The Waiting Room: Manifesto Special

17/06/2024
Introduction

Welcome to the eighth edition of the Atticus Partners Health Newsletter: The Waiting Room. This special edition focuses in on the Conservatives, Liberal Democrats and Labour’s manifestos, analysing what each of the healthcare commitments mean for the sector.

In this edition the health team has focused on the four crucial themes arising from each of the manifestos: social care, health technology, staff shortages and waiting lists, and mental health. Each section of our analysis highlights the importance of health to each party’s General Election pitch to voters, with the Lib Dems especially using health as the central focus of their entire document.

Despite all the plans and pronouncements, stakeholders have suggested the two main parties are not being realistic enough about the amount of extra funding needed to recover the UK’s health system. The Institute for Government points out waiting times are the longest on record, and targets for elective care, A&E and cancer treatment have not been met since 2016, all whilst the numbers of patients per GP have risen by 18% since 2015.

For more information about Atticus Partners’ work in the health sector and our plans for upcoming events, or if you have any questions about how we can support you, particularly in light of the upcoming General Election, please get in touch via health@atticuscomms.com.

Social care: Various plans and promises but little detail

For decades, social care has been one of the more politically difficult issues in British politics. Recognising the precarious state of this viral public service, all the major parties’ manifestos include commitments on social care, albeit to varying degrees of detail and ambition.

The Labour Party’s manifesto called for “deep reform” of adult social care, highlighting issues including inconsistent and inadequate standards, alongside staff shortages.

Labour’s signature pledge was the creation of a National Care Service underpinned by locally delivered services. Other notable promises included establishing a Fair Pay Agreement in adult social care and developing local partnership between the NHS and social care providers regarding hospital discharge.

A cap on adult social care costs was notably missing from the manifesto text, despite Shadow Health Secretary Wes Streeting later insisting that Labour is committed to implementing the Government’s current plan to introduce this from October 2025 onwards.

Labour have been criticised for failing to provide “new commitments” and for the lack of clarity on both the timeline and funding methods for these proposals, with the King’s Fund think tank describing it “as a plan to come up with a plan”.

With a Labour victory likely on 4th July, there is clearly still much more detail needed to ensure social care is not yet again a neglected political issue.

Meanwhile, the Conservatives committed to implementing their planned reforms to cap social care costs from October 2025 and promised to give local authorities “a multi-year funding settlement to support social care”. Their previous plan included an £86,000 lifetime cap in England which was due to be introduced from October 2023 before being delayed.

While, unlike Labour, the Conservatives committed to implementing this cap in their manifesto, the Institute for Fiscal Studies (IFS) criticised the lack of additional funding commitments for this policy and suggested further spending cuts to unprotected departments would be required to fulfil this pledge. This would be the crucial hurdle for the Conservatives should they defy the current polls and form the next government.

The Liberal Democrats notably placed a £9 billion NHS and care ‘rescue package’ at their heart of their election pitch, with Sir Ed Davey’s party promising free personal care for older or disabled people at home.

Similarly to Labour, they pledged to set the salary for care workers at £2 above the minimum wage. These reforms would be funded by changes to capital gains tax and increasing levies on banks.

Several stakeholders, including the Health Foundation,welcomed the Liberal Democrats’ bold pledges as a significant step in the right direction to address some of the most urgent issues facing the social care sector.

The Digital Health Revolution: How Have the Manifestos Embraced Technological Advancements in Healthcare?

Embracing the digital and technological aspect of healthcare is something that has been touched upon by the Conservatives, Labour, and the Liberal Democrats. The parties hope this trend in the health sector will help revolutionise and improve patient outcomes, but how do their approaches differ?

The Conservatives have pledged to use technologies, including artificial intelligence, to establish 50 Community Diagnostic Centres, and provide £3.4 billion for new NHS technology in the hope these tools enhance diagnostic speed and accuracy, and boost productivity. In addition to this, the Conservatives aim to the make the NHS App a primary gateway for NHS services.

The Liberal Democrats have also pledged to use new technology to benefit patients, however, they plan to do this by specifically ring-fencing budgets for innovative digital tools and replacing outdated computers.

Labour, on the other hand, has singled out treating cancer in their manifesto, with the aim of boosting cancer scanners with AI capabilities to detect conditions earlier. They also plan to implement the NHS Innovation and Adoption Strategy which would allow for streamlined procurement and faster regulatory approvals for new technologies and medicines.

