Health and social care election tracker
How did health and social care issues shape the political landscape in the run-up to the 2015 UK general election?
David Cameron confirms new Conservative health team
David Cameron confirms the first all-Conservative team of health ministers since 1997. Jeremy Hunt remains Secretary of State. Alistair Burt becomes the new Minister of State and assumes responsibility for social care, primary care and mental health policy. Ben Gummer replaces Dr Daniel Poulter as Parliamentary Under Secretary of State, and David Prior resigns his post as Chair of the Care Quality Commission to replace Earl Howe in the House of Lords. They join Jane Ellison and George Freeman, who are reappointed.
In a short statement issued on 12 May, Jeremy Hunt says that his biggest priority is a ‘mission’ to transform care outside hospitals.
Conservatives win majority in general election
The Conservatives win a majority of seats in the House of Commons, despite pollsters predicting a hung parliament throughout the campaign. The Conservatives win 331 seats, with Labour managing 232, the Scottish National Party 56 and the Liberal Democrats eight. UKIP and the Green Party each win one seat.
Labour’s Ed Miliband; the Lib Dems’ Nick Clegg and UKIP’s Nigel Farage resign the leadership of their parties.
Exactly five years since the last election, the country goes to the polls – the first time in history this date has been fixed.
Labour warns of NHS deficit as campaigns reach closing days
Ed Milliband warns of a £1.9 billion ‘financial bombshell’ facing the NHS as Labour releases an unpublished analysis by umbrella body NHS Providers, suggesting that two-thirds of trusts expect to be in deficit in 2015/16.
The revelations come as all parties make a last-ditch bid to
voters, with Labour campaigning hard to make the
NHS the dominant issue in the run-up to polling day. At a rally on the same
day, Milliband calls on voters to use their vote to ‘rescue
the NHS’, while Andy Burnham tells the
Financial Times that he would argue for ‘the best settlement that I can
possibly get’ for social care funding alongside the NHS.
Clegg announces NHS funding is a 'red line' for negotiations
Nick Clegg says that the Liberal Democrats’ manifesto pledge to fund the NHS by an extra £8 billion a year by 2020 would be a non-negotiable issue in negotiations with other parties after the general election. He also confirms that the party would not budge on its commitment to new waiting time targets for mental health.
The announcement comes as polls continue to suggest that a majority government is unlikely, and the spotlight turns to different forms of parliamentary arrangement that could be made between the parties after 7 May.
Cameron questioned on NHS policy
David Cameron takes questions about Conservative commitment to the NHS in the last major televised event with party leaders. The Prime Minister is asked why voters 'do not trust your party with the NHS’, telling a studio audience that improving the health service is his ‘life's work’ but is only possible with a strong economy.
The BBC Question Time special edition follows a round of set-piece televised discussions featuring the main parties, including debates with health spokespeople on BBC’s The Daily Politics and Newsnight.
Think tanks call for a 'dose of realism' from parties
The chief executives of two leading health and care think tanks call for a ‘dose of realism’ from the parties about their NHS funding pledges. Writing jointly to the Guardian, Chris Ham of The King’s Fund and Nigel Edwards of the Nuffield Trust say that ‘promises of jam tomorrow are not enough’ given the immediate pressures facing the service. They also caution that the £8 billion quoted as the amount needed by the NHS is ‘the bare minimum’ needed to maintain standards of care.
Miliband promises to hit the ground running
Ed Miliband announces that if elected, Labour would launch a recruitment drive for new nurses on its first day in office. Pledging to fund 1,000 extra training posts in 2015, he adds that a Labour administration would use an early Budget to start raising money to pay for this from a mansion tax and a levy on tobacco firms during its first year in government.
The speech forms part of a week of intensive Labour campaigning on health issues, launched the previous day with a poster claiming that the NHS is 'on life support'.
Parties vie on staff pay
The Liberal Democrats and Labour both promise to end real-terms pay cuts for NHS staff. Nick Clegg pledges that the Liberal Democrats in government would issue guidance to advisory bodies such as the NHS Pay Review Body to ensure public sector pay increases at least in line with inflation from 2016–18.
Meanwhile, Andy Burnham tells the audience at the health and care debate that Labour would guarantee no real-terms pay cuts for NHS staff. This goes further than the party’s manifesto, which merely calls for greater heed to be paid to pay review body recommendations. Jeremy Hunt refuses to be drawn when pressed on the same issue.
The week before, Mr Burnham suggested to the Unison annual health conference the Labour would initiate a review of the Agenda for Change pay system of NHS pay rates and assured the audience that additional pay for unsocial hours would be maintained.
Candidates clash over health and care plans
Candidates from the four major parties discuss health and social care issues at a debate organised by The King’s Fund and other leading health organisations. Jeremy Hunt, Andy Burnham, Norman Lamb and UKIP’s Dr Julia Reid make their pitches for government, followed by a public question and answer session with an audience of professionals, patients and policymakers.
Scottish National Party launches manifesto
The Scottish National Party publishes its manifesto, which commits to an extra £9.5 billion in UK-wide health spending by 2020/21 and pledges the party’s support for the NHS five year forward view. The manifesto also restates the SNP’s commitment to oppose ‘further privatisation’ of the English NHS, and back moves to restore the Health Secretary’s responsibility to provide a comprehensive health service in England.
The commitments mark a shift in approach as, by convention, SNP MPs have not voted on policy matters restricted to England. They reflect a growing sense that the SNP’s support may be important if there is a hung parliament, and send a signal about their priorities in any future negotiations with other parties.
Funding warnings from former health chief
Sir David Nicholson, former Chief Executive of NHS England, weighs in to the debate about NHS funding in an interview with the BBC Radio 4 Today programme. He warns that services, particularly hospitals, face a 'substantial financial problem' that will become clear in the autumn.
Sir David says that it would be 'helpful' if Labour joined the Conservatives and Liberal Democrats in committing to £8 billion of extra funding a year for the NHS, but claims that this money is needed immediately and not by 2020 as they have pledged. He also calls the £22 billion of efficiencies identified in the NHS five year forward view a 'big ask'.
