General election – how do the main parties’ manifesto commitments stack up against BGS’s priorities?

Sally Greenbrook joined the BGS in April 2019 as Policy Manager. She has more than a decade of experience in the UK health policy sector, having worked for the Department of Health and, most recently, as Policy Manager for Breast Cancer Now. She has for many years had an interest in the health and care of older people, having written her MA thesis on housing for older people. She tweets at @SallyGreenbrook

We’re two weeks out from a snap general election and the major parties have set out their stall in their election manifestos. The BGS, like many other charities, has also published our manifesto, setting out what the incoming Government must prioritise to improve healthcare for older people in England. We sent our manifesto to the five English political parties that currently have MPs in the House of Commons and the Scottish National Party (SNP). Health and care are devolved matters and the MPs elected in this election only have influence over services in England. This is why our manifesto is focused on England and why we mainly sent it to English political parties. We did choose to share it with the SNP because in the last Parliament, they were the third biggest party. While the health policies decided upon in Westminster won’t have any impact on the constituents of SNP MPs (this is the responsibility of the Scottish Government), the way those MPs vote in Westminster does impact upon health services in England.

So how do the parties stack up when judged against the five priorities of the BGS manifesto? Well, let’s see.

But first, a couple of disclaimers.

For the sake of space, I have limited this blog post to analysis of the manifestos of the three biggest English parties – Conservative, Labour and Liberal Democrats. I have not analysed how much the manifesto commitments are expected to cost or how the parties have said that they’ll pay for them. And finally, for the sake of political neutrality, I am commenting solely on the content of the manifestos. I am not commenting on how realistic the manifesto promises are or any praise or criticism they have attracted in the press or on social media.

1. Provide a lasting solution to the social care crisis.

Social care has been front and centre in recent months with a BBC Panorama two-parter in May showing the pressures that services are under in Somerset, with scenes that I’m sure BGS members across the country would have recognised. In July, when Boris Johnson took office, he stood on the steps of Downing Street and declared that he would ‘fix the crisis in social care once and for all’, adding him, if we’re honest, to the long line of Prime Ministers to make this pledge. So, what are the parties promising on social care?

The Conservatives and the Lib Dems have both put finding a cross-party consensus at the forefront of their social care promises. The Lib Dems have extended this to include patients, professionals and the devolved governments as well as Westminster politicians.

The Conservatives have also promised £1billion additional funding every year and that a prerequisite of a new system would be that no one will need to sell their home to pay for care.

Labour have committed to introducing free personal care, starting with older people, with an ambition to extend this to all working age adults who need it. Labour and the Lib Dems have both proposed a lifetime cap on personal contributions to care costs although neither party have suggested what the cap would be. Labour have however proposed a cap of £100,000 on catastrophic care costs.

2. Integrate services between health and social care and between primary and acute care.

The Lib Dems say they’d support NHS England’s proposed changes to the Health and Social Care Act which aim to help the NHS to work in a more efficient and joined-up way. They are particularly keen for Clinical Commissioning Groups and local authorities to collaborate on commissioning and for emerging governance structures for Integrated Care Systems to include local government and be accountable to them.

Labour would go in the opposite direction and have committed to repealing the Health and Social Care Act and would bring in initiatives to allow people to live better lives in their own homes, including developing more joined-up community and close-to-home health and social care.

The Conservatives do not touch on this issue in as much detail although they do mention that they’ll focus on helping patients with multiple conditions to have streamlined and more joined-up access to the NHS.

3. Enable access to high-quality care and support that is appropriate to older people’s needs including a comprehensive geriatric assessment and personalised care and support plan.

None of the three main parties address this point.

4. Ensure that the health and social care workforce is fully and sustainably resourced.

All of the main parties have acknowledged that there is a crisis in the NHS workforce and have made significant promises to address this. However, they have chosen considerably different ways to do this.

The Conservatives have focused on numbers – 50,000 more nurses, 6,000 more doctors in general practice, 6,000 more primary care professionals, 50 million more general practice appointments.

All three parties have committed to introducing financial support for student nurses with both the Conservatives and the Lib Dems providing incentives for specialties or regions where recruitment is a particular challenge.

All three parties have also committed to simplifying international recruitment with the Conservatives saying they would introduce a specific NHS visa for healthcare professionals with a job offer from the NHS.

Labour have focused on work conditions including putting safe staffing limits into law, investing in staff training and development throughout their careers and providing mental health support for the workforce to ensure that the NHS is safe, flexible and free from harassment, bullying or violence.

The Lib Dems have also said they would end the GP shortfall both by training more GPs and making greater use of other healthcare professionals as well as phone and video appointments. They are also the only party that has acknowledged the lack of diversity in senior management in the NHS.

5. Prioritise prevention of ill health to help older people stay healthier for longer.

All of the main parties address prevention to some extent although none of them mention older people in this context and they all focus on prevention in childhood. However, they all make similar commitments to lifestyle factors that could have an impact across the life course such as addressing alcohol abuse, providing smoking cessation services and measures to address obesity. Both Labour and the Lib Dems talk about the importance of physical activity but only in the context of ensuring that children are able to be physically active.

Other key points

There are a couple of points addressed in the party manifestos that we didn’t call for but are of interest to us anyway.

All of the parties make commitments on mental health, all with the aim of achieving parity with physical health. Labour and the Lib Dems have both promised better access to psychological therapies with the Lib Dems specifically identifying older people as a group that is particularly in need. The Conservatives specifically mention dementia as a priority, specifically finding a cure and increasing funding for research.

All three parties have made commitments relating to carers with both the Lib Dems and Labour making promises around the Carer’s Allowance. Labour have stated that they will increase the Allowance and the Lib Dems have promised to increase the amount carers can earn before they lose their Allowance. The Lib Dems also promise to introduce a statutory guarantee of respite breaks for carers and the Conservatives have promised to extend the entitlement to leave for carers.

This is very much a whistle-stop tour of the bits of the parties’ manifestos that directly related to the areas that BGS is interested in – the actual manifestos range from 64 pages to a massive 107 pages long. We’ve provided links below for you to have a look for yourselves.

• Get Brexit Done – Unleash Britain’s Potential (Conservatives)
• It’s time for real change (Labour)
• Stop Brexit – Build a Brighter Future (Liberal Democrats)