Main parties’ 2010 manifesto policies on health and social care
Kindly supplied by DT.
Labour Party
- will focus capital investment on primary and community care
- will scale down NHS Programme for IT [already Government policy]
- £20bn of efficiency savings over the next four years, to be reinvested in front-line services [already Government policy]
- all hospitals to become Foundation Trusts (reportedly by 2015, although no target date is given in the manifesto itself) [already Government policy: the original deadline was the end of 2008 and it was subsequently put back to the end of 2010]; failing hospitals to be taken over by new management [already Government policy]; FTs to be allowed to expand into primary and community care, and to increase provision of services for private patients
- active role for the independent sector in the NHS, particularly in providing innovation and increased capacity; PCTs expected to challenge all NHS services and use alternative providers where NHS services persistently fail [already Government policy: the NHS itself is the “preferred provider” of existing services, but where poor services fail to improve after being given two opportunities to do so, they will be put out to tender – and NHS providers will not be given preference in any tendering exercise]
- right for patients to choose from any provider who meets NHS standards of quality at NHS costs, guaranteed in law [already Government policy]
- year-on-year increases in the proportion of the tariff allocated to quality incentive payments, up to 10% [already Government policy]
- emphasis on prevention and early intervention [already Government policy]
- more than 8,000 more therapists, to widen access to psychological therapies
- right of NHS staff to form social enterprises / co-ops / mutual organisations to take over running services [already Government policy] to be extended
- will increase Foundation Trust membership to over three million [already Government policy]
- no structural changes to PCTs, SHAs or hospital payment systems
- legally binding guarantees in NHS Constitution [already Government policy]:
- treatment within 18 weeks of referral or NHS will pay for treatment from a private provider
- all cancer patients to be seen within two weeks of referral and test results returned within one week
- routine health checks for all 40–74-year-olds
- access to a local GP in evenings and at weekends
- more GP-led health centres, providing services from 8am to 8pm
- telephone and online booking services for NHS organisations [already Government policy]
- online publication of patient comments on services [already Government policy]
- national “111” non-emergency number
- more services provided at home, and by GPs and pharmacists [already Government policy]
- right to register with a GP wherever is convenient (not just in area of residence)
- one-to-one dedicated cancer nursing
- people with long-term conditions to have the right to a care plan [already Government policy] and an individual budget [already being piloted]
- right to a home birth and a named midwife [already Government policy]
- Family Nurse Partnership for post-natal care in all parts of the country [already being piloted]
- NHS Constitution to guarantee the right to NICE-approved drugs [already Government policy]
- all leading drugs available internationally to be assessed by NICE within six months [already Government policy]
- National Care Service to be established: free care at home for people with the greatest needs from 2011 (funded from DH and local government efficiency savings); free residential care after two years from 2014 (funded from freezing the Inheritance Tax threshold); a comprehensive free service from 2015 (Commission to advise on how this will be funded) [already Government policy]
- end to age discrimination in health and social care [already Government policy]
- every patient admitted to hospital to be screened for MRSA [already Government policy]
- national infection control standards to be established, with the regulator (CQC) having strong enforcement powers [already Government policy]
- the ban on smoking in public places will be maintained
- will act to protect children’s health from tobacco, alcohol and sunbeds
- alcohol treatment places will be trebled to cover all persistent criminals where alcohol is identified as a cause of their crimes
- GPs and Change4Life will be used to promote healthier lifestyles [already Government policy]
Conservative Party
- will support co-operatives and mutualisation as a way of transferring public assets and revenue streams to public sector workers, encouraging them to come together to form employee-led co-operatives and bid to take over the services they run
- will never change the principle that the NHS is free at the point of use
- will increase spending on health in real terms every year
- will match Labour’s spending plans for 2010/11 in health
- 4,200 more Sure Start health visitors, paid for out of the DH budget
- will give every patient the power to choose any healthcare provider that meets NHS standards, within NHS prices, including independent-sector providers [current Government policy]
- patients to be in charge of their health records
- wider use of Payment by Results [current Government policy]
- payment according to quality [current Government policy]
- will publish online detailed data on performance [current Government policy]