The intervention follows comments three days earlier from Lord Kerslake, former head of the civil service, in which he warned of 'immediate financial challenges' in the NHS. Lord Kerslake also aired concerns that it would be 'unwise' to make large cuts to local government in order to protect other ring-fenced Whitehall budgets, as these could have an impact on services such as social care.
Nick Clegg launches Liberal Democrat Manifesto
Nick Clegg presents the Liberal Democrat manifesto. As expected, its cover features a guarantee of ‘equal care’ for mental health as one of five policy priorities, signalling that the issue would be central to negotiations with other parties if there is a hung parliament.
The manifesto confirms the pledge to find the extra £8 billion a year in NHS funding called for by 2020 in the NHS five year forward view. It also confirms commitments to secure local agreement on fully pooled health and social care budgets by 2018, transfer responsibility for social care to the Department of Health and remove NHS mergers from the jurisdiction of the Competition and Markets Authority.
UKIP show their hand
UKIP are the final major UK-wide party to publish their prospectus for government. The manifesto pledges that the party would spend £3 billion a year more on the NHS and £1.2 billion a year more on social care over the next parliament. It also pledges that migrants and visitors to the United Kingdom will be required to have medical insurance and that full entitlement to NHS services will only be granted once someone has paid taxes in the United Kingdom for at least five years.
Other commitments in the manifesto include fully integrating health and social care under the control of the NHS and abolishing hospital parking charges in England. UKIP also say that they would replace Monitor and the Care Quality Commission with 'county health boards' made up of locally elected health and social care professionals.
NHA party manifesto promises £30 billion for NHS
The National Health Action Party launches its manifesto with a promise to fund the NHS in order to meet a predicted £30 billion gap by 2020. This includes the commitment to an immediate cash injection of £4.5 billion, to be funded by higher income tax.
The manifesto reiterates the party’s commitment to support a bill that would repeal the Health and Social Care Act, ending competition in the NHS and restoring the Health Secretary’s responsibility to provide a comprehensive health service in England.
Greens reveal plans for government
The Greens promise to end ‘health service austerity’ and the ‘creeping privatisation of the NHS’ as leader Natalie Bennett and Caroline Lucas, the party’s sole MP, present their election manifesto.
Many of the party’s policies receive their first public airing, including a pledge to increase NHS funding by £20 billion a year by 2020. This is matched by commitments to restore the proportion of NHS spending on primary care to 11 per cent, and to spend an extra £9 billion a year to provide social care free at the point of use in line with the recommendations of the Commission on the Future of Health and Social Care. The manifesto also restates the party’s commitment to introduce an NHS Reinstatement Bill to abolish competition and the commissioner–provider split, and restore the Health Secretary’s responsibility to provide a comprehensive health service.
Cameron launches Conservative manifesto
David Cameron launches the Conservative manifesto with a speech that promises voters a ‘good life’ built on economic recovery. He reaffirms the party’s commitments to fund the NHS five year forward view in full, at an extra cost of at least £8 billion a year by 2020, and to ensure 7-day access to key NHS services for all patients by the end of the next parliament.
The manifesto also includes pledges to guarantee same-day GP appointments for everyone over 75, reintroduce the right to a named GP, and improve transparency by giving patients access to full information about the safety record of hospitals and other providers.
Labour Party launches manifesto
The Labour Party publishes its programme for government. It highlights the pledges that a Labour administration would repeal the Health and Social Care Act 2012 and prioritise the integration of health and social care. It also confirms the promise to establish a £2.5 billion-a-year ‘time to care’ fund to pay for 20,000 more nurses, 8,000 more GPs and 3,000 more midwives.
Labour’s funding commitment falls short of the £8 billion a year called for in the NHS five year forward view. Defending this decision, Andy Burnham tells the Health Service Journal that the Forward View ‘leaves many big questions unanswered’ and that Labour would make ‘other fundamental changes’ which would change the assumptions it is based on. He claims that Labour is the only party with a ‘costed, fully funded proposal’ and says he does not rule out funding increases above the £2.5 billion it has pledged.
Conservatives confirm promise of at least £8 billion a year more for NHS
George Osborne confirms that the Conservative manifesto will commit the party to at least £8 billion a year of extra NHS funding by 2020. This would be in addition to the £2 billion ‘down payment’ for the NHS in 2015/16 announced in the Autumn Statement, and matches the minimum amount called for by senior health service leaders in the NHS five year forward view.
Responding to charges that the pledge is an unfunded spending commitment, senior Conservatives say they are ‘absolutely confident’ the money can be found and it is part of a ‘balanced plan’. However, despite being pressed several times in interview, they do not offer any detail about how the extra funding will be raised.
Milliband pledges 3,000 new midwives as Labour publishes health manifesto
Ed Miliband announces that his government would create 3,000 extra midwife posts if elected. Launching Labour’s health manifesto in Leeds, he pledges that the party would enshrine in the NHS constitution the right to dedicated one-to-one maternity care during labour and childbirth.
The health manifesto reiterates Labour’s plans to provide integrated whole-person care bringing physical health, mental health and social care into a single service. But the party claims that it would avoid a major structural overhaul of the NHS, warning that integration 'cannot be imposed by top-down edict'.
Labour attacks coalition record on access to doctors
Labour claims that under the coalition, patients are less likely than in 2010 to be able to get a doctor's appointment at evenings and weekends. As the party unveils a poster warning 'The Tories have made it harder to see a GP', Andy Burnham claims that NHS funding cuts are diverting patients to A&E services, with the proportion of surgeries open at evenings and weekends falling from 77 to 72 per cent.
Government parties refute Labour’s analysis, arguing that figures used are out-of-date and exclude the Prime Minister’s Challenge Fund to extend access to general practice.
Liberal Democrats pledge new fund to provide care closer to home
Nick Clegg reveals plans to establish a £500 million-a-year ‘care closer to home’ fund if the Liberal Democrats are elected to government. The fund would support measures to expand provision of home and community care, and to encourage GP surgeries to work together to provide diagnostic and other services traditionally provided by hospitals. The Lib Dems say that the measures would relieve pressure on hospitals by reducing unnecessary admissions.
