The Election countdown continues, and we have now seen the Liberal Democrats, the Conservative Party, and the Labour Party launch their manifestos.
The Conservatives
The Conservatives’ healthcare-related manifesto commitments are an exercise in caution, with relatively insignificant proposed increases in primary care services.
For instance, the proposed building of 100 new GP surgeries is hardly likely to shift the needle given the pressures on primary care. The number of GP surgeries has fallen from 7600 to 6300 since 2015, and the number of fully trained full-time equivalent GPs has decreased by 1800 over this period.
The Conservatives also offer the usual canard to long-term critics of the very ethos of the NHS, through a promise to reduce the number of managers within the NHS. This is likely to reduce NHS productivity, as studies show NHS management numbers are comparatively lean and the decimation of management talent that occurred in the 2012 reforms should be avoided.
There is a promising mention in the Conservative manifesto of social care charging reforms (with an £86,000 lifetime limit on social care costs), albeit this was promised before and kicked into the long grass. There is no meaningful commitment to properly fund the sector without which commissioning, care delivery and effective workforce within it will all suffer.
The Liberal Democrats
By contrast, the Liberal Democrats have been bold enough to call for free personal care in England, increases in levels of pay (at a rate of £2 above the standard minimum wage) for care professionals and a Royal College for Care Professionals.
There have been reports that the Labour Party will introduce a £12 per hour minimum wage for carers. This should be welcomed, but there must be detailed policy priority to fully fund the sector and roll back the regressive impact of underfunding which has brought social care to its current crisis.
Social care continues to be discussed in the rhetoric of costs when it should be viewed through the lens of the contribution it makes to our society: £55billion of economic value add.
The Future Care Coalition (including the likes of Rt Hon Stephen Dorrell and Minister of State for Care Services, Phil Hope) last year argued that for every £1 invested in the sector over £1.75 of value is generated.
Labour
In terms of tangible and concrete commitments to health and social care, the Labour manifesto meets the promise from Keir Starmer not to “over promise”. That said, it makes a relatively bold commitment to eliminate NHS waiting lists with 40,000 more appointments a week.
There is, however, no certainty that broader system change will be provided, or the additional funding needed to deliver these commitments- and needed they will be. NHS England CEO, Amanda Pritchard, speaking at the NHS ConfedExpo this week highlighted the growth in over 85’s and that this will mean “…requiring more capacity…more people… more places…more equipment… more drugs. All those things add up to more costs”.
The manifesto is also light on detail about the transformation needed in primary care (the “return of the family doctor”), something which Ms Pritchard said is “the bedrock of the NHS” and would require GP numbers to grow.
On social care, Labour has set out a plan to create a National Care Service. Whilst this is a more expansive view than the Conservative proposal for social care, it remains a laggard compared to the broader vision and funding set out by the Liberal Democrats.
Perhaps we should leave the final word to Ms Pritchard who, when commenting on the dramatic demographic changes (and expanded treatment demands the NHS will face) impacting the country, said candidly this will need more capacity, more people and resources and “of course, it’s how we boost capacity and quality in social care. A question to which we still need an answer.”
Unfortunately, even after the publication of the manifesto from the party likely to form the next Government (if polling is accurate), a detailed funded answer to this question remains unanswered.
