Thank you for all your support


Nearly all the votes have been counted in the general election and, in a shock result, no party has achieved a majority.

The Conservatives will be the largest party and are expected to form an informal coalition with the Democrat Unionist Party.

You can read our analysis of the results and what it will mean for health and social care on the Patients Association website.

We would also like to thank everyone who pledged to Vote4theNHS and shared our campaign. Thanks to you we managed to reach a total of 235 pledges.

If you are interested in being kept up to date with all the other work the Patients Association does you can sign up to our weekly newsletter.

You will still be able to view all the election material on the website for a short while before we take the site down.

Thank you for all your support

 

 

Polling Day


Today the UK votes to elect MPs to the House of Commons, and decide the make-up of the Government. Polling stations across the country will be open from 7am until 10pm, with voting finally closing once everyone who was in line before 10 has cast their ballot.

The campaign has been hard fought, and health and social care has often figured centrally within it.

If health and social care are important issues for you, and you are unsure what each party says, you can view what all the major parties standing in England had to say about health and social care in their manifestos before you vote.

Whichever party is elected, we hope they will develop well thought out long-term solutions to some of the key issues facing health and social care.

Finally, we would like to thank everyone who has pledged to Vote4theNHS. 

Visit www.yourvotematters.co.uk/uk-general-election-2017 if you require any further information about the voting process.

Ashworth gives further detail on Labour’s health policies


One of Labour’s manifesto pledges was to ‘halt and review Sustainability and Transformation plans.’

Speaking to the Health Service Journal (£), Jon Ashworth, Shadow Secretary of State for Health, clarified this pledge. He said the review would be done by a new body, NHS Excellence, which would have patients and carers on its board and would be “definitely finished by the end of the year”.

He added: “It won’t stop change happening, we are not against change, but it will listen properly to clinicians and the public. If I may say so, and I mean this in the gentlest of terms to the NHS world, what has struck me since I got this job is the extent to which there is a feeling that if you involve the public you will just have another Kidderminster Hospital all over the place, as if the public cannot come to a sophisticated decision about the provision of health services in their area.

“I think you can trust the public a bit more. We have got nothing to fear by having proper discussions.”

In the interview he also gave his support for NHS England chief executive Simon Stevens, as well as admitting that Labour’s waiting list pledge uncosted (£).

Labour pledged to take 1 million people off NHS waiting lists by 2022, and Mr Ashworth says he is confident that this and other pledges can be delivered, “within the extra £37 billion,” identified in the party’s spending plans.

While he accepted the extra £37 billion over five years did not match the historic increase the NHS has received of 4% a year he also stated Labour, “will set up the NHS Office of Sustainability, modelled on the Office of Budget Responsibility, to make recommendations to government,” believing this will provide transparency about what the NHS needs in the future.

Think tanks call for action to strengthen NHS finances


The Health Foundation, the King’s Fund, and the Nuffield Trust have written an open letter calling for action to strengthen NHS finances after the election. The letter read:

“Sir, A strong NHS is vital for a thriving population, workforce and economy. Public spending on healthcare accounts for just over 7 per cent of our national wealth. That is not enough to cope with the ageing population and other cost pressures.

“Projections by the independent Office for Budget Responsibility suggest that a real-terms funding increase of about £30 billion a year is needed in five years’ time to enable the NHS to deal with these pressures. None of the main political parties has pledged enough to cover even half of that, while the share of our national wealth spent on healthcare would fall under all of their plans.

“The next government must act quickly to strengthen the health service’s finances in the short term, as well as developing a sustainable, long-term approach to funding the NHS, to put an end to the cycle of feast and famine. This should include establishing an independent body to assess and advise on health and social care funding needs.

“The NHS must also focus on improving efficiency and use additional funding to reform care to meet changing population needs. Failure to provide sufficient funding and improve efficiency will result in longer waiting times for patients, poorer access to cost-effective drugs and treatments and a decline in NHS and social care.”

King’s Fund assess manifestos’ commitments to population health


The King’s Fund has assessed the Conservatives’, Labour’s and the Liberal Democrats’ manifesto commitments to population health, and have concluded that the exercise was like ‘looking for needles in haystacks’.

The manifestos’ discussions of the inequalities that exist in health attracted criticism. While the Conservatives recognise, “If you are born poor, you will die on average nine years earlier than others,” the King’s Fund criticised them, along with Labour and the Liberal Democrats, for offering little in the way of explicit commitments to tackle this, observing that seemingly the parties, “have either given up on explicit policies that tackle social inequalities in health, or assume that the wider polices in their manifestos will automatically tackle them.”

They were more positive about some of the parties’ wider policy commitments that would affect health, in areas including housing, access to education and work. They gave specific praise to the Liberal Democrats for being the most direct with their pledge to for a National Wellbeing Strategy that, “puts better health and wellbeing for all at the heart of government policy.” But the King’s Fund also congratulate all three parties for offering, “welcome commitments on housing, including on increasing the amount of social housing and on insulating homes.”

