The future of the NHS is taking centre stage as election campaigns gather pace, with long term care falling further down the priority list
The three major political parties have laid down their plans for the future for the NHS, with each party envisioning different levels of interaction between the public and private sectors. However, less attention has been paid to the problem of funding long term care.
Of the three, the Liberal Democrats is the only party to agree with the Royal Commission on long term care, and has proposed the introduction of both free nursing and personal care. In contrast, the Tories have proposed that people should be able to 'ring fence' their assets against the cost of long term care. Dr Liam Fox, shadow health secretary, said although the exact details have not been clarified they would seek to reward those people who make a moderate provision for themselves and their family.
Fox said: 'Those who make a reasonable provision through a lump sum or insurance of around £25,000 to £30,000 would be allowed to ring fence it for LTC. It would mean that people would not be stripped of their assets to pay for long term care. If the fund is used up by this provision then the State will pick up further costs, and anything left when the person dies can be inherited tax free.'
The Labour party meanwhile has announced that it is to support equity release schemes in a bid to help the elderly fund care, but again details are yet to be clarified. However, Rod Macdonald, head of sales and marketing at Permanent, said this was simply another indication that individuals cannot continue to rely on the State. 'The main issue with the proposed plans for equity release is that it is not actually going to cost the State any more money. People are being encouraged to pay for it themselves, which is carrying on along the same lines as stakeholder,' he said.
The Continuing Care Conference (CCC) has spoken out against both the Conservatives and Labour for not clarifying their proposals on the issue of long term care before the election. The group believes that a more coherent approach is needed and is calling for older voters to closely examine the political parties' proposals for long term care. Bob Lewis CBE, chairman of the CCC, said: 'As the proportion of over 65s rises, they are deemed as carrying the casting vote. Issues regarding the elderly should be made more important. Although progress was made with the last government, there is still a huge agenda.'
Care concerns
Sandy Johnstone, retirement and protection strategy manager at Norwich Union, agreed. 'There are a number of issues that have not yet been signed off by this government. While we are in the midst of a debate concerning regulation and CAT standards, these two issues are not as important as the central issue, which is clarity about what an individual is entitled to. We need to make sure that older people have a clear picture of how they can plan for retirement,' he said.
Plans for the future of the NHS also vary. The Labour party has reaffirmed its commitment to the concordat between the NHS and the private sector, which would see more interaction between the two, although in its manifesto it reiterates that it will not be pushing patients into paying for their operations.
Tim Baker, commercial director at Norwich Union, said that while the concordat makes sense, it does not go far enough. 'The concordat is between the NHS and private hospitals, however, we feel that it could be extended to insurers. There are systems in other countries where insurers are able to take the pressure off the public system.'
Shaun Newcomb, proprietor of IFA Healthguard, agreed: 'In the long term, the NHS cannot afford to pay for the services that it currently provides. The NHS should continue to provide accident and emergency services and treatment for chronic conditions, but it would make sense for the private sector to provide the rest. The relationship between the NHS and the private sector needs to be restructured so that PMI becomes more accessible by ensuring that everyone can afford premiums.'
The Tories also intend to encourage the use of the private sector and have said they will abolish tax on PMI where it is affordable to do so. But Baker said: 'We agree in principle with anything that reduces the cost of PMI for people. However, there is still a lack of detail so it is difficult to tell how effective it will be.'
The Liberal Democrats meanwhile have pledged to restore free NHS dental and eye checks and to set up a new pharmaceuticals agency to cut £1bn off the health service's drugs bill.
Labour has announced plans for 20 new fast-track treatment centres, which would combine diagnosis and operations on one site. It is believed that the private sector will be allowed to run some of these centres under contract to the NHS, but it is not clear whether the NHS would still have to supply the doctors and clinical staff, or whether healthcare companies would be allowed to run them independently. There is also a question mark over whether the centres would only provide NHS treatment.
Waiting lists
All the major parties have announced plans to cut NHS waiting lists, which could impact on the number of people who decide to take out PMI. The Tories aim to achieve this by replacing waiting lists with a patients' guarantee, which will set maximum waiting times based on medical needs. This means that if the NHS cannot treat the patient within this time treatment will be provided for them by the private sector.
Labour has said that no patient will have to wait for more than 48 hours to see a GP, or more than six months for hospital admission. Booked appointments will replace traditional waiting lists and the waiting time for a routine outpatient appointment will be reduced to three months. The Liberal Democrats have claimed they will recruit an extra 4,600 doctors and 27,500 new nurses over five years and increase pay levels as part of its bid to reduce waiting times.