Parties clash over NHS in TV debate
Party leaders trade blows on health policy as they set out their priorities in the only head-to-head debate of the campaign. In the televised discussion, Ed Miliband urges Britons to use their vote ‘to fight for the future of the NHS’ while David Cameron speaks of his personal experience of using the service, calling it the ‘most important national institution and national public service that we have’. Nick Clegg says that the NHS needs ‘hard cash’, reminding the audience that the Liberal Democrats are the only party so far to have explicitly promised an extra £8 billion a year for it if elected.
Nigel Farage is criticised by other leaders for raising the issue of so-called ‘health tourism’, including the claim that 60 per cent of those diagnosed as HIV positive in the UK each year are foreign nationals. Farage defends his comments two days later, as a YouGov poll finds that half of respondents would support UKIP’s flagship policy of a five-year ban on NHS treatment for those coming to live in the UK from other countries.
Liberal Democrats pledge an extra £3.5 billion for mental health
The Liberal Democrats launch the party’s ‘Manifesto for the mind’, promising that if elected they would spend £3.5 billion more on mental health care in England over the next parliament. This represents an additional £2.25 billion on top of the £1.25 billion over five years announced in March’s coalition budget.
The ‘manifesto’ reiterates key mental health pledges made by Nick Clegg and Norman Lamb in the past year, including new waiting time standards, better access to talking therapies and better services for pregnant women and new mothers.
Parliament is dissolved
As parliament is dissolved, the five-and-a-half week election campaign begins in earnest. With polls suggesting the result is still on a knife edge, the spotlight will remain on the policies of, and political chemistry between, all parties.
Extra NHS funding among UKIP’s ‘pledges to Britain’
Nigel Farage unveils UKIP's five key pledges as the party launches its election campaign in central London. It includes the promise, first made in January, to increase NHS spending by £3 billion a year.
Hunt drops NHS funding hint
In an interview with The Sunday Times, Jeremy Hunt appears to suggest a future Conservative government could provide the £8 billion in additional funding called for in the NHS five year forward view. Hunt claims that, if he remains Health Secretary after the election, he will review efficiency in the NHS, with the remaining funding gap bridged in the next Spending Round. He goes on to say the gap ‘might be more than £8 billion, it might be less’.
However, when pressed on this two days later, David Cameron refuses to be drawn. Asked to confirm in a BBC interview whether a Conservative government would find the £8 billion, he says only that ‘It depends how much you save from efficiencies’.
Hunt’s comments are the first time the Conservatives have suggested they may go further than their pledge to increase the NHS budget in real terms. Should they commit to finding the £8 billion, this would present a challenge to Labour who would need to decide whether to match it, with their pledge for a £2.5 billion ‘time to care’ fund coming on top of this. The Lib Dems have already committed to finding the £8 billion.
Cameron promises seven-day NHS by 2020
David Cameron outlines Conservative plans for a ‘truly seven-day’ NHS, including the expansion of hospital services at weekends. Addressing the party’s spring forum, the Prime Minister says the plans will build on the commitment to allow patients to see a GP seven days a week, adding that under a Conservative government, England would become ‘the first country in the world’ to provide comprehensive hospital care seven days a week.
Sir Bruce Keogh, NHS England’s Medical Director, has previously referred to this as his ‘number one priority’.
Miliband launches Labour campaign with pledge to cap private profits in NHS
Ed Miliband announces that if elected, Labour would introduce a cap on the profits made by private companies providing NHS services in England. Speaking at the East London site of the 2012 Olympics at an event that Labour bills as the launch of its general election campaign, he promises to ‘stop the tide of privatisation’ by setting a default cap of 5 per cent profit on private sector contracts worth more than £500,000. Miliband adds that Labour would end the ‘cherry-picking’ of easier or more profitable contracts by private providers.
The speech, which reiterates Labour’s five main pledges for government, shows that the party is keen to keep the NHS at the forefront of its campaign. It follows the first televised major party leader interviews the previous night, which saw Miliband and David Cameron interviewed separately on Sky News and Channel 4.
Farage confirms UKIP manifesto to be published 'as late as possible'
Nigel Farage tells Prospect magazine that UKIP’s manifesto will be published ‘as late as possible’ – perhaps 15 to 18 days before polling day. There has been speculation about its timing since Tim Aker MEP, the party’s former head of policy, stepped down in January. The manifesto is now being drafted under the leadership of UKIP’s deputy chair, Suzanne Evans MEP.
Describing ring-fencing the NHS budget as ‘a waste of time – it’s moonshine to think we can’, Farage says that UKIP does not have detailed plans for the reorganisation of the NHS but is adamant that the service’s efficiency could be improved. UKIP’s current policy – as set out by health spokesman Louise Bours – is to invest an extra £3 billion a year in the NHS front line.
Parties trade blows after the budget
The main parties clash a day after the Chancellor outlines plans to reduce public spending by £30 billion by 2018 in the last Budget before the election. Opposition leader Ed Miliband claims that ‘this scale of cuts cannot be made without cutting our NHS’. However, George Osborne tells ITV that the government’s ‘difficult decisions’ on the economy would protect the health service.
The Budget makes no major announcements on health and social care, apart from reiterating the commitment to spend an extra £1.25 billion on mental health services in England over five years. Danny Alexander follows this by delivering an ‘alternative’ Liberal Democrat Budget to Parliament. By increasing taxes and raising more from tax avoidance measures, the Lib Dems say they would cut the welfare budget by much less than the £12 billion outlined by the Chancellor.
Clegg announces extra mental health funding
Nick Clegg announces that the forthcoming Budget will include an additional £1.25 billion for mental health services in England.
Speaking at the Liberal Democrats’ Spring Conference in Liverpool, the Deputy Prime Minister confirms that the extra money, spent over five years, will be used to improve children’s and adolescent mental health services and to treat more than 100,000 young people by 2020. It will also be spent supporting armed forces veterans, pregnant women and new mothers.