However, they were critical of what is not mentioned in the manifestos. They were disappointed Labour and the Liberal Democrats did not challenge the current Government’s plans to make local authorities self-fund all their public health work, and that Labour said nothing about reinstating the public health funding cuts or putting health at the heart of all government policies – a pledge they had made in 2015.

In their overall assessment the King’s Fund said: “while the Conservative manifesto is the sparsest of all in terms of commitments on public health, none of the manifestos stand up to scrutiny on inequalities in health, or have anything really meaningful to say on the role of the NHS in population health, such as strengthening accountability through STPs. Neither do they offer a compelling vision for leveraging the power of people and communities in creating health.”

You can view the population health commitments as well as other health and social care commitments made by the major parties standing in England on our website.

Differences in public opinion on the NHS


recent survey conducted by the Health Foundation and Ipsos Mori found that about nine in ten people agreed on a number of topics relating to the NHS, including that it should be tax funded, free at the point of use, and a provider of comprehensive care for all citizens. This supports the widely-held view that there is a national consensus about the importance of the NHS, with just a small number not supportive of it. In a recent article, the Health Foundation has assessed this view, looking at the answers to all their survey questions in detail.

Their analysis shows that when asked across a range of topics, people offer views on the NHS that are more mixed, though they also found that people’s responses can be put into two broad groups. They therefore suggest as a more accurate representation of views about the NHS that 60% of people are strongly supportive and 40% more sceptical.

The first group was strongly supportive of the NHS across nearly all the questions in the survey and about 58% of survey responders fell into this group.

  • They almost unanimously think the NHS should be protected from cuts.
  • They for the most part strongly agree with the principles of the NHS.
  • They mostly think that EU workers should be allowed to stay after Brexit and that NHS staff should get a higher than planned pay rise.
  • They think that tax should be increased to pay for the NHS.

Interestingly they found this group was the slightly more likely to have used an NHS service over the last year.

The majority of the second group, while still supportive, disagreed with the first group on a number of issues.

  • They don’t think tax should be increased to fund the NHS.
  • 60% of them are happy to be cared for in a non-NHS setting.
  • 63% of them think that the NHS wastes money.

What their evidence suggests is while it is easy to think a small minority do not support the NHS, it is more accurate to conclude that there is a larger minority that is mostly supportive, but also somewhat sceptical, of the NHS.

Parties criticised for lacking plans to tackle the GP shortage


Pulse has criticised the three main parties manifestos for lacking plans to tackle the GP shortage, saying:

“Lip service is paid in all the manifestos to ‘getting the numbers [of GPs] we need’ (Conservatives), ‘long-term workforce plans’ (Labour) and ‘ensuring we never again experience a shortage in the numbers of GPs’ (Lib Dems).

“But there is no trace of the big plan to tackle this and one is desperately needed: the latest workforce figures show GP numbers fell between March 2016 and March 2017 by more than 500, despite the millions invested by the GP Forward View.”

Analysis by Pulse has revealed that, if patient demand grows at its current rate compared to GP numbers, the average GP will have to work an extra clinical session a week just to keep up with demand. The extra workload does not take into account the extra admin that would be involved in seeing the patients.

They estimate that even with an extra 5,000 GPs, the workload would grow by two hours a week. The Conservatives had previously promised to add 5,000 GPs, however did not include a pledge to do so in their current manifesto.

Chair of the Royal College of General Practitioners, Professor Helen Stokes, said: “Hard-pressed GPs around the country are already running on empty so these predictions are really concerning. As well as huge increases in the volume of patient numbers, disease management is also becoming much more complex and we simply cannot do any more without a significant injection of investment in general practice, including a significant influx of GPs.”

The Health Foundation assess social care pledges


The Health Foundation have assessed what some of the main parties have said about social care.

Social care is currently facing massive challenges.  Adult social care in England has seen, in real terms, a 9% fall in public spending between 2009/10 and 2014/15, and 400,000 fewer people receiving publicly funded care over this period. There is also going to be increasing demand for social care services: LSE and Kent University estimate a 40% increase in demand for local authority funded residential care between 2010 and 2030, and a 70% increase for home care.

Commenting on the social care pledges in the Conservatives’, Labour’s and the Liberal Democrats’ manifestos the Health Foundation said:

“Labour and the Liberal Democrats both offer immediate investment, around an extra £2bn a year by 2021/22. This appears close to our estimate of a £2.1bn funding gap in 2019/20, but demographic and cost pressures will continue to rise. So while the extra funding is welcome, it is still likely to fall short of rising need.

“The Conservatives have committed to increasing the means testing threshold from £23,250 to £100,000, but other factors, such as the size of a spending cap and crucially how the additional increase in public spending will be funded, will be worked through in the green paper, to which they have recommitted.

“All three main political parties now seem to support a cap on care costs, with Labour offering to lay the ground work for an NHS-style national care system, but detail is limited and there will be much to work through after the election.”