While all three parties recognise the potential of technology to improve patient outcomes, they clearly have distinct approaches to incorporating digital technology in healthcare. The Conservatives and Liberal Democrats appear to place more emphasis on using technology to improve infrastructure and increase productivity, while Labour focuses more on improving procurement to secure new technologies for treating and detecting illnesses. Despite such commitments to harness digitalisation in health, all three parties have been criticised for a general lack of detail in their plans, attributed by the fact the subject of digitalisation itself is not particularly a vote-winning matter.

Do the manifestos keep us on hold for the solution on waiting lists?

The Labour Party has pledged to cut NHS waiting times, delivering an extra million appointments a year, forming their headline promise in their manifesto. To do this, Labour would pay staff overtime rates to do extra shifts out of hours, funded by scrapping the non-dom tax status. To tackle the workforce crisis, Labour have pledged to publishing “regular, independent workforce planning, across health and social care”, delivering on the NHS Long-Term Workforce Plan.

The Conservative’s Long-Term Workforce Plan holds a similar focus on localising healthcare, with training and recruitment focused on community investment. Included in this plan are commitments to further expand Pharmacy First, build or modernise 250 GP surgeries, increase the number of community diagnostics centres, particularly with the focus on “underserved areas”. However, it is important to note, speeding up diagnosis also necessitates speeding up access to treatment post-diagnosis.

Whilst the Lib Dem’s pledged 8,000 more GPs in England, their manifesto focuses more directly on retainment and treatment of staff, including by establishing an independent pay review body. Highlighting the levels of staff leaving the NHS, they hope to address this head-on with a ten-year retainment plan. With statistics and strikes showing retainment and morale in the NHS to be at low levels, the focus on maintaining existing staffing is crucial: a fact which Labour will be wary of in their plans to “incentivise existing staff to carry out additional appointments out of hours”.

The balance of the private-public sector demand in tackling the NHS backlog is largely brushed over in all three manifestos, but it will remain a key area for the incoming Government to address. Labour’s decision to use “spare capacity in the independent sector”to bring down waiting lists will be crucial to their ambitions on reducing waiting times. Yet the detail, such as the extent to which a Labour government will use private provision, has not been fleshed out.

How will the manifestos address the record number of mental health cases?

With one in seven adults claiming their mental health is currently worse than it’s ever been before, the crisis is now reaching such a scale that it is having an economic impact, affecting youth unemployment rates.

There appears to be consensus across the political spectrum for the policies needed to solve this. The Labour Party has promised the introduction of Young Future hubs to provide open access mental health services for children and young people. Similarly, the Conservatives have outlined their plans to open early support hubs for those aged 11-25, and the Liberal Democrats have stated they will establish mental health walk-in hubs for young people in every community, with the intention to improve early access to mental health services and regular check-ups.

Labour is also seeking to tackle mental health through their education reforms. In order to provide an improved avenue for students to access mental health, they will provide access to specialist mental health professionals in every school. Once again in apparent agreement, the Liberal Democrats are pledging to establish qualified mental health professionals in all schools – funded by increasing the Digital Services Tax on social media firms and other tech giants. Possibly the weakest of commitments, the Conservatives said they would expand coverage of Mental Health Support Teams from 100% of schools and colleges in England by 2030.

One subject that remains missing from the Conservative’s manifesto is the reforming of the Mental Health Act. Implemented in 1983, the Act regulated compulsory treatment of people with a mental disorder; however, the Act has been criticised as overly restrictive, with inadequate scope for patient choice and autonomy. Interestingly, the Conservatives had vowed to reform the Act in 2021 in order to improve patient autonomy and reducing assessment and detention under the Act, however it failed to be mentioned within their manifesto. Nevertheless, the Liberal Democrats have pledged to modernise the Act to strengthen people’s rights in providing them with more choice and control over their treatment. Equally, the Labour Party have claimed that they will reform the Act with the inclusion of similar legislation.

With the Labour Party currently seen as the Government-in-waiting, according to recent polls, the challenges aren’t about proposing ideas to win voters relating to policies with the aim to crack down on the spiralling mental health crisis. Labour will face their biggest challenge after the election – in successfully delivering their proposed manifesto pledges.