- will set up HealthWatch: an independent statutory body to investigate and deal with complaints
- will give GPs control of budgets and commissioning [i.e. a return to Fundholding]
- will link GP pay to results [builds on existing Government policy, i.e. QOF]
- will scrap targets that have no clinical justification
- all NHS providers to become Foundation Trusts [current Government policy]
- an independent NHS Board to allocate resources and provide commissioning guidelines
- protection of NHS whistleblowers [current Government policy]
- will cut the cost of NHS administration by a third [current Government policy]
- will commission 24/7 urgent care services in all areas, including GP OOH, and ensure 8am to 8pm GP services in all areas – with a single urgent care number, parallel to 999
- will stop “forced” A&E and maternity reconfigurations; and create local “maternity networks”
- more single hospital rooms
- an end to mixed sex wards
- hospitals will not be paid in full where an avoidable infection occurs [builds on existing Government policy re “Never Events”]
- will roll out cancer screening [current Government policy]; create Cancer Drug Fund using money that would be spent by the NHS on increased NI contributions; change the commissioning of cancer drugs; encourage clinical trials of cancer treatments
- a new dentistry contract based on health outcomes, not the volume of work done; will tie newly qualified dentists to the NHS for five years; will allow dentists to fine patients for missed appointments; dental check-ups for all five-year-olds
- combined health and social care budgets for people with long-term conditions [current Government policy]
- direct payments to help with care needs and greater access to respite care [current Government policy]
- £10m p.a. beyond 2011 for children’s hospices; per patient funding for hospices and palliative care
- voluntary social care insurance with an £8,000 premium and a voluntary top-up to cover domiciliary care
- DH to become the “Department for Public Health” and focus more on prevention; dedicated public health funding for communities, with payment according to success; a “health premium” for the poorest areas with the worst health outcomes
- welfare-to-work providers and employers to be able to commission services from mental health trusts; more access to talking therapies
- will allow councils and the police to shut down permanently any shop or bar found persistently selling alcohol to children; double the maximum fine for under-age alcohol sales to £20,000; raise taxes on those drinks linked to anti-social drinking, while abolishing the Government’s planned new rate of duty on cider; ban off-licences and supermarkets from selling alcohol below cost price
- will give courts the power to use abstinence-based Drug Rehabilitation Orders
Liberal Democrats
- will increase health spending in some areas by cutting waste in others; no net cuts in spending on front-line services [current Government policy]
- will link payment of commissioners and GPs to preventive healthcare [builds on current Government policy in respect of GPs, i.e. QOF]
- will cut the DH in half; abolish unnecessary quangos; cut budgets of other quangos; abolish SHAs; pay managers no more than the Prime Minister
- will generalise clinical best practice (on length of stay, day cases, etc.) [current Government policy]
- will integrate health and social care, keeping people at home for longer [current Government policy]
- will use funding earmarked for the Personal Care at Home Act (from DH and local government efficiency savings) to pay for guaranteed respite for the million informal carers working the longest hours
- an independent cross-party Commission to develop proposals on long-term care of older people
- will prioritise dementia research
- will ban below-cost selling of alcohol; establish how minimum pricing can be used; and review alcohol taxation
- will cut air pollution
- will replace targets with entitlements, backed up by a guarantee that the NHS will pay for private treatment [builds on current Government policy]
- will put front-line staff in charge of budgets and allow them to set up employee trusts [builds on current Government policy]
- will replace PCT Boards with elected Local Health Boards, to take on commissioning in partnership with local authorities; it is implied that this will mean A&E and maternity services will not “keep being closed, even though local people desperately want them to stay open”
- right to register with a GP wherever is convenient (not just in area of residence) and to contact GPs by e-mail
- GPs to be directly involved in providing OOH services
- GPs to be paid a premium for each patient they take on from an area of deprivation and poor health
- will allow Local Health Boards to commission services from a range of providers, including staff co-ops, with no bias in favour of private providers [builds on current Government policy]
- hospitals will be required to be open with patients about errors
- it will be illegal for a Local Health Board to employ an overseas doctor without robust checks on language skills and clinical competence [current Government policy in respect of PCTs]
- will clamp down on violence and aggression towards A&E staff
- will set up a working group to look at financial support for people who contracted HIV from contaminated blood
- will make hospitals share with police non-confidential information on gun and knife crime
15 April 2010