The Health Foundation believes the manifestos show social care will be a priority for all the parties, however it also warns that the manifestos only provide ‘clues’ to potential funding and not to the scale that would be needed to stabilise the sector. The Office for Budget Responsibility’s analysis suggests net public funding for social care would need to rise to £22bn in 2021/22 (in current prices) even before accounting for any costs inherent in introducing reforms such as a cap.

The Health Foundation warns the problem is complex and requires ‘time, careful thinking and public engagement’ and is not something that can be solved in the course of a snap election.

What might the election hold for health-focused MPs?


With the election now not far away, we look at the constituencies of some prominent MPs who currently hold offices, or shadow offices, relating to health and social care, and their possible outcomes on election night.

First there is current Secretary of State for Health, Jeremy Hunt. According to polling, Jeremy Hunt’s handling of the junior doctor’s strike has dented his popularity in the country as a whole. However, it appears not to have harmed the likelihood of his holding his seat. In 2015 he won his constituency of South West Surrey with 59.6% of the vote. And although there has been a well-publicised campaign to unseat him by National Health Action Party representative Dr Louise Irvine, with controversial talks of support from a cross-party alliance, it seems unlikely to overturn the local support for Mr Hunt.

Minister of State for Health Philip Dunne also appears to be assured of a safe return to the Commons, having won his seat of Ludlow with a majority of 18,929 in 2015.

Other members of the current ministerial team at the Department of Health are facing less straightforward contests, however. Nicola Blackwood, Parliamentary Under Secretary of State for Health Services, won her seat of Oxford West and Abingdon with an increased majority in 2015. However, 70% of people in Oxford voted to stay in the EU, so if the Liberal Democrats’ pitch to position themselves as the ‘party of Remain’ against the Conservatives were to succeed, they might mount a strong challenge to her – their candidate came second in 2015, and the Greens have stood down in their favour this time round. Nationally, however, this approach appears not to be working, and this may be reflected in Oxford West and Abingdon – Electoral Calculus give the Conservatives a 91% chance of holding it, although YouGov’s new and somewhat controversial forecasting model calls the seat as a ‘toss-up’. Ms Blackwood’s track record of campaigning to remain in the EU may also assist her.

Under Secretary of State at the Department of Health, David Mowat, could also face a tight re-election race. His seat in Warrington South is seen as a bellwether, and often indicates national voting trends. YouGov currently forecasts the seat as leaning slightly to Labour, while Electoral Calculus give Mr Mowat a 2-in-3 chance of being re-elected. However, UKIP are not fielding a candidate, and last time received a 6.9% share of the vote – if Mr Mowat can pick up a good proportion of ex-UKIP votes, his re-election seems likely.

Chair of the Health Select Committee, Dr Sarah Wollaston, is in a safe seat, having received a 53% share of the vote with a majority of 18,385 in her Totnes seat at the 2015 election.

Shadow Secretary for Health, Jon Ashworth, similarly has a very safe seat. He won his constituency, Leicester South, in 2015 by a majority of 17,845, gaining 59.8% of the vote. This is another seat where UKIP are not standing, but Mr Ashworth’s majority is such that it is very hard to see the Conservative candidate prevailing even with the support of the seat’s 2015 UKIP supporters.

An MP who is at significant risk of losing their seat is Norman Lamb, current health spokesman for the Liberal Democrats, and previously a health minister in the Coalition Government. He won his seat, North Norfolk, by a majority of 4,043 votes in 2015, and is being targeted by the Conservatives at this election, UKIP again standing aside in their favour. YouGov and Electoral Calculus both predict it as a Conservative gain. A strong vote in the region for Brexit, of 58.9%, is another indicator that the Liberal Democrats may struggle to hold the seat.

The Green Party do not have a health representative, and while UKIP is represented on health and social care issues by Suzanne Evans, she is not standing in this election.

Notes: All data from previous elections has been taken from Electoral Commission at https://www.electoralcommission.org.uk/our-work/our-research/electoral-data

 

Labour to ‘sweep away’ the provisions of the Health and Social Care Act


One of Labour’s manifesto pledges is to ‘reverse privatisation in the NHS and return services to expert public control’. Speaking on the BBC’s Today Programme Shadow Health Secretary, Jon Ashworth, explained the pledge in more detail.

Mr Ashworth said, “We are going to sweep away the provisions of the Health and Social Care Act that insist on all this competitive tendering and outsourcing,”

He wants the NHS to be the ‘preferred provider’ for services like providing community care. Arguing services like this are frequently being contracted out to private companies who were, “often not providing the quality of care people expect.” However, when questioned on examples where private companies did provide quality care at a reasonable cost, he accepted there will be cases where private providers would be required.

He clarified that the pledge will not affect the involvement of charities and not-for-profit organisations, who he says have always been involved, complementing the care provided by public services.

You can listen to part of the interview below.