General Election 2017 - What Does Each Party Offer NHS Nurses?
With the General Election just days away, we consider what the main parties in England stand to offer the electorate as part of their manifestos for the NHS and nurses.
2nd June 2017
Written by Ruth Underdown
So here we are, amid a snap election the Prime Minister said she wouldn’t call. For the third year in a row, the public are faced with making a decision that will determine the fate of the country, the NHS, and all our futures.
Theresa May, we imagine, felt secure when calling the election that she would face a relatively straight forward victory. And yet, as the weeks have gone on, polling is suggesting that things may not be so cut and dried.
For those of us who work in health care there has been unrest and frustration – whichever colour your politics are. Doctors have been outspoken about policy changes and more recently 91% of nurses balloted in an RCN poll voted in favour of industrial action.
Despite all political parties publishing a manifesto in the lead up to a General Election, there is no obligation for the winning party to follow through on any of the pledges they have made.
The Conservative manifesto of 2015 promised to increase GP numbers by 5,500 by 2020. In the 2 years since its publication, the number of GP’s working in the NHS has decreased due to the pressures within the service.
Yet, the Manifestos remain as a useful document to beat the political parties with, when they promise pre-election and fail to deliver once in Government.
So, what do the manifestos say in 2017? More importantly, what impact will the promised policies have on the NHS and the staff who work in it?
www.conservatives.comContinue to increase spending on the NHS, supported by a strong economy, so the NHS stays free for you to use.Spend at least an additional £8 billion by 2020, over and above inflation, to fund and support the NHS’s action plan for the next five years.Ensure you can see a GP and receive the hospital care you need, 7 days a week by 2020, with a guarantee that everyone over 75 will get a same-day appointment if they need oneIntegrate health and social care, through our Better Care Fund. Lead the world in fighting cancer and finding a cure for dementia.Implement the NHS’s plan to improve health care even further; the Five Year Forward View.Millions more people can see a GP 7 days a week, from 8am-8pm, but by 2020 we want this for everyone.Ensure your family doctor appointments and repeat prescriptions are routinely available online, wherever you live. Guarantee same-day GP appointments for all over 75s who need them.Continue to eliminate mixed-sex wards and hospital infections.Continue ensuring we have enough doctors, nurses and other staff to meet patients’ needs, and consider how best to recognise and reward high performance.Boost transparency even further, ensuring you can access full information about the safety record of your hospital and other NHS or independent providers, and give patients greater choice over where and how they receive care. Give you full access to your own electronic health records, while retaining your right to opt-out of your records being shared electronically.Act to reduce childhood obesity, and continue to promote clear food information.Continue to invest in our life-saving Cancer Drugs Fund. We will work with the NHS, charities and patient groups to deliver the new strategy recommended by NHS England’s cancer taskforce.Increased funding for mental health care. We will enforce the new access and waiting time standards for people experiencing mental ill-health, including children and young people.Increased support for full-time unpaid carers. We will guarantee that you will not have to sell your home to fund your residential social care.
www.labour.org.ukInvest £2.5 billion more than the Conservatives to recruit 8,000 more GPs, 20,000 more nursing jobs and 3,000 more midwives.Guarantee GP appointments within 48 hours, and cancer tests within one week.Join up services from home to hospital, with a single point of contact for all who need it.Give mental health the same priority as physical health, with a new right to access talking therapies.Repeal the Government’s privatisation plans, cap profits and put the right values back at the heart of the NHS.End time-limited 15-minute social care visits, and recruit 5,000 new home-care workers to support people in their home.Step in with a long-term workforce plan for our health service that gives staff the support they need to do the best for their patients.Scrap the NHS pay cap, put pay decisions back into the hands of the independent pay review body, and give our NHS workers the pay they deserve. Guarantee the rights of staff working in our health and care services.Protect patients and legislate to ensure safe staffing levels in the NHS.Re-introduce bursaries and funding for health-related degrees. Labour will support doctors to deliver the best care possible by investing in the training, education and development of doctors throughout their careers.Support NHS whistle-blowers to ensure health service staff can speak up in support of the best possible standards for patients.Make it an aggravated criminal offence to attack NHS staff.
www.libdems.org.ukGuarantee the NHS budget will rise by at least the rate of inflation every year. We will commission a Fundamental Review of NHS and social care finances in 2015, before the next Spending Review, to assess the pressures on NHS budgets and the scope for efficiencies. This will allow us to set multi-year budgets that will be sufficient to maintain and improve the current standard of NHS services, including keeping waiting times down.We will always ensure access is based on need and not on ability to pay, and that the NHS remains free at the point of delivery.Reform the NHS payment system to encourage better integration of hospital and community care services, and better preventative care for people with long term conditions. This would include more use of personal budgets for people who want them, and better access to technology and services to help people get care closer to home.Secure local agreement on, and pooling of budgets between the NHS and social care.Encourage GPs to work together to improve access and availability of appointments, including out of hours.Incentivise GPs and other community clinicians to work in more disadvantaged areas.Act to improve the mental health of children and young people, promoting wellbeing throughout schools and ensuring that children and young people can access the services they need, as soon as a mental health problem develops.Deliver genuine parity of esteem between mental and physical health, by improving access and waiting time standards for mental health services, and establishing a world-leading mental health research fund to improve understanding of mental illness and treatments. Do more to tackle the causes of ill health, including promoting healthy eating and exercise, making people aware of the dangers of smoking and excessive consumption of alcohol and other drugs, and helping to improve mental health and well-being.Invest in research and set ambitious goals to improve outcomes for the most serious life-threatening diseases like cancer, and long-term conditions like dementia.
