The document discusses healthcare policy and politics in the lead up to the UK general election. It provides an overview of the major parties' healthcare platforms, compares their stances on issues like funding and private sector involvement. It also analyzes polling data and predicts that the next government will be a Conservative majority or minority government, possibly with support from unionist parties in Northern Ireland. This would likely mean continued emphasis on integration with social care and multiple healthcare providers.

1. PRE-ELECTION
HEALTHCARE SPECIAL
With Dave Roberts,
Audience Communications
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4. Hullabaloo
Elections
All elections create plenty of noise.
But do they tell us much about policy detail on any given issue?
It depends on the issue, level of detail expected and the degree of openness by politicians.
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5. Hullabaloo
Elections
Two examples of hidden policies:
• In 1997, Labour kept plans on Bank of England independence confidential from nearly
everyone - including senior figures in their own party.
• Conservatives stated in 2010 that there would be no top down reorganisation of the NHS –
what followed was the complete opposite.
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7. Campaigns are broadly about macro issues and this election is no different.
• The economy - austerity
• Immigration
• Tax and spend - welfare
• The NHS
