This week, the Royal College of General Practitioners (RCGP) Wales has warned that patient care must not be forgotten during the election as a result of an overwhelming focus on Brexit. The warning was issued after the RCGP published its general election manifesto last week, which proposed six measures to promote safer general practice. In its warning this week, RCGP Wales urged all politicians to commit to investing more funds for general practice; to boost the GP workforce; and to make sure GPs have the time they need to focus on patient care.

General election: sector reactions & manifesto speculation

Draft Labour manifesto leaked

A draft copy of the Labour manifesto – originally due to be launched next week – was leaked on Wednesday evening prior to being formally approved by Labour’s National Executive Committee and shadow cabinet on Thursday afternoon. Several of the policies have been widely trailed during Labour’s election campaigning, but the manifesto also contains some new proposals. The key headlines for the PCF are:

  • Labour would establish a £250 million Children’s Health Fund to support their child health ambitions, and increase the number of health visitors and school nurses.
  • Labour would implement a “SEND strategy based on inclusivity, and embed SEND more
    substantially into initial teacher training so that staff, children and their parents are properly
  • More than £6 billion in additional funding per year would be allocated to the NHS through
    increasing income tax for the top 5% of earners, raising tax on private medical insurance and
    “halving the fees paid to management consultants.” This would be alongside £8 billion for
    social care over the course of the next Parliament.
  • As already announced, Labour would halt the Sustainability and Transformation Partnership
    process and task local health groups with redrawing them “with a focus on patient need rather
    than available finances”. The manifesto elaborates slightly on the proposed role of a new body,
    NHS Excellence, which would be a “quality, safety and excellence regulator”.
  • Labour would also repeal the Health and Social Care Act and reinstate the Health Secretary’s
    ultimate responsibility for the NHS, as well as a new legal duty on the Secretary of State and
    NHS England.
  • The manifesto says Labour would increase funding for GP services – without stating how
    much, or referencing the GP Forward View – and create a “new model of community care
    which takes into account not only primary care but social care and mental health as well”,
    focused on delivering care closer to home.
  • Labour do not explicitly promise to reverse regional discrepancies resulting from the new
    schools funding formula, instead only promising to allocate “transitional relief to schools set to
    lose out under the new funding formula” and reversing Conservative cuts to education budgets.

In addition, the draft manifesto upholds Labour’s pledges to not increase income tax or National
Insurance contributions for those earning below £80,000 a year, or VAT. Labour would also intend to
eliminate the existing budget deficit within five years.

Labour makes child health policy announcement

Prior to the party’s manifesto being leaked, Labour announced that if it wins on 8th June, it will implement a new health programme to improve health and wellbeing amongst British children, supported by a Child Health Bill. The policy received positive feedback from the Royal College of Paediatrics and Child Health (RCPCH), which urged all parties to focus their attention on improving child health in the UK.

Labour’s child health policy will seek to boost the numbers of school nurses and health visitors, to overcome health inequalities and to provide adequate healthcare for children regardless of socioeconomic background. In sum, Labour’s new child health policy would:

  • Introduce a new Child Health Index, to measure progress on obesity, dental health, under-fives
    and mental health against international standards.
  • Legally require all Government departments to have a child health strategy.
  • Boost the numbers of school nurses and health visitors, to give all children help with
  • Create a £250 million annual child health fund to support the strategy, by halving the annual
    £538 million cost of management consultancy in the NHS.
  • Provide extra funding for Child and Adolescent Mental Health Services, with counselling in
    every school.
  • End government cuts to public health budgets – £200 million in 2015-16 – by ring-fencing

Additionally, fighting childhood obesity would be central to the policy. According to shadow health secretary, Jonathan Ashworth, the party would seek to decrease childhood obesity by 50% within ten years and make the UK “the healthiest country in the world to grow up in.” Labour would also release a new childhood obesity strategy within the first 100 days, which will ban junk food advertising from being aired on TV before 9pm.

Commenting on Labour’s announcement, Professor Neena Modi, President of the RCPCH, welcomed the strategy and its attention to child health. Professor Modi said that the proposals “[put] down a marker and signal a clear commitment to improving the health of the nation by focusing on getting it right for children. We hope all parties will show vision and insight in giving child health, and so too the health of the population, the attention it deserves.”

