Health Care Policy Overview

Election 2019

PB’s Managing Director Dan Jones gives his reaction to the major healthcare policies announced this election.

Despite the fact this election has been billed as the ‘Brexit Election’, the NHS finds itself taking centre stage once again; featuring quite prominently in debates and general discussion. Some things never change. Both Labour and the Conservatives have pledged to turn the funding taps back on and dramatically increase NHS funding after almost ten years of austerity.

With each party’s healthcare plans now published, PB Consulting have provided an assessment of the key pledges for Conservatives, Labour and Liberal Democrats.

The Conservatives

Key pledges:

• Enshrine the NHS Long Term Plan into law in first three months
• Additional funding of £34 billion per year by the end of Parliament
• Between 2018 and 2023, funding increase of 29%, by the end of Parliament, that will be more than £650 million extra a week
• Increased investment in capital expenditure projects
• 50,000 more nurses and 6000 more GPs
• Extend the successful Cancer Drugs Fund into an Innovative Medicines Fund

The Conservative manifesto did not set out to create a bold vision for the future of the UK. Still reeling from the sting from their attempted changes to social care, otherwise known as the ‘dementia tax’, during the last election, it’s pretty clear this document is designed not to cause any controversy.

The healthcare element of the manifesto fits this brief. Key pledges relate to the increase in spending and clinician numbers – more nurses and GPs promised. The Conservatives have maintained their 2010 promise to increase spending on the NHS above inflation, but the strain on the service is clear and the calls for increased investment have proved too strong for the Tories to ignore.

Recent spending plans were clearly established to create good news locally, with a series of announcements in relation to direct investment in local hospital building projects and expensive diagnostic equipment.

Unlike Andrew Lansley’s wholesale changes to the NHS in 2010, the Conservatives clearly have no plans for radical reform. Quite the opposite, a commitment to the Long Term Plan would see the current direction of travel maintained and simply see them implement the plans set out by the NHS Chief Executive, Simon Stevens. It is a plan for stable administration of the NHS.

For the life sciences industry the commitment to extend the Cancer Drugs Fund to become an innovative medicines fund will be welcomed by many but may cause concern amongst the cancer charities.

The Labour Party

Key pledges:

• Pledge to increase expenditure across the health sector by an average of 4.3% a year.
• For the purpose of reversing privatisation in the NHS, there is a commitment to repeal the Health and Social Care Act
• Keep the NHS out of any trade negotiations
• Establish a generic drug manufacturer

Unlike the Conservative party, Labour have set out a radical policy programme that would represent the biggest change in Government policy since Margaret Thatcher’s Government. They have committed to increases in spending in whole host of areas, including the NHS.

With regards to healthcare delivery, Labour have made two key pledges – repeal the Health and Social Care Act and stop privatisation.

Previous Labour policy in relation to the repealing the 2012 Health and Social Care Act referred directly to part three of the Bill which allowed for the provision of services by ‘Any Qualified Provider’. It is not clear from Labour whether they are planning to make wholesale changes to the current structure of the NHS based around CCGs. Previously Labour have been critical of the establishment of Integrated Care Systems, bolstered on the Long Term Plan. The manifesto is clear – they will stop ‘Tory plans to further entrench the private sector delivery of health care under the cover of integration plans set out in the NHS Long Term Plan’ and will instead set out their own plans for integrated care. However, there is no detail on what this will look and how it will differ from the plans in the Long Term Plan.

Labour healthcare policy in recent years has rarely gone beyond ‘stop privatising the NHS’. They have pledged to remove all private provision from the system and to bring all subsidiary companies back in house. Logistically this could prove challenging as the private sector currently provides a whole host of services for the NHS. Removing this will be costly and complicated.

For life sciences the document is less positive. The manifesto contains the pledges set out during the conference in September – to establish a generic drug manufacturer and to use Patents Acts provisions to break patents on expensive drugs. This would have severe implications for the UK life sciences industry and would make the UK are far less attractive place to be based and operate.

The Liberal Democrats

Key pledges:

• The Liberal Democrats are pledging to raise £7bn a year over five years, a total of £35bn, to spend on the NHS and social care, through one penny in the pound extra on income tax.
• Over the next Parliament, a Liberal Democrat government promises to invest £11 billion in mental health to expand access to therapies and increase the number of psychiatrists and specialist mental health practitioners.
• Commission the development of a dedicated, progressive Health and Care Tax
• Introduce a statutory independent budget monitoring body for health and care, similar to the Office for Budget Responsibility.

The Liberal Democrats also pledge to increase healthcare spending, alongside pledges to increase the number of doctors and nurses in the system. Norman Lamb’s legacy lives on in their continued commitment to building a cross-party convention on health and social care, and on the long term funding challenges.

The idea of an independent budget monitoring body is relatively novel, but is unlikely to win many votes ‘on the door step’.

Given the undeniable pressures felt currently felt by UK health care services, it is hardly surprising that each of the main parties have felt the need to loosen the purse strings. Following the mistakes of 2017, the Tories know they cannot win an election without substantial investment in public services. For Labour to remain the ‘party of the NHS’, they need to show themselves to be going beyond the pledges of their political counterparts. It is this jostling for position that has thrust the NHS into the spotlight of this Brexit election, with certain factions hoping that it can leapfrog the issue altogether.