Paul Bristow is Managing Director of PB Consulting, and was parliamentary candidate in Middlesbrough South & East Cleveland in 2010.
David Cameron once said that “Tony Blair explained his priorities in three words: education, education, education, I can do it in three letters: NHS.” For years, Labour arrogantly believed that the NHS is ‘our issue’, and that they would always lead the Conservatives on which Party was best suited to managing the country’s health. Cameron did an excellent job of reassuring the public that the NHS was safe in the hands of a future Tory Government. Indeed, I remember many hours at campaign stands in Middlesbrough and Guisborough during the run up to the 2010 election, convincing local people of our commitment to the health service. And while there will always be controversy after reform, Jeremy Hunt deserves credit for ensuring the NHS did not become a vote-winner for the Labour Party during the 2015 election.
While the Labour Party its own problems, and Brexit will dominate the political agenda for the foreseeable future, we as a Party cannot be complacent. With a new Prime Minister, we should again demonstrate that the NHS is key to our ambitions in Government, and we are determined to build a service that will address the challenges of an ageing population, many with long-term conditions.
Where to start? Let’s be bold, and begin with finance. As Conservatives, we know that compassion cannot be measured by how much you spend on something. It was an achievement that the NHS was protected from budget cuts when David Cameron became Prime Minister.
However, real-term funding for the NHS has remained fairly level since 2010. New accounting methods from the OECD, which includes social care, puts UK health spending at 9.9 per cent – behind Germany and France, but above the OECD average. This sounds promising, but King’s Fund research shows that UK GDP is forecast to grow in real terms by around 15.2 per cent between 2014-15 and 2020-21 while on current plans, NHS spending will grow by much less – 5.2 per cent. Few would claim that the NHS and social care are not facing serious financial challenges in the short and medium term. Unless something drastic changes, these will get worse, simply because of demographics.
Some will argue that the NHS has been treated well during austerity, has had more money than the rest and should have modernised years earlier. There are plenty of efficiencies to squeeze out of the system. I have a lot of sympathy with this view, and feel that much can be explained by an NHS culture that does not embrace innovation and new ways of delivering care. But, in defence of the service, there have also been a lot of distractions, and an obvious need to focus on the day job.
While the NHS has sometimes been poor at modernising, local authorities have on the whole been very efficient. Despite significant decreases in budget, they have become very proficient at operating at the margins, contracting out and reducing cost. It is local authorities that have faced the brunt of the funding squeeze when it comes to social care which, in turn, affects the NHS, the care sector, private providers and the third sector.
Might a tapered aspiration – depending on economic performance – to get health spending (NHS and social care) consistently over the EU and OECD average by 2025 be something that a May Government could consider? It would demonstrate commitment to social care as well as the NHS, and show that the Government is taking the long-term costs of healthcare seriously.
Finally, we should have a message to send to the 1.3 million people (and to the millions more in social care) who work in the NHS. Not just doctors and nurses, but ancillary workers, allied health professionals and social care staff. These are tough jobs, and there are certainly reputational bridges to be built after the junior doctors’ strike. Recruitment in healthcare is and will continue to be a major challenge unless politicians of all sides back staff with measures much more than platitudes about hard-working doctors and nurses.
Poor recruitment costs us millions. We have to tackle spiralling agency costs with a meaningful push to get nurses back working in the NHS. Some ideas that have been discussed among health commentators include free and tailored retraining packages; free childcare, and/or the free use of public transport.
Others published include a shorter, better experience for trainee doctors. Why not dump the ‘junior doctor’ title and have levels of training that aren’t based on the assumption everyone wants to be a consultant. We want the NHS to be an employer everyone wants to work for
It may seems that I simply want to throw money at the problem. However, it would be wrong to assume just because it has been protected from the worst of austerity that everything is fine with our health and social care system. The population is getting older, and we will need an appropriately funded and staffed health system. Provided that the economy continues to perform well, and the deficit is narrowed further, the Conservatives will have to prioritise healthcare if we are to remain the party of the NHS and if the current service model is to be retained.