The funding will be accompanied by new waiting time standards for child mental health and a commitment to provide specialists in children’s talking therapy in every area of the country by 2018. The announcement follows Norman Lamb’s pledges in January to invest an extra £500 million to improve mental health care in each year of the next parliament and to encourage every part of the NHS to sign up to eliminate suicides.
MPs introduce 'NHS Reinstatement Bill'
12 MPs present a Private Members’ Bill calling for the re-establishment of the Secretary of State’s legal duty to provide NHS services in England.
The Bill, introduced by Green Party MP Caroline Lucas and backed by Labour, Liberal Democrat, SNP and Plaid Cymru MPs, would dismantle much of the present architecture of the NHS by abolishing NHS England, CCGs and NHS trusts and transferring their responsibilities to regional committees of a new national health authority. It would also restrict the role of private companies in the NHS, abolish Monitor and repeal the legal framework governing competition in the NHS.
The Bill has no chance of becoming law but its supporters say they will challenge candidates from all parties to say whether they support the Bill during the election campaign.
Dementia campaign wins cross-party backing
A campaign led by novelist Nicci Gerrard to allow friends and family 24-hour hospital access to vulnerable dementia patients gains cross-party support.
The Observer reports that Norman Lamb will write to all NHS trusts about the idea and Andy Burnham has committed to including it in Labour’s election manifesto and strengthening the NHS constitution.
Charities will be preferred providers pledges Andy Burnham
Andy Burnham says charities could be given five or ten year contracts to deliver health services under a Labour government.
In a speech to the ACEVO health and social care conference, Burnham reassures voluntary sector leaders that charities will not lose out under his plans to make the NHS the preferred provider of health services. Expanding on comments he made at The King's Fund in January, he pledges to legislate to ensure the voluntary sector has a 'different status in law when it comes to contracting'.
Lamb calls for single ‘health and care department’
'It’s ridiculous that we have funding for the health and care system flowing through two different government departments and endless negotiations between two. It has to be one department.'
Norman Lamb says a single government department for health and social care should be created immediately after May’s general election.
In an interview with the Health Service Journal the care minister, who has previously suggested all local health and social care budgets should be fully integrated by 2018, says that a new financial settlement will need to be agreed nationally for health and care after May.
He also joins Andy Burnham in calling for the NHS Trust Development Authority (TDA) to merge with Monitor, making him the first minister to propose this.
UKIP launch NHS policy
UKIP health spokesman Louise Bours launches the party’s policy programme for health and social care. Reiterating its commitment to invest £3 billion per year extra in the NHS front line, Bours adds that if elected, UKIP would increase dementia funding by £130 million per year over the next parliament and would increase social care funding for older people by £1 billion each year. The party also announces that integration of health and social care is a priority, and that it would enable this by bringing funding of both under an NHS-controlled ‘social care fund’.
Bours confirms the party’s pledges to scrap hospital car parking charges in England, make private medical insurance compulsory for many migrants, introduce a license to practice for medical mangers and abolish the Care Quality Commission, with inspections undertaken by democratically elected local health boards.
Liberal Democrats present health as a manifesto priority
Health is confirmed as one of five policy priorities to feature on the cover of the Liberal Democrats' general election manifesto. The party has already pledged to invest an extra £8 billion a year in the NHS by 2020 and to guarantee equal care for mental health. By including these commitments on its manifesto cover, Nick Clegg sends a signal that they would be central to negotiations with other parties if there is a hung parliament. While no party has formally outlined non-negotiable commitments, Liberal Democrat sources tell Liberal Democrat Voice that they would 'fight tooth and nail' to build consensus on the five manifesto cover priorities.
Farage says NHS funding model will need to be reconsidered
Nigel Farage warns that there will need to be further debate about how the NHS is funded in future, in response to the pressures of an ageing population. Challenged by the BBC on his previous statements favouring an insurance-based funding model, the UKIP leader says that 'as time goes on, this is a debate that we're all going to have to return to'. He confirms that his party colleagues had 'outright rejected' his proposal for an insurance-based system.
The comments appear to mark a shift from Farage's statement in November 2014 that UKIP had 'an unshakeable commitment to a health care system that is free at the point of use' and that there would be 'no more debate, no more argument' in UKIP about the funding of the NHS.
Louise Bours, UKIP's health spokesman, claims that 'if the party discuss it again, we will reject it again'.
Mental health pledges from Clegg and Miliband
Nick Clegg promises to sign the NHS up to a 'zero suicide' campaign as the Liberal Democrats and Labour set out their stalls on mental health. Speaking at a government mental health conference held at The King's Fund, Clegg says that 'every part' of the NHS in England should sign up to eliminate suicides, building on commitments already made by health leaders in some local areas. In a very political speech, Clegg adds that his party wants 'to go much, much further' on mental health, reiterating plans to invest £500 million to improve mental health care in each year of the next parliament.
Meanwhile, Ed Miliband promises that a Labour government would end 'the scandal of the neglect of child mental health', as he presents the report of an independent Mental Health Taskforce, commissioned by the party and led by Sir Stephen O' Brien, Chair of Barts Health NHS Trust. The report proposes a package of priorities and measures to improve mental health services, with greater emphasis on better support, prevention and early intervention.
Labour opens a lead on the NHS as voters say it is a top concern
Ipsos MORI’s first Political Monitor survey of 2015 shows 46 per cent of those asked naming health care, the NHS or hospitals as a very important issue in deciding how they will cast their vote. This is more than any other issue, and up from 29 per cent in the same poll in September 2014. It echoes the findings of a ComRes poll for ITV News, published on Wednesday, in which 50 per cent of respondents named the NHS as one of their top three concerns (up from 39 per cent in the same survey last month).
In YouGov’s most recent poll for The Sun, taken in early January, health was identified as one of the most important issues facing the country by 46 per cent of those surveyed, up from 33 per cent the month before. While these results partly reflect sustained public focus on NHS performance and continued pressures on A&E services, the NHS is now consistently vying with the economy and immigration as the top concerns for voters.
