News / Campaigning on health

Politicians tend to be wary of numbers – detail can blur their message, confuse voters or, to be cynical, be a hostage to fortune. Numbers can be tricky. At the start of the election campaign, shadow health secretary Dianne Abbott tied herself in knots on the cost of Labour’s proposed increase in police officers – all of which perhaps demonstrates why representatives from all parties have shied away from the detail.

While Ms Abbott’s slip on 2 May was unfortunate, the debate over the future of the health service soon replaced it as lead story in news bulletins. Both the British Medical Association and the NHS Confederation outlined their wish lists for a new government. Both want ministers to set health spending at a fixed proportion of GDP.

The official dissolution of Parliament on 3 May energised the election campaign. Labour moved quickly to grab the agenda, with a policy announcement on safe ground – the NHS. On 3 May, shadow health secretary Jon Ashworth said Labour would immediately halt the implementation of sustainability and transformation plans if elected. He said the plans would be paused while they were reviewed by a new arm’s length body, NHS Excellence. 

Mr Ashworth said the STP process was chaotic and plans to close hospitals, move A&E services and shut children’s wards had caused concern and confusion. ‘These decisions have been decided behind closed doors, with no genuine involvement of local people. It’s a disgrace. The public deserves better,’ he said.

Health secretary Jeremy Hunt has kept a pretty low profile since the start of the calendar year, but election campaigns mean politicians have to go out and canvass support. On a visit to St Helier Hospital on 3 May, he was confronted by a local campaigner who accused him of ‘demolishing the NHS’ and of planning to shut the hospital he had just visited. The hospital may be downgraded or even shut if proposals in the South West London STP are implemented. 

After the visit, Mr Hunt said: ‘St Helier has made huge strides in recent years and I was delighted to hear more on my visit about progress and plans for the future.’

The main contenders from left to right: Jeremy Corbyn, Theresa May and Tim Farron

Next up, the Liberal Democrats focused on another real issue for voters – waiting times for hospital treatment. Responding to a report in The Times on a confidential document predicting that within two years more than 5 million patients could be waiting for hospital treatment, health spokesman Norman Lamb said rising waiting lists were ‘disgraceful and unacceptable’. The party followed this up on 6 May with a glimpse of its manifesto – promising to raise £6bn a year, ring-fenced for health and social care, by raising income tax by 1p in the pound.

In their first official statement on health during the campaign, on 7 May, the Conservatives pledged to reform mental health laws in England and Wales to end ‘unnecessary detention’. Pointing to an additional £1bn for mental health services announced in January, Mr Hunt promised 10,000 more NHS mental health staff by 2020 and to tackle discrimination against those with mental illness. The Tories said mental health funding was at record levels and would be up by £1.4bn in real terms by 2020.

Labour claimed its plans to tackle childhood obesity would include a ban on TV junk food ads before 9pm. Currently, adverts for foods high in salt, sugar or fat are banned only on children’s TV. Given that childhood obesity cost the NHS £6bn a year, said the party, its strategy would aim to halve the number of overweight kids in 10 years. It would fund a £250m programme in schools by cutting fees for management consultants used by the NHS.

Visitors, patients and staff would get free hospital car parking under a Labour government, the party added. It said the £162m raised by parking charges at England’s NHS hospitals would be replaced by increasing insurance premium tax for private health insurance to 20%.

NHS Providers urged the next government to scrap the ceiling on pay rises, which, alongside a number of other factors, was making it more difficult for the service to recruit and retain staff. Both Labour and the Lib Dems picked this up in their manifestos (more of which later). NHS Providers also called for greater funding for health and social care and a concerted effort to ensure parity of esteem for mental health through dedicated funding.

While the leak of a draft version of Labour’s manifesto on 11 May was embarrassing for the party, in terms of health it told us that the party planned to raise £6bn a year for the NHS by raising income tax for the top 5% of earners. A further £8bn would be spent on social care over the five years of the Parliament. Bursaries for student nurses would be reinstated and the cap on NHS pay rises – limited in recent years to 1% of the pay bill – would be scrapped. Instead, Labour would take the advice of the independent pay review bodies.

There was some controversy late in May, however, when NHA Improvement confirmed it would not be publishing the final 2016/17 figures for financial performance until after the election. Publication had been scheduled for late May, but Whitehall officials reportedly advised the oversight body not to publish during the period of purdah.   

Operational performance figures for March were published in May by NHS England. Although most targets were again not met, there were signs of improvement. For Labour, the figures showed Conservative mismanagement of the health service. Shadow health secretary Mr Ashworth said the winter crisis was stretching into summer and the Conservatives had admitted that waiting times were only going to continue to grow. 

‘Thousands more people are waiting for A&E care and routine treatment every week because of the failures of this Tory government,’ he said. ‘Behind every one of these statistics is a patient and their family in pain because of Theresa May’s refusal to give the health service the funding it needs.’ The Conservatives defended their record, saying A&E performance had greatly improved compared with the same month last year. Elective waiting times had been cut and patient outcomes were better, the party added.

Electioneering on the NHS took, briefly, a back seat as the service in Scotland and England was hit by a cyber attack on Friday 12 May. Though Jeremy Hunt attended a COBRA meeting – the group convened by the government in emergencies – on the Saturday, opposition politicians and some in the media questioned why the health secretary had not made a public statement. He did emerge on 15 May to give an interview to the BBC. 

Once the scale of the problem became apparent, opposition parties jumped on the opportunity to blame lack of capital funding and highlighting the movement of capital to revenue in recent years. They claimed trusts did not have sufficient funds to update their IT. 

Labour leader Jeremy Corbyn said £2bn of Labour’s pledge of an additional £7.4bn a year for the NHS would be ring-fenced for capital, including IT projects. Ministers sought to deflect the blame, claiming the NHS had enough money to protect itself and had been given sufficient warnings of the threat of a cyber attack.

Mid to late May was dominated by the main party manifestos. Broadly speaking, they offered similar funding increases – £7.4bn (Labour), £6bn (Lib Dems) and £8bn (Conservatives). Nuffield Trust analysis suggested that by 2022/23 the pledges equated to spending of £12bn (Labour), £8bn (Conservatives) and £9bn (Lib Dems) higher than 2017/18. The Tories and Liberal Democrats had a focus on mental health. The former promised to ring-fence £1bn of their additional funding for the services, while the Tories said they would reform mental health law.

Labour and the Lib Dems promised to set up an Office for Budget Responsibility-style body for health. The Conservatives would review the internal market and hold NHS England leaders to account for implementing the forward view.

The Conservatives attracted a lot of flak over their plans to pay for social care, which appeared to abandon their policy of capping the amount individuals would pay towards their care. The party manifesto pledged to charge people receiving care in their own homes for the full cost of their care if their home was worth at least £100,000. Currently, assets are not taken into account if someone is receiving care in their own home. Those in residential care must pay the full cost if they have savings and other assets of more than £23,250 and the value of their home may be taken into account. 

After a weekend of adverse coverage, with the Conservatives still in a commanding lead but polls showing some gains for Labour, the prime minister promised there would be an ‘absolute limit’ on the amount people would have to pay. Though denied by the party, opponents quickly labelled this a U-turn by Mrs May. Numbers had got another politician into trouble.