Whether it is remaining or leaving, proroguing parliament, islamophobia, anti-Semitism, the social care crisis, or anything else, the past few years of British politics have certainly been a rollercoaster to say the very least. Whatever your political opinion, on Thursday 12th December, the British population chose a One Nation Conservative government led by Boris Johnson, with the Tories gaining their biggest majority since the 1980s. Whether you are celebrating the win or checking out opportunities for moving abroad, it remains that our country is faced with a Conservative government for the next five years at the most. But what does this mean for health and social care? How can we expect the Tory manifesto to be implemented and what can we hope for as we enter into a new decade?
Early last year, the BASW said that there needed to be, “a real end to austerity policies and welfare cuts”, stating that whoever is in power, it is critical that they invest in health and social care. Amongst their manifestos, each of the main political parties recognised the crisis in care and promised action to address it. However, the Conservative polity manifesto was criticised for having a lack of clear focus, and it was said to be predominantly concerned with frontline services with the chance of missing more niche areas. The main points of the manifesto related to practice include:
Get Brexit Done
Arguably, one of the key reasons for BoJo’s success has been his clear commitment to the results of the 2016 referendum, in which 17.4 million people expressed a desire to leave the European Union. There are some which fear the impact of Brexit, with many suggesting that this will have an overarching effect on our economy, our health and social care sector and the policy and legislation that underpins practice. For leavers who believe Brexit will be a positive change, it is considered that exiting from the EU will release extra funds for the health and social care sector. Whilst Brexit has been one of the most important talking points in this Christmas election, it is important to remember that only hindsight is 20/20 and the true impact of leaving remains to be unclear.
Prior to the election, all of the main political parties highlighted the need to improve NHS performance. The Conservative government proposed that they would donate the largest amount of cash to the NHS with a £20.5 million real-term increase to the revenue budget. However, it is not clear as to where this extra funding will come from. They also pledged to build at least 6 new hospitals across the country by 2025, and introduce further funding of £100 million for a potential 34 other hospitals; provide 50 million extra GP appointments; clamp down on health tourism, and reduce hospital car parking fees.
Staff Training and Recruitment
The Tory government stated that they would combat the shortage of nurses and the Conservative party manifesto included promises to increase nurse recruitment, retention, and training. The now infamous claim of 50, 000 more nurses, which has been heavily disputed due to at least 18,500 of these being retained, was undoubtedly a talking point. However, Tories did propose that they would provide student nurses with a £5000-£8000 maintenance grant, but they did not promise to reinstate the nurse’s bursary which May’s government had removed in 2017. In order to attract health professionals from abroad, an NHS visa was also discussed, which would fast-track the immigration process.
A recent study by the NHS Confederation reported that 97% of the health leaders surveyed suggested that the crisis in social care is having a damaging effect on patient care and the NHS. Professionals across the sector have continuously stressed the need for increased resources, and austerity has had a significant impact on the delivery of care. The Tory manifesto stated that “We must build the same level of consensus on social care as we have built on the NHS”, and an additional £1 billion per year was promised, which will be split between children and adult’s social care. It is important to note that whilst there have been some increases in spending on social care recently; this has yet to reach pre-2010 Welfare Reform Act levels, despite increases in the number of people relying on services.
The Conservatives also referred to the development of a cross-party consensus regarding long term social care funding. However, they do not state what they are hoping to achieve. The only comment included is that ‘no one should have to sell their home to pay for care’, but with no clarity as to where such funding will come from. The Manifesto also pledged new funding to support individuals with autism and/ or learning disabilities out of inpatient care, which has been a priority for some time. However, there has been some debate regarding funding for individuals with autism and/or learning disability, with some on social media suggesting that this will go to zero after three years. However, the numbers that people are referring to on page 4 in the costing document, actually refer to the £74 billion extra funding that will be delivered over the next three years.
Prioritizing Mental Health
One of the most important pledges included in the Conservative manifesto was the importance of recognising mental health, and ensuring that mental and physical health are treated with the same sense of urgency, Moreover, they suggested that people with mental health conditions should be granted greater control over their own treatment. With regard to funding and resources, they promised a 20% increase in spending into mental health care, with an additional £2.4 billion invested by 2023.
Overall, there is definitely a lack of clarity when it comes to the Tory’s plan for the health and social sector, and their manifesto has tended to focus on acute need; rather than long term investment. Whilst their health and social care plans remain unclear, it is clear that the past few years have highlighted the political divide in this country, and responses to the election have further indicated the need to come together. It is imperative that we move towards a healthier discourse of communication and dialogue. Whether it is Boris selling the NHS, the Labour plans costing 1.2 trn, or the removal of funding for individuals with autism, wild claims, stereotypical misconceptions, and unrealistic generalisations have become ubiquitous in British politics.
With Christmas on the horizon and a new decade beckoning, there are some which suggest that Boris may move towards a more centrist approach to parliament after Brexit is complete, and all we can do is hope that we are able to meet demand in the meantime.