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.
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.
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.
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.
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.
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.
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’.
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.
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.
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.
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’.
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.
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
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.
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.
'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.
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.
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.
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.
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.