Meanwhile, polling by Conservative peer Lord Ashcroft shows Labour with an 18-point lead over the Conservatives as the party most trusted to tell the truth on the NHS. This is a significant shift from recent polls that have shown Labour or the Conservatives with a narrow lead on the issue.
Burnham unveils Labour public health proposals
Andy Burnham pledges that a Labour government would ‘take tougher action’ to protect children from the harmful effects of sugar, alcohol and tobacco. Launching a paper detailing the party’s approach to public health, he announces plans to set maximum limits on levels of fat, salt and sugar in food marketed to children, and that the party is considering the option of a time watershed for TV advertising of products high in sugar, fat or salt.
The party’s overall approach is to pursue more interventionist and regulatory policies as regards child health, but to empower adults to make healthier choices by raising the level and consistency of information available to them. Other proposals in the paper include giving local councils clearer powers to restrict the number of fast food outlets, and targeting cheap high-alcohol drinks that ‘fuel binge drinking’.
The announcement follows a speech by Liz Kendall the day before, in which she set out Labour’s plans to improve support to people providing informal care to family members. These included introducing a new NHS duty to identify family carers, and introducing a single point of contact with care services for carers of relatives ‘with the greatest needs’.
Election debate hots up as NHS pressures mount
Ed Miliband faces criticism over allegations that he outlined Labour plans to ‘weaponise’ the NHS as part of its general election strategy.
These allegations follow heated exchanges about winter pressures facing the service, a subject that overshadowed the opening week of the parties’ campaigns for 2015. Miliband later outlined Labour’s five-point plan to ‘end the mounting A&E crisis’ in an interview with the Daily Mirror.
As the Conservatives unveil the six key themes for their manifesto, the NHS is notable by its absence. In a speech, David Cameron says his party’s plans to eliminate the deficit would be accomplished while ‘not a penny’ is cut from the NHS. However, he gives no indication of whether a future Conservative government would go further than the pledge already made to maintain NHS spending in real terms beyond 2016-17.
Nick Clegg pledges £8 billion more for NHS
The Liberal Democrats outline plans to increase NHS spending by £8 billion a year by 2020–21, in line with the minimum requirement for additional funding set out in the NHS five year forward view.
Nick Clegg says the party would deliver the additional funding in three stages: (1) making permanent the extra £2 billion a year outlined in the coalition’s Autumn Statement; (2) adding an additional £1 billion a year raised from taxes affecting higher earners and scrapping employee ‘shares for rights’ benefits; and (3) investing some of the proceeds of economic growth, once the deficit has been reduced from 2017–18.
The party says it would focus additional funding on ending the discrimination against mental health, and better joining up health and social care to provide a focus on preventing ill-health. It would also commission a cross-party ‘fundamental review’ of NHS and social care funding before the next Spending Round to consider financial pressures and the scope for efficiencies.
Parties begin 2015 NHS campaigning
Labour fires the starting pistol on a new year of NHS campaigning, showing that health and care remain at the top of the pre-election agenda. Douglas Alexander, the party’s Chair of General Election Strategy, publishes a 27-page dossier criticising the coalition’s management of the service, arguing that it ‘cannot survive five more years of David Cameron’. He claims that on current trends the NHS of 2020 could see waiting lists of 4 million, and more than half a million older people no longer able to access to social care.
Labour also reiterates its own NHS proposals, including the creation of a £2.5 billion a year Time to Care Fund and repeal of the coalition’s Health and Social Care Act, and unveils its first election poster for 2015, which parodies David Cameron’s 2010 pledge to ‘cut the deficit, not the NHS’. In an interview with the BBC, David Cameron highlights extra NHS funding made available by the government in December, and calls on all parties to unite behind this commitment and the vision outlined in the NHS five year forward view.
Meanwhile, Nigel Farage tells Sky News that, while ‘overall health spending is going to go up over the next few years’, efficiency savings could still be made, pinpointing NHS middle managers as a potential target. He also says that a UKIP government would ‘winnow out’ doctors and nurses not meeting a prescribed standard of spoken English.
'Long campaign' begins
Although they do not officially become candidates until Parliament is dissolved next year, the 'long campaign' as it is defined by the Electoral Commission starts today. This means all prospective candidates must now spend within agreed limits and must keep a record of their spending and donations.
Labour's new plans for cancer treatment
Andy Burnham outlines Labour’s new plans for an annual Cancer Treatments Fund. This would replace the Cancer Drugs Fund when it expires in March 2016, building on current provision to include non-pharmaceutical treatments such as radiotherapy and surgery. £50 million from a pharmaceutical industry rebate would be added to the existing Cancer Drugs Fund budget to create a new fund of £330 million per year.
Speaking to the Britain Against Cancer conference, Burnham also pledges that a Labour government would publish a new cancer strategy within six months, and would commission Cancer Research UK and others to recommend ways to tackle under-treatment of older cancer patients.
Cancer caused lively debate during the 2010 general election campaign, after David Cameron unveiled Conservative plans for a Cancer Drugs Fund, then worth £200 million per year.
Chancellor outlines extra NHS spending
George Osborne provides details of extra health spending as he presents his Autumn Statement, one of the last major set-piece political events before the general election. The Chancellor pledges ‘£2 billion of additional funding for the frontline NHS in England’ in 2015/16.
This includes a £200 million ‘transformation fund’ to kick-start the NHS five year forward view, and the first share of a proposed £1 billion investment in GP services over four years. The figures were first confirmed to parliament by Jeremy Hunt the previous day following widespread media coverage.
The announcements follow intense pressure to increase the NHS budget, including from the Chancellor’s Liberal Democrat coalition partners as well as the Labour opposition.
Elsewhere, the report from the Office for Budget Responsibility accompanying the statement makes it clear that less than half of the savings required to meet the government’s deficit reduction target have been delivered during the current parliament, signalling further eye-watering cuts to departmental budgets after the election.
Hunt hints at Conservative election priorities
Jeremy Hunt drops hints about the direction of Conservative manifesto policy by emphasising the role of transparency, inspections and data in driving performance.
In an interview with the Health Service Journal, he points to ‘very powerful commissioning’ as a more important factor than choice in improving services. This emphasis marks a clear departure from the position of his predecessor. The interview reflects further efforts by Hunt to present himself as patient champion rather than cheerleader for the NHS.
