Analysis: Lib Dems, UKIP and Greens on health

clock • 3 min read

In the third and final part of analysis, Richard Walsh discusses the Liberal Democrat, Green Party and UKIP manifestos on health and welfare in the wake of last night's party leader debate.

Having commented on the Labour and Conservative manifestos, it's time to move to the three national minor parties and their policies on health.

Rather than look for similarities I have chosen to highlight some key ideas that are unique to each of them.

First the Lib Dems - the party said it will commission a fundamental review of the NHS and social care funding.

This was the task former Labour prime minister Gordon Brown would not let Derek Wanless do (in follow up to his 2002 report on the NHS.) It is a welcome addition to the debate on the future of these sectors in England.

It also fits with their plan to full pooling of budgets between the NHS and care services by 2018.

Secondly their policies on primary care are innovative. Rather than simply proposing 7/7 opening hours for face to face consultations with GPs they will encourage phone and Skype appointments and will utilise the network of community pharmacists across the country so they become the first point of contact for advice on minor illnesses and are joined-up with GPs and community health teams.

Many pharmacies are also open 7 days a week. I have never understood why this has not been done here before, unlike in most other EU countries where you see a pharmacist and if they cannot deal with the issue.

For example, if it's something that needs a drug which is not "over the counter", they ring the GP and agree treatment and are given permission to prescribe it.

UKIP

Moving to UKIP, as expected, immigration and EU Directives are to blame for the problems in the NHS. UKIP will insist migrants and visitors who come to Britain have approved medical insurance.

Only those who have the permanent right to remain in Britain and who have paid UK taxes for at least five years will be given an NHS number and be eligible for the full services offered by the NHS. Enforcing this will be very intrusive indeed and create real issues around doctors' duty to care.

They also have a plan for getting more doctors. They will waive university tuition fees for new medical students who work in Britain for five years after qualifying. As far as I am aware there isn't a shortage of people wanting to study medicine and interestingly some Eastern EU countries have applied a ban on medics working abroad for 5 years.

The policy has not been a happy one as many just went abroad anyway and it was then very difficult for them to get work in their own country. A more convincing proposal is to put GPs on duty in A&E departments. In essence A&E services become a one stop shop.

Green Party 

Finally, we come to the Green Party. With them, we go back to the system that existed before the NHS reforms in 1990.

There will be no market based commissioning and procurement and they will abolish the purchaser provider split. They will also seek to extract the government from existing PFI contracts setting aside £5 billion to buy themselves out.

Then we go even further back in time as they will remove a patient's right to choose which hospital they go to. You will go to your local one. While local hospitals may deliver excellent care for some conditions, for others specialist centres are known to provide much better outcomes.

This proposal would have an adverse effect on morbidity and mortality rates. They also propose moving hospital care to primary care services.

This is fine given advances for example in tele-medicine and remote monitoring but their focus is on low tech solutions. It all has a sort of year zero feel to it.

Richard Walsh is a fellow of SAMI consulting

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