Analysis: The Labour manifesto on health

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In the first of a series of articles analysing at the parties' manifestos in relation to the NHS, health and social care, Richard Walsh looks at what Labour are pledging.

Yesterday the Labour Party were first out of the stalls to launch their manifesto. It is certainly not short of policies. I guess the area of most interest to COVER readers is the NHS.

The headline commitments were already well known, funding 8,000 more GPs, 20,000 more nurses, 3,000 more midwives and a guarantee of a GP appointment within 48 hours, and on the same day for those who need it. But where will these extra staff come from?

The obvious route is to increase training places in universities but training staff takes time and that won't deal with the current crisis in A&E. More immediately I think they have two options.

The first is to break the agency professional providers' business model. It could be that the profit cap on the private sector combined with aggressive recruitment by the NHS will result in a mass exodus of staff from agencies into the NHS.

This would also save money. The second will be to recruit more staff from other EU countries.

The last government promised no top-down reorganisation of the NHS and then we had the Lansley reforms. These were so big they could be seen from space.

So will we have a repeat of this? Labour says it will repeal the government's Health and Social Care Act, scrapping the competition regime and restoring proper 'democratic' accountability for the NHS. 

I am covering the first point in more depth in the article that will be published in COVER's monthly magazine in May.

The second point is likely to involve greater Local Authority control of the NHS.

They could do this by expanding the role of health and wellbeing boards. It also fits with their plans to merge health and social care together. This could be achieved without another massive piece of regulatory change by using managerial change based on local alliances.

However they will want to see early tangible results so we can expect to see pro-active interventions from NHS England.

Then they mention something most people will be unaware of, the negotiations on the Transatlantic Trade and Investment Partnership Treaty between the EU and the USA.

Agreements like this are intended to boost international trade, so foreign businesses can get market access to particular sectors.

Market access usually means that state monopolies must be abolished. The EU has said it will try to exempt health services. But is obviously worrying Labour enough to include it in their manifesto.

Not surprisingly the failings at Mid-Staffordshire get a mention. Here they promise to modernise the regulation of healthcare professionals. What could they mean by this?

Andy Burnham is on record as calling for the regulation of healthcare assistants. They have an increasingly important role in delivering health and social care. We would see a new regulator, operating like the GMC, to register and discipline healthcare assistants.

NVQ3 qualification could be a vehicle to achieve this. But it will put up staffing costs as it will eliminate the unskilled end of this workforce. This is maybe no bad thing.

Finally they will have quite a long list of patients they want to prioritise. First, they will create a Cancer Treatments Fund so patients have access to the latest drugs, surgery and radiotherapy.

By 2020, patients will wait no longer than one week for cancer tests. For some cancers this may enable England to reach the sort of survival levels we see in many EU countries.

Second mental health will be given the same priority as physical health. This is very good news. Mental health services have not done well under the previous government. 

Richard Walsh is a fellow at SAMI Consulting 

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