Hunts adds that he has asked the Prime Minister if he can remain as Health Secretary if the Conservatives are in government after the general election, saying that he has ‘always said I want to do this job for five years’.
MPs vote to support Labour NHS bill
A bill that would reverse reforms introduced as part of the coalition's Health and Social Care Act 2012 has cleared its first parliamentary hurdle, with MPs voting by 241 votes to 18 to give it a second reading. Seven Liberal Democrats, two Conservatives, both UK Independence Party MPs and the Green Party’s solitary member joined forces with Labour members to vote in favour of its provisions, while only Conservatives opposed.
The Bill is introduced as a Private Member's Bill by Labour MP Clive Efford, who claims that it would ‘cut the heart out’ of the coalition government's health reforms. It has the public support of the shadow health ministerial team and foreshadows legislative changes Labour would make if elected. It has been used by Labour as a campaigning focus and to test support for these aspects of the coalition’s reforms among Lib Dem MPs ahead of the general election. It now awaits a date for committee stage, although there is unlikely to be enough time in the parliamentary calendar for it to become law.
The Bill contains provisions to 're-establish' the Secretary of State’s responsibility for the NHS in England, with a duty based on 'social solidarity'. It would also amend the role of Monitor, reduce the amount of income that foundation trusts can earn from treating private patients, and repeal rules related to the compulsory tendering of NHS contracts, made under Section 75 of the Act.
Farage clarifies UKIP's position on NHS
Ukip leader Nigel Farage is forced to clarify the party’s position on the NHS, after a video from 2012 emerges of him suggesting public funding of the NHS should be replaced by a private insurance model.
In a column for The Independent Farage confirms Ukip will keep the NHS free at the point of use and gives some further details of Ukip’s health policy, which include ending the use of PfI contracts and ensuring all migrants have private health insurance.
Lamb calls for extra NHS spending in Autumn Statement
Ahead of the Chancellor’s Autumn Statement, Norman Lamb argues that the NHS needs up to £1.5 billion of extra funding in 2015/16. He tells the BBC that, while the NHS has ‘performed remarkably well’, it ‘could crash’ without this additional money.
The Liberal Democrat health minister also repeats his call for an increase in funding for mental health to improve access and reduce waiting times.
Any spending commitments for 2015/16 contained in December’s statement will be inherited by the incoming government after the general election.
Health policy a central issue on Rochester and Strood by-election trail
Health is a high-profile issue in the Rochester and Strood by-election, caused by the defection of Conservative MP Mark Reckless to UKIP. Politicians and commentators are watching events closely for an indication of the public’s priorities and mood ahead of the general election.
In an October poll, voters in the constituency identified the state of local NHS services as the most important issue facing them and their families, ahead of issues such as immigration, crime and employment.
Some of this debate has focused directly on the local hospital, Medway Maritime Hospital. This has been in special measures since July 2013, with regulators judging that it had made ‘no progress’ by July 2014.
Burnham gives more detail on Labour plans
Andy Burnham says a future Labour government would ‘strengthen’ the role of NICE and consider making its clinical guidelines mandatory rather than advisory.
In a wide-ranging interview with the Health Service Journal, he suggests that health and wellbeing boards could develop a role ‘signing off’ commissioning plans, with clinical commissioning groups acting as an ‘executive’. He also suggests that he would 'repatriate' commissioning support units to support CCGs and HWBs.
Additionally, Burnham confirms that the NHS would be given the ‘first chance’ to provide services under Labour’s preferred provider policy. Services would be opened up to competition only if commissioners judge the NHS is unable to meet their requirements.
Labour makes new cancer pledge
In an interview with The Times, Ed Miliband announces a 10 year ambition for Britain to have the best cancer survival rates in Europe. This is backed by a guarantee that patients will have to wait no longer than a week for cancer tests and results by 2020. The pledge will be paid for from the proceeds of the tobacco levy announced at the Labour Party Conference. This follows moves from Labour to respond to concerns that its plans will result in a top down reorganisation. Writing in HSJ, Debbie Abrahams MP says whole person care would be implemented through an ‘evolutionary’ process.
At a glance: key pledges so far
- A real-terms increase in NHS funding
- All patients to have access to a GP from 8am to 8pm, seven days a week by 2020
- 5,000 more GPs to be trained
- A £2.5 billion Time to Care Fund to pay for 20,000 nurses, 8,000 GPs, 5,000 care workers and 3,000 midwives
- Whole person care to be at the heart of Labour’s manifesto
- The Health and Social Care Act to be repealed
- A guaranteed appointment with a GP within 48 hours
- The NHS to be the preferred provider of services
- A real terms increase in NHS funding of £1 billion in 2016/17 and 2017/18
- An extra £500 million for mental health services
- Health and wellbeing boards to be increased in size and given power to hold budgets
- NHS mergers will no longer come under the jurisdiction of the Competition and Markets Authority and commissioners will not have to put all services out to tender
- All patients to be issued with a ‘care footprint’ detailing the costs of their care
Lib Dems put mental health centre stage
The Lib Dems pledge a real terms increase in NHS funding of £1 billion in 2016/17 and 2017/18, holding out the possibility of higher funding increases in the latter years of the next Parliament. In an interview with HSJ, Norman Lamb indicates that the Lib Dems will also press for extra funding for the NHS in 2015/16 ahead of December’s Autumn Statement. Announcing a new five year strategy, Nick Clegg promises that the party’s commitment to mental health will be ‘on the front page of our manifesto’ and pledges that at least half of the promised £1 billion funding increase would be spent on mental health services. The strategy includes two waiting time targets to be implemented from April 2015 – one to promote timely access to talking therapies and the other to ensure rapid access to treatment for people with psychosis.
Lib Dems publish detailed policy proposals
A policy paper published ahead of the Liberal Democrat party conference outlines their ideas for ‘flexible, accessible, accountable’ public services. This includes proposals for local bodies to form Better Outcomes Boards to share budgets and jointly commission services. The paper states that the Competition and Markets Authority would have no jurisdiction on NHS competition issues and commits to shifting the balance of NHS funding towards mental health over time. It also outlines an enhanced role for health and wellbeing boards, including a possible role in commissioning GP services.
