The government risks simply papering over the cracks in the systemby Tim Gardner / November 26, 2019 / Leave a comment
In terms of health and social care, the Conservative manifesto published on Sunday was more notable for what it didn’t say. The biggest omission was the lack of a clear policy on social care.
In his first speech as prime minister, Boris Johnson promised to “fix the crisis in social care once and for all.” Four months on, the manifesto falls well short of solutions. There’s a commitment to seeking cross-party consensus on reform, but little detail on what the Conservatives want to achieve through it—aside from a single precondition that no one should have to sell their home to pay for care.
From a new government, that might be understandable. But the Conservatives have been in power for nearly ten years and working on a still-unpublished green paper for nearly 1,000 days. There’s even a flexible model for capping social care costs already on the statute book, awaiting implementation—a legacy of the coalition with the Liberal Democrats.
Instead, the manifesto looks to start from scratch.
The Conservatives have promised £1bn per year over the course of the parliament to prop up the existing social care system—both children’s and adults’ services. But this won’t come close to the £4.1bn needed by 2023/24 to address the costs of rising demand and match NHS pay increases. In the meantime, more people will go without the care they need.
On the NHS, the theme of the manifesto is “business as usual,” with a few new piecemeal commitments sprinkled on top.
Most eye-catching is the carefully-worded pledge to deliver an extra 50,000 nurses, including through improved retention. Our analysis with the King’s Fund and Nuffield Trust suggests that, even with a substantial boost in training, recruitment and retention, a significant portion of these nurses will need to be recruited from outside the UK.
With a global shortage of health professionals, ethically recruiting this many nurses from abroad in a way which is not detrimental to developing countries is going to be difficult. A non-restrictive migration policy—including but not limited to the government’s proposed fast-track NHS visa for migrant health workers—will be crucial, but may present a tricky balancing act with implementing wider changes to immigration controls set out elsewhere in the manifesto.
There is a new…