The debate around health and social care

The debate around health and social care


By James Maxwell, Senior Account Manager, Incisive Health

In possibly the last conference season before the next general election, the respective parties have been setting out their stalls when it comes to their vision for the future of the country and perfecting their agenda for government. This year, Labour seems to be having the last word with the party unusually coming after the Conservatives.

This week in Manchester, Health Secretary Steve Barclay announced an expansion of medical school training places and a £30m bid for health systems to invest in backlog-busting technology. The stage was set for Sunak, but despite it being long on rhetoric, there was little in the way of practical solutions to the challenges facing the NHS and social care. Sunak’s major health announcement, to introduce a gradual ban on smoking, was bold in the face of an increasingly libertarian Conservative Party. The measure has been widely backed by medics and the public health community. Banning smoking for future generations, however, is truly a “long term decision” at a time when the NHS is crying out for short term relief. But with a King’s Speech and then the Autumn Statement to come, the Government have more opportunities in the near future to continue building their offer before the next general election.

For Labour, on the other hand, the stakes are higher. They expect to be in Downing Street before too long and will aim to use this conference to shore up confidence in their governing capabilities. When it comes to the NHS, Keir Starmer has already set out his long-term health mission which will drive a government he leads, should he be elected. The proposals set out in Labour’s National Policy Forum (NPF) document speak to the priorities of the party and will form much of the basis of its manifesto and 10-year plan for the NHS. On Sunday with Laura Kuenssberg, Wes Streeting hinted that social care will form a core part of his speech, with fair pay for care staff coming front and centre. Whilst the NPF sets the framework for the manifesto, there is still plenty of time for the Labour top team to add policies which they think will improve their offer to voters.

The challenge for Labour, however, is money. How can Labour transform health and social care without promising a significant enough cash-injection to breach Rachel Reeves’s spending limits? A combination of industrial action (and settlement), inflationary pressures, and a growing care backlog has left health systems significantly weakened. The Department of Health and Social Care is teetering on breaching the legal spending limits imposed on it by Parliament. The NHS is simply struggling to keep-up with ever-rising costs as it is. Any plan to transform care, to revolutionise community services, or to launch ambitious preventative programmes will need to compete for funding for the elective care backlog, collapsing hospitals, and a depleted workforce. It is difficult to imagine how Labour can achieve its vision for the NHS within its tight fiscal rules, but it must stick to them to be the credible alternative it envisages. Squaring this circle will be difficult, but the party must rise to the challenge if it is serious about governing responsibly.

This conference season is strange to say the least, and that’s without factoring in the empty chairs, the ratty interviews, and questionable robotics. The politics of government and opposition at the moment means that both main parties are limited in what they can say, what they can do, and what they can promise on health and social care, albeit for different reasons. When it comes to the election, however, the public are frustrated about the state of the NHS and will expect a comprehensive strategy, both for the short and long term. If conference is not the moment to outline this, then both parties are playing for time.