A separate paper on the ageing society proposes that the duty on local authorities to promote wellbeing established in the Care Act should be extended to the NHS and education, while the current NHS, social care and public health outcomes frameworks would be combined into a single national wellbeing outcomes framework. Other proposals include a requirement for all NHS patients to be issued with a ‘care footprint’ detailing the costs of their care and a commitment to work with the royal colleges to increase the number of geriatricians.
Conservatives come out fighting on the NHS
Speaking at the Conservative Party Conference, David Cameron pledges that all patients will be able to access a GP from 8am to 8pm, seven days a week, by 2020. This will extend the Prime Minister's Challenge Fund under which extended opening hours are currently being piloted in 20 areas of the country. The government says this will cost £400 million over the next five years, while Jeremy Hunt also pledges that 5,000 more GPs will be trained.
Later in the day, Hunt announces that the new GP contract for 2015/16 will include requirements for all patients to have access to a named GP (currently a requirement for people over 75), and for patients to have online access to detailed information from their medical records by April 2015. Bringing the conference to a close, Cameron pledges to protect NHS funding and invest more in research and technology to combat genetic diseases.
UKIP health spokesman's speech to conference
At UKIP’s annual conference, health spokesman Louise Bours MEP pledges to end hospital car parking charges in England. This would be done using £200 million of an estimated £2 billion, which UKIP claim can be saved by charging NHS health insurance to migrant workers and visitors entering the UK.
Bours also proposes that Monitor and the Care Quality Commission be replaced by ‘county health boards’ of locally elected health professionals, and confirms the party’s proposal of a statutory ‘licence to manage’ for NHS managers, overseen by a professional regulator on the same footing as the General Medical Council.
Bours denies that the party would introduce charges for GP appointments.
Labour Party Conference: Miliband seizes the initiative on NHS funding
Labour become the first party to make a significant commitment on NHS funding, as Ed Miliband pledges to establish a £2.5 billion 'Time to care' fund. This will pay for 20,000 nurses, 8,000 GPs, 5,000 care workers and 3,000 midwives. It will be funded by the proceeds of a mansion tax, measures to tackle tax avoidance and a levy on tobacco companies.
In his speech to the conference, Shadow Health Secretary Andy Burnham announces that all hospitals will be asked to evolve into integrated care organisations, as well as support for carers and a right to die at home.
In an interview with HSJ following his speech, Burnham indicates he is considering changing Monitor's role to make it responsible for promoting integrated care and overseeing the financial sustainability of local health economies, rather than individual organisations.
The Scottish referendum
The Scottish referendum dominates the political landscape throughout the summer and early autumn. Health takes centre stage towards the end if the
campaign as the No campaign raise fears about funding and privatisation.
Where are the parties saying about public spending and NHS funding?
What the parties say about funding for health and social care will be heavily influenced by their wider plans for public spending and reducing the budget deficit. Here we set out their positions. The main parties have all made commitments to eliminate the deficit during the next parliament, although there are differences, particularly in their approach to capital spending, which will affect their room for manoeuvre on public spending.
Lib Dems promise to protect NHS spending in 'pre-manifesto'
In a pre-manifesto document published ahead of the Liberal Democrat conference, the party guarantees that the NHS budget will rise by at least the rate of inflation in each year of the next Parliament. They also pledge to commission a review of the pressures on NHS and social care finances before the next Spending Review and to introduce multi-year budgets.
The document reiterates previous promises on health, particularly commitments on integrated care, parity of esteem for mental health, and improved rights and benefits for carers.
Lib Dems promise to boost mental health research spending
Nick Clegg announces that the Liberal Democrat manifesto will include a pledge to establish a mental health research fund to support the development of new treatments, which would be worth £50million a year by 2020.
The fund would aim to bring medical understanding of mental health up to the same level as physical health, Clegg says.
Labour deny tax increases are on their agenda
"People feel they are paying too much tax already"
In an interview with The Telegraph, Ed Balls rules out the introduction of a so-called ‘death tax’ – a levy on estates to fund adult social care – or a 1p increase on national insurance for the NHS by a future Labour government.
Andy Burnham calls for pause in NHS private contracts
Labour launches its summer offensive on the NHS by attacking the coalition's health reforms. In a speech in Manchester, Andy Burnham draws the battle lines for the election campaign by claiming that privatisation of the NHS is proceeding 'at pace and scale' and calling for a moratorium on contracts for NHS services being given to private providers until after the election.
Lib Dems consider NHS tax
Newspaper reports suggest senior Liberal Democrats are considering a hypothecated tax to boost NHS funding during the next parliament. Former health minister Paul Burstow will expand on this idea in a Social Market Foundation report due to be published in September. This follows reports earlier this year that Labour are exploring a similar proposal mooted by Frank Field MP.
Labour confirms pledge to match coalition spending plans
Labour's National Policy Forum endorses the leadership's pledge to match the coalition's spending plans for 2015/16 (not including capital spending). No details of significant changes to the health and social care policies already outlined by the party emerge from the Forum. The policies endorsed by the Forum will be published at Labour's party conference in the autumn and will form the basis of their election manifesto. Meanwhile, shadow health minister Andrew Gwynne outlines plans to establish a new body to oversee service reconfigurations. The new body would manage public consultations on proposed service changes and have the power to amend the changes proposed.
'Free' GP surgeries?
Enfield MPs Nick de Bois and David Burrowes suggest that the principles of ‘free schools’, the Conservatives’ flagship education policy, should be applied to GP services. They argue this would improve access and quality of services by making it easier to set up new practices, and challenge ‘GP cartels’ who currently prevent new entrants from setting up practices in their area.
