Beyond the headlines; what is the future of the NHS?

By April 2, 2015EU

By David Talbot, Consultant, London

The NHS is always a major issue at elections. In 2015 it sits alongside the economy and immigration as top amongst voters’ concerns. But the main political parties couldn’t be further apart on their willingness to talk about this most salient of political issues in the run-up to May. Labour wish to talk about nothing but, the Conservatives wish to avoid at all costs. The rationale is clear; Labour retain a clear, commanding and unassailable  Unsurprisingly, Labour is playing to its strongest card – with calls to “save the NHS” at the centre of its campaign. The Conservatives, meanwhile, have centred their campaign on the economy and have only recently, and reluctantly, it would seem, started talking about the health service.

Labour’s campaign on the NHS began back in September last year with Ed Miliband announcing a £2.5bn ‘Time to Care’ fund which, the Labour leader declared, would “transform the NHS”. Andy Burnham, the Shadow Secretary of State for Health, has relentlessly attacked the Conservatives over “privatisation and fragmentation” of the NHS under the Conservatives, with Andrew Lansley’s deeply controversial Health and Social Care Act attracting particular ire. The attacks have damaged the Conservatives, with Lansley losing his job and Jeremy Hunt being brought in to dampen down the NHS as a political issue ahead of the election.

Hunt has been conspicuous by his absence thus far in the election campaign, with Burnham tweeting that he is yet to turn up to any of the five hustings organised for the health spokesman of the political parties. To counteract the political prominence of the NHS, and Labour’s command of it, the Prime Minister pledged “a 7-day NHS” within five years/. Alongside this announcement, Hunt entered the election fray by indicating that the Conservatives would meet NHS England’s £8bn spending requirement over the lifetime of the next Parliament to sustain the NHS at current levels.

Giving mental health parity of esteem with physical health is a key element of the Liberal Democrat’s general election offering, and is set to appear on the front page of their manifesto. Through the Care Minister Norman Lamb, whose own son has experienced mental health problems, the party has pledged to “bring mental health out of the shadows” and pledged £1.25bn over the lifetime of the next Parliament.

In the 7-way leaders debate tonight expect the subject of the NHS to come front and centre. All the main political parties are committed to its continued funding and free-at-the-point-of-use delivery, but with deep disagreements on how to sustain it in the years ahead with a growing, elderly and ever more demanding population clashing up against finite resources. What is a glaring omission from the current mainstream debate is an alternative vision for the NHS; UKIP are the party that has flirted most with a privatised, insurance-based health service, but even Farage has had to row back acknowledging his own party’s, and the public’s, deep sentiment towards it.

Labour will ensure health policy generates election controversy, and thereby – it hopes – conjure votes. The Conservatives’ aim is simply not to lose voters over the NHS. Amid all this NHS England, the public body that actually oversees the day-to-day running of the NHS, has published the Five Year Forward View, the first time the NHS itself, rather than a government, has commissioned a paper on its very future. Reading and implementing its recommendations will no doubt do far more for the future of the NHS then whatever is uttered tonight, or over the next five weeks, by any one of the political leaders.

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