www.greenparty.org.ukFunding will be diverted away from centralised facilities towards community healthcare, illness prevention and health promotion. Community Health Centres will be the focal points for self-help and community-based initiatives, and will also provide a wide range of services including primary healthcare, and health education and health promotion programmes. A variety of specialist services, midwifery, obstetrics, family planning, counselling and psychiatry, will also be available. It becomes an offence to stop nursing mothers from breastfeeding their children in public places (including the breastfeeding of toddlers in premises where children are already allowed). Businesses that break the law, or whose employees break the law, will face significant fines. Councils are required to provide breastfeeding facilities in all their significant buildings open to the public, such as town halls and libraries.The Green Party is opposed to the development of "Foundation Hospitals" which, although argued to be locally controlled, could result in reduced democratic accountability given that they will be unanswerable to parliament or local authorities. Foundation Hospitals are in fundamental opposition to the Green Party policy of the public health service remaining fully funded by public taxation, given that they are required to produce a profit and can seek commercial partnerships. We lament the disappearance of the School Nurse and would therefore bring back a dedicated NHS School Nurse in every school, both at primary and secondary level. Prescription, and other charges, are wrong in principle, unfair in practice, and generate little income for the Health Service. They will be abolished as soon as possible. The Green Party will support a change in the law to remove the requirement for two doctors to approve a woman's decision to have an abortion, and will support a change in the law to allow the procedure to be carried out by appropriately trained nurses and midwives up to three months of pregnancy. The Green Party will not support any change to the current laws on abortions which would aim to make it more difficult for women to obtain them.Assisted death presents moral and legal concerns to health care professionals and the public. We believe that people have a right to an assisted death within the framework. The Green Party recognises that suicide is the biggest killer of young men in the UK. We would ensure that local authorities took preventative action in terms of well-known suicide spots. For example, installing barriers and anti-suicide nets on bridges where suicides have taken place. The Green Party would also introduce a complete ban on the promotion of tobacco and alcohol products, including sponsorship, advertising (direct or indirect) and product placement on remuneration or reward.
The problem with manifesto pledges is that they appear to present a perfect answer to whatever the current issues are within the NHS. More so when listed like this. Every promise seems to have the improvement and benefit of people’s health at its heart. So how do you choose which party to vote for?
This is where a manifesto cannot always provide the answers, and the politicians and analysts need to answer the questions over costing, budgets and the details behind each policy.
According to the Kings Fund, when looking at the costing behind the pledges, none of the promises will match the level of funding required to make a dramatic improvement to the NHS.
‘…spending under any future Government will rise by only around 1 per cent per annum in real terms, well below the long-term annual trend of 4 per cent and less than the Office for Budget Responsibility has indicated is likely to be required.’
This is where the fundamental problem lies. Massive under-investment over the past decade has led us to the situation that we’re in now, and that cannot be reversed overnight, regardless of which Government is elected.
Ultimately, the only way the NHS can survive is with adequate funding and resourcing. But this money must come from somewhere. The Conservatives have accused Labour of being unable to make the numbers work for their pledges. Conversely, when you consider the Conservatives promises, neither can they.
More recently we have heard much about the publication of the Naylor Report which Theresa May has voiced support for.
As we have seen, the Naylor Report is a recommendation that:
‘…sets out recommendations on how the Government can fund NHS reforms by selling land it no longer needs and buildings that are expensive to maintain.’
The question here is where the money goes after land and buildings are sold off. Opponents of Naylor point out that here is no guarantee that it will be reinvested back into the NHS.
There is also talk of using hedge funds to invest in the NHS to provide extra income. Criticism for this plan orbits around the motivation of those who would choose this as an area for investment, and whether it is sustainable long-term.
In all, it seems that Conservatives believe if the NHS can work with free market forces then they will ensure its prosperity at lower cost to the tax payer.
And then there is Brexit and all the implications it brings for the many European nurses who contribute to the NHS and have made lives here.
Labour has promised to guarantee the right to remain for all healthcare workers from the EU.
The Conservatives have been less forthcoming with such guarantees, but recognise they need to allow time for our own workforce to be trained to replace the EU workers. Since we’re facing a shortfall of over 40,000 nurses, this could well take much longer than anyone can correctly anticipate.
The Liberal Democrats and Green Party are not even considering the notion of Brexit. They want to return to the polls for a second bite at the Referendum cherry. Whether there will be any national appetite for that prospect remains to be seen.
The YouGov Poll for the Times this week showed that the gap between Conservatives and Labour has reduced to just 3 points.
If Labour continues to close this gap then the prospect of another coalition government becomes very real.
How that would work throws other potential political party collaborations into the mix. The advantage of a coalition is that the individual parties could potentially temper the determination of the party which has the majority share with their policies. This could serve the NHS well.
We wait with baited breath.
General Election Result: What Next?