Health Foundation publishes election briefing

The Health Foundation has published two briefings before the General Election on 8th June, analysing the state of NHS and social care financing, and the quality of care provided by the NHS. The key points of the first briefing, which focuses specifically on the finances of the health and social care system, are:

  • Social care needs immediate attention from an incoming government. Despite the extra money
    allocated to social care in the spring budget, the current system is severely under-funded
    and unaffordable for people on low incomes who are ineligible for free care.
  • Funding for the NHS in England needs to increase in the next two years to protect access to
    care and the quality of services for patients.
  • Beyond 2020, the pace of funding growth for the NHS and social care system will need to
    accelerate, taking a greater share of GDP.
  • An independent financial body for the NHS should be established, similar to the Office
    for Budget Responsibility, to lay out the long-term financial outlook for health and social care,
    as recommended by the House of Lords’ committee on sustainability.

The key findings from the Quality of Care briefing were:

  • That waiting times for many urgent and emergency services are at their worst in five years, but
    there is little evidence that quality of care is deteriorating.
  • Standards on cancer and ambulance care waiting times are also decreasing, with the
    proportion of people with suspected cancer waiting less than 62 days between referral and
    treatment having increased by around 5% over the past four years.
  • While quality of care is harder to measure, clear improvements have been made for people
    with stroke, and bowel cancer. Progress against quality standards for people with diabetes
    and suffering from heart attacks has levelled off over the past couple of years.
  • Mental health services – particularly for children – are struggling to meet demand, despite the
    fact that 430,000 people in England completed psychological therapies for conditions such as depression in the first nine months of 2016/17: almost double the number from the same period
    five years ago.

Commenting on the report on healthcare finances, Director of Research and Economics at the Health Foundation, Anita Charlesworth, said: “Government funding plans are not keeping pace with demand and cost, and, as a result, these vital services are showing increasing signs of serious strain.” On quality of care, senior policy fellow Tim Gardner said that “while international comparisons also show… recognised improvements in the quality of care for heart attack and stroke… the NHS is still lagging behind comparable countries on patient outcomes.”

The Foundation will produce a third and final pre-election briefing – on NHS and social care staffing –

Liberal Democrats pledge to raise taxes to fund NHS

The Liberal Democrats have pledged they will raise income tax to help fund the NHS and social care if elected on 8th June. According to their own estimates, a raise of one pence on every pound on all income tax bands and on company dividends will raise around £6 billion per year for the NHS and social care. The party suggested this would cost an average of £3 a week and would equate to someone earning £15,000 paying an extra £33 per year, while someone earning £50,000 would pay £383 more.

The pledge of a 1p income tax rise to fund health is a replication of one of the Liberal Democrats policies introduced in the 1990s, which was launched to generate funding towards education. Party leader Tim Farron said that the party is now looking to be “honest with people and say that we will all need to chip in a little more” to pay for health and social care.

Labour and Liberal Democrats announce education funding policies

On Wednesday, Labour and the Liberal Democrats both announced they will allocate multibillion pound funding for schools if either are elected. While the Labour Party claimed it would halt cuts to education through a £20 billion investment in English schools by 2020, the Liberal Democrats pledged they would invest £7 billion over the same time period to “reverse crippling Conservative cuts to school budgets”.

The announcements came in the same week that the Institute of Fiscal Studies stated that protecting schools from real-terms funding cuts would entail raising an extra penny on the basic rate of income tax, equivalent to £3.7 billion. IFS Programme Director Luke Sibieta suggested that this figure would be broken down into £2 billion to protect per pupil spending and £1.7 billion to cover other costs incurred by schools.

Simon Stevens says Five Year Forward View priorities are essential for future of NHS

The Chief of NHS England, Simon Stevens, has reconfirmed his view that the Five Year Forward View, originally published in October 2014 by NHS England, is key for the NHS to provide better social and mental health services. While also confirming his support for the next steps for the Five Year Forward View plan published in March, Mr Stevens said that the five year plan for the NHS will be needed regardless of which party wins the election. Commenting on the forthcoming election, Mr Stevens said that while the NHS will be led by the next government, ”it is pretty clear that the core operational priorities that the NHS set out in the next steps document are the right things for us to be working on over the year ahead.”

Mr Stevens also said that the NHS Confederation conference in June will be used to announce additional measures from the NHS to further change in the operation of the NHS over the coming years. Speaking specifically about primary care, Mr Stevens said: “NHS England will set out practical things on primary care that we now want to see layered in every part of the country in the next 24 months.” He later also added that the NHS will release further opinions on how STP leaders should implement the Five Year Forward View at the local level.