £20 billion higher than current spending. At the same time it would increase social care funding by £9 billion by 2020. It would ensure everyone who needs a mental health bed can access one locally and establish community health centres next to GP surgeries. Sources of this funding would be increased taxes on alcohol and tobacco. It would repeal the Health Act and introduce a radical structural change to remove all NHS market structures.
  • UKIP – would immediately increase the overall NHS budget by £3 billion a year and social care funding by £1.5 billion a year, increase funding in mental health by £170 million a year and provide free chiropody, dentistry and prescriptions in England. It would aim to recruit an extra 20,000 nurses, 8,000 doctors and 3,000 more midwives. It would put GP services in A&E departments seven days a week, abolish Monitor and the Care Quality Commission and transfer their inspectorate functions to county health boards. UKIP would also fully integrate health and social care functions. 

So there we have it, and as demonstrated above, there is a lot uniting rather than dividing the three main parties, including increasing investment in mental health services with integration between health and social featuring strongly. All claim they can be trusted to keep the NHS safe in their hands, but, again appear intent on using levers such as targets, regulation and legislation to deliver their vision. Without the increase in funding and staff resources promised alongside these levers, the ability of the front line services to deliver, is an entirely different matter. 

Indeed, the various commitments to increase numbers of staff look exceedingly challenging, especially given the length of time needed to train a doctor and other healthcare professionals. There is also the question of how quickly Universities can expand to accommodate these increases and who will fund the expansion? Previous ambitions to increase staff numbers have relied on overseas recruitment, and back to work initiatives, both of which are now more challenging than ever before. The complexities of a minority or coalition government may make achieving the above even harder, especially once the need for trade-offs get under way. 

The NHS, however, has proved time and again to be remarkably resilient. Indeed most staff turn up to work come rain or shine, intending to do the best job they can for patients. And on Friday morning, and the weeks following, that's just what they will continue to do. And whatever the outcome of the election, and at least for now, the NHS is safe in staff hands.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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