General Election 2019: What Boris’ victory means for the health system

By December 18, 2019 UK

While most polls predicted a Conservative majority, the scale of the win came as a shock to many. Boris Johnson gained an 80-seat majority, the biggest electoral win for the Conservatives since Thatcher in 1987. The resounding win gives Johnson a clear mandate to deliver Brexit and if he does so, he can focus more time and resource on domestic policy. The NHS was found to be the most important issues to voters this election, surpassing Brexit, and Johnson has wisely cited it as his top priority following his victory.

He has promised to increase the NHS England budget by £20.5bn in real terms by 2023-24. While this will be the biggest uplift in cash terms that the NHS has received, the Institute for Fiscal Studies warned that this will not match the rising demand for care. He also pledged to build 40 new hospitals by 2030 at an estimated cost of £13bn, but experts suggested the figure could be closer to £24bn. Johnson will likely have to make concessions on spending to deliver this ambitious pledge or focus on smaller, specialist hospitals to keep costs down.

Absent from the manifesto was the Medicines and Medical Devices Bill that was first mentioned in October’s Queen’s Speech. The Bill fell due to the dissolution of Parliament before the election, but the new government may still choose to take this Bill forward, especially if tech-enthusiast Matt Hancock remains as Health Secretary. Hancock has since reiterated his desire to invest in digital technologies, e-prescriptions and wearable but with many hospitals complaining of outdated equipment and crumbling infrastructure, government will have to toe the line between investing in innovative new technologies that promote the best of the UK’s thriving life sciences sector and ensuring that hospitals have the basic equipment necessary to meet targets.

Workforce retention will also be a huge issue facing the new government. The Conservative manifesto promised 50,000 new nurses but these claims were criticised once it emerged that 18,500 of these nurses would be existing staff that they hope to retain. They are hoping to mitigate any risk to understaffing that their migration policy could pose through a fast-track ‘NHS Visa’. This would see overseas applicants receive preferential treatment under the proposed points-based immigration system, but critics of the policy warn that this still risks deterring overseas clinical staff who currently come to the UK for free.

The party’s manifesto commitments on social care were far from radical, offering an additional £1bn per year to be split between children’s and adult social care services and a promise to initiate cross-party talks on long-term reform of adult social care in the first 100 days in office. With high-profile policy issues such as Brexit and the NHS grabbing headlines and no evidence of a Social Care Green Paper, we are unlikely to see any notable reform of social care in the near future.

The elephant in the room remains the impact of any post-Brexit trade deal with the US. Labour’s reveal of documents that demonstrated that drug pricing and patent laws had been the subject of initial trade discussions failed to derail the Conservative campaign, in part because the documents did not prove that any agreement had been made. The Conservatives have been firm that NHS services and drug prices will be “off the table” in any trade agreement but opposition parties are keen to introduce legislation that would ensure the NHS is excluded from trade discussions. It remains to be seen whether government will do so, in an effort to quell concerns.

The Conservatives have an opportunity to build support by prioritising an issue that voters traditionally have more trust in Labour on. With many working-class Labour safe seats turning blue, Johnson may be hoping to maintain this support at future elections by proving that the NHS can be trusted to thrive under a Conservative Government.