A week in NHS politics: health becomes election battleground

Conservatives pledge £8bn uplift for the NHS

The Conservative Party firmly backed the NHS Five Year Forward View in its election manifesto with an explicit commitment to spend at least an extra £8bn a year on the NHS, over and above inflation, by 2020.

The document also includes a series of commitments to increase access to services and set up a “truly seven day NHS”, but prompted concerns from the Health Foundation over how these would be funded.

The manifesto does not identify a clear source for the funds and says only that the £8bn extra spending would be possible with a “strong economy”.

Challenged on this at the manifesto launch, David Cameron said the £8bn was not unfunded as it was part of the Tories’ fiscal plan, which includes eliminating the national deficit by 2018. However, how the deficit will be cut while the NHS funding is increased has not been fully explained.

• Conservatives pledge to fund forward view in election manifesto

Hunt says social care will gain from NHS boost

In an exclusive interview with HSJ, health secretary Jeremy Hunt stressed that his party’s promise of an extra £8bn for the NHS was not dependent on continued economic growth, and reiterated the Conservatives’ insistence that the pledge was “fully funded”.

Mr Hunt also told HSJ the better care fund should be “accelerated and extended”, helping the social care sector to benefit from increased spending promised for the NHS.

He said the £8bn would be honoured, even if Britain went back into recession. “It is a firm manifesto commitment. It is not dependent on external factors,” he said.

However, the Conservative manifesto does not commit to protect social care services, despite the forward view stating that the NHS could only deliver very high productivity increases if these services were maintained.

But the health secretary said: “What I would say to the social care system is, ‘Are you, or are you not, better with an extra £8bn going into the NHS when we now have mechanisms like the better care fund where the benefits of NHS funding are shared across the health and social care system in a way that never happened before?’

• Exclusive: Social care will benefit from £8bn NHS boost, says Hunt
• Hunt: Seven day NHS may be cheapest way to meet rising demand

Burnham: Forward view leaves big questions unanswered

While the Conservatives and Liberal Democrats reiterated their support for the forward view, Andy Burnham said the document left “many big questions unanswered”, in an exclusive interview with HSJ.

The shadow health secretary said Labour would not be setting the health service “on the right path” by adopting it without making “other fundamental changes”.

He suggested the “big questions” unanswered by the document were around the present competition regime in the NHS, and the integration of health and social care. Mr Burnham said the forward view’s assumptions were based in part on current government policies, which Labour would change.

Mr Burnham also stood by the party’s decision not to “get drawn into a bidding war” with the Conservatives and Liberal Democrats, who he accused of trying to “shift goal posts” in the argument around how much more money the NHS needs.

“The £8bn [funding issue] arises in five years’ time and it’s not the issue now. The issue is what happens to the NHS now, this year, immediately, that’s the issue,” he argued.

• Exclusive: Forward view leaves ‘big questions unanswered’, says Burnham
• Burnham: Social care will benefit from Labour’s £2.5bn health cash boost
• Leader: Neither politics nor personality should throw the NHS’s plan off course

Labour accuses Tories of ‘unfunded commitments’

Ahead of Labour’s full manifesto launch on Monday, it revealed its “health manifesto” at the weekend.

Labour accused the Conservatives of making “unfunded commitments”, referring to the Tories’ £8bn pledge.

The document confirmed a number of flagship NHS commitments the party has set out previously, including plans to:

• “repeal the Health and Social Care Act to scrap David Cameron’s privatisation plans and put the right values back at the heart of the NHS”;
• impose a profit cap on private providers of NHS “clinical services”;
• inject up to an extra £2.5bn a year to pay for 20,000 more nurses, 8,000 more GPs, 5,000 more careworkers and 3,000 more midwives;
• make health and wellbeing boards “a vehicle for system leadership”; and
• “improve access to a GP by guaranteeing appointments within 48 hours, or on the same day for those who need it”.

Lib Dems want to repeal elements of the Health Act

The Liberal Democrats criticised the role of competition in the health service, pledging to repeal parts of the Health Act 2012 and end the Competition and Markets Authority’s role in health.

In a new move, which strongly aligns with previously stated Labour policy, the Lib Dem manifesto says the party wants to repeal any parts of the Health Act 2012 that “make NHS services vulnerable to forced privatisation through international agreements on free markets in goods and services”.

The Lib Dems were the first to commit to increase the NHS budget in England by at least £8bn a year in real terms by 2020 to support the forward view.

The manifesto also restated Liberal Democrats’ intention to seek to invest an extra £500m a year in mental health and set up a £50m mental health research fund.

• Liberal Democrats commit to repeal competition elements of Health Act