Polls suggest support for increased NHS funding
Amid growing concerns about a potential financial crisis, a number of opinion polls suggest strong public support for increasing NHS funding. A poll for The Independent finds that nearly 60 per cent of people would pay more tax to maintain current services. Asking a slightly different question, a poll for The Observer finds that more than 40 per cent would pay higher taxes if the money raised goes to the NHS. Meanwhile, a survey for HSJ finds that almost 90 per cent of people agree that NHS funding should increase as the economy improves.
Liberal Democrats promise to introduce carer’s bonus
Nick Clegg announces a manifesto pledge to give Britain’s 1 million full-time carers an annual ‘Carer’s Bonus’ of £125, rising to £250 a year by 2020. The bonus would be linked to the Carer’s Allowance, with no conditions on what it could be spent on.
Cameron and Miliband clash over NHS waiting times
David Cameron and Ed Miliband clash over NHS waiting times at Prime Minister's Questions. The Guardian reports a party source saying that Labour intends to make the NHS 'one of the major issues in the run up to the next election.'
Will the Conservatives pledge to end national insurance?
Newspaper reports suggest that plans to merge income tax and national insurance and replace them with a single ‘earnings tax’ are being seriously considered for the Conservative manifesto. Critics express concern that this could undermine NHS funding.
As expected, the final Queen’s Speech before the general election does not include any significant health-related legislation. A Small Business, Enterprise and Employment Bill will include provisions to stop highly paid public sector employees, including NHS staff, keeping redundancy payments when they return to similar roles within a short period of time.
NHS Confederation conference
All three of the main party spokespeople address the NHS Confederation’s annual conference on the same day.
Norman Lamb goes much further than he has before in calling for a legal obligation to pool health and care budgets. Andy Burnham indicates that reform should come before an increase in NHS funding. Meanwhile, Jeremy Hunt links the future sustainability of the NHS to improving patient safety and changing care outside hospitals.
European and local elections
Taking place almost a year before polling day, the European and local elections provides an early indication of the parties’ electoral prospects. With UKIP the big winners and the Lib Dems the big losers, Labour make little headway, perhaps prompting newspaper headlines that its manifesto will include a pledge to increase NHS spending. Meanwhile in an interview in HSJ, Jeremy Hunt refuses to be drawn on whether the NHS needs a funding increase.
Labour inquiry questions purchaser/provider split
An inquiry by the Parliamentary Labour party concludes that competition increases health inequality and that there is little evidence that the purchase/provider split has improved quality, while it has led to additional transactional costs. Among a number of recommendations to the party, it suggests that health and wellbeing boards and clinical commissioning groups should be able to direct NHS and social care spending through integrated budgets, and that the NHS should be more democratically accountable.
Labour pledges action on exploitation of care workers
An independent review commissioned by the Labour Party calls for an end to 15-minute time slots for home care visits and for the remit of the Care Quality Commission to be extended to protect care workers from exploitation. Ed Miliband welcomes the report and pledges a future Labour government would end 15-minute visits.
Ed Miliband revives GP appointment guarantee
Ed Miliband announces that Labour would introduce a guarantee for all patients to get a GP appointment within 48 hours, effectively promising to reinstate a target abandoned by the coalition in 2010. He promises £100 million to pay for this, mainly funded by reducing costs associated with competition. The old target caused some embarrassment for Tony Blair during the 2005 election campaign when an angry patient complained that it prevented her from booking an appointment with her GP more than 48 hours in advance.
Who should commission primary care?
In response to NHS England’s proposals to give clinical commissioning groups a stronger role in commissioning primary care, Andy Burnham suggests that Labour would consider giving this responsibility to health and wellbeing boards.
A year to go to the election
With a year to go until the general election, comparatively little is known about how the party manifestos will shape up. All the main parties are currently consulting their members on the policies that will eventually make up their manifestos.
We know most about where Labour are heading – their health offer is likely to focus on their proposals for whole person care, although some significant questions remain about how this will be implemented and paid for. The Lib Dems are beginning to differentiate themselves from their coalition partners by setting out their own policy positions – expect more of this as polling day draws nearer. We know least about how the Conservative manifesto will shape up – the way their policy process works means that little will be revealed before their party conference in the autumn. Among the other parties, UKIP’s health policy remains a blank slate, other than a requirement for migrants and visitors to the UK to show proof of health insurance as a condition of entry, while the Green party have pledged to ‘restore the NHS to public ownership’ and introduce free personal care for older people. Finally, this election will see a new name on some ballot papers, with the National Health Action Party pledging to field up to 50 candidates.
Labour’s ambitions for public health
A policy paper leaked to the Daily Mail indicates that Labour are considering a wide range of measures to improve public health including regulations to limit the levels of fat, salt and sugar in children’s food and a minimum unit price for alcohol.
Jeremy Hunt comments on charges and the NHS budget
'We want a service that's free at the point of use, that is there for rich or poor, young or old, city or country... no charges and we're absolutely clear.'
In an interview on the Andrew Marr Show, Jeremy Hunt states that a future Conservative government would not increase user charges for NHS services and indicates that his party’s ‘instincts’ are to continue to protect the NHS budget.
Labour considers an increase in National Insurance to fund an increase in NHS funding
'We have to think about the second phase of the life of the NHS. It has to be reborn. Otherwise it will be unsustainable in a few years' time.'
Newspaper reports suggest that Labour are considering proposals to increase National Insurance to pay for an increase in NHS funding.
Lib Dems publish policy proposals on public services
A consultation paper presented to the Liberal Democrat's Spring Conference recycles their 2010 manifesto commitment to give people money to go private if NHS treatment is not provided promptly and signals that health and wellbeing boards could evolve to include more elected members.
Clive Peedell to stand against David Cameron in Witney
'If we carry on the way we are, we’re going to lose our National Health Service, there’s no doubt about that.'
Dr Clive Peedell, co-leader of the National Health Action Party, announces that he will stand against David Cameron in Witney, making him the first of up to 50 candidates the party have pledged to field at the election.
Oldham Commission report published
Norman Lamb calls for OFT 's role in NHS mergers to be scrapped
Speaking at The King’s Fund, Norman Lamb says that the role of the Office of Fair Trading in overseeing NHS mergers should be scrapped, making it clear afterwards that he was speaking as a Lib Dem, not for the government.