The party promises much-needed funds but do its plans raise the spectre of another reorganisation?by Hugh Alderwick / November 22, 2019 / Leave a comment
The NHS has been central to Labour’s election campaign so far. But the arrival of the party’s manifesto gives us a clearer picture of what a Labour government would mean for health and care.
The most eye-catching pledge is for more cash—and lots of it. The manifesto promises a 4.3 per cent real terms annual increase in the health budget over the next parliament. If delivered, this would see spending on health services increase at a faster rate than the average for most previous governments over the NHS’ history. The exception is the New Labour years, when health spending grew by 6 per cent annually. This spending would unambiguously be a good thing: the NHS needs investment, and Labour promises it.
What would the new money buy? According to our projections, this investment would be enough to maintain NHS quality in the face of growing demand, and support care improvements. It would cover improvements in day-to-day NHS spending, investment in buildings and equipment, and training for new doctors and nurses. It would also reverse cuts to the public health grant seen over recent years—though wouldn’t be enough to then keep public health spending growing as fast as NHS services.
Turning the cash into tangible care changes won’t be easy. The system is playing catch up after a decade of austerity, so a chunk of the new money will need to go towards getting the system back on track. Take capital investment. While Labour has promised a spending boost that would bring investment up to the OECD average, the NHS faces a capital maintenance backlog worth £6.6bn.
Crucially, the extra money needs to translate into extra people. The NHS is currently short of around 100,000 staff. Social care is down 120,000. Like the Liberal Democrats’, Labour’s manifesto acknowledges these issues, but is light on detail about how chronic staff shortages will be addressed.
Any credible manifesto needs to include a plan for reforming social care. The Labour Party proposal is to introduce “free personal care” for older people and a lifetime cap on care costs.
Before you get too excited: free personal care isn’t the same thing as free social care. Under the same model already in place in Scotland, people over…