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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.