The Tory manifesto for the NHS is a very disappointing read. It includes nothing new and is essentially a replica of the 2015 manifesto, except for a promise of legislating to enable delivery of the Five Year Forward View.
The pledge to review the internal market is a belated recognition that collaboration rather than competition offers the best way to sustain the NHS and improve health outcomes.
The manifesto also reveals a plan to ‘extend the scope’ of the CQC to oversee local authorities management of additional funding to social care.
The promised £8bn funding will not match the demand and cost pressures on the NHS, which the independent Office for Budget Responsibility estimates at more than 4% a year above inflation. It would leave a financial gap of £12bn by 2020-21.
Furthermore, the so-called announcement of £8bn is simply a ‘smoke and mirror’ device, the usual spin and double counting.
There is hardly any mention of the GP crisis, let alone any solutions. Increased red tape and GP shortages have left many patients struggling to get appointments, while 300 GP practices across the country are facing closure. The £2.5bn deficit in general practice could grow further, aggravating what is already a dire situation to a tipping point. The party is also proposing a new GP contract, to meet the needs of the new care models to provide greater access, more innovative services, shared data and better facilities, while ensuring care remains personal and facilitates the integration. A possible salary model?
The manifesto promises to ‘make it a priority’ that the 140,000 staff from EU countries are able to continue to work in the NHS after Brexit. But, many are already leaving and recruiting others is not going to be easy. A levy on employers who hire skilled foreign workers will rise from £1,000 a year to £2,000 with implications for trusts hiring overseas staff.
Social care is broken, and the Conservative manifesto pledge to fix it is nothing more than a sticking plaster.
The King’s Fund’s CEO Prof Chris Ham is spot on when he says the Tory NHS manifesto is ‘tinkering with a broken system and does not provide the sustainable solution that is desperately needed’.
Every General Election is about the NHS. It is simply an area in which there is a clear divide of party perceptions. On 8th June, the election takes place at a time when NHS providers are reporting unprecedented deficits, general practice is at the brink of extinction and the social care system is in a real crisis. The failure to address the crisis in health and social care may in time define this government as much as Brexit will. This election is effectively about these two horses: Brexit and health and social care. Voters will have to decide which party will jockey them to the winning post but based on the Conservative manifesto, I will not bet on the Tories doing anything more than causing further damage through cuts, underfunding and more privatisation.
There is nothing in the Conservative manifesto to cheer the NHS in general and general practice in particular.
Dr Kailash Chand is a retired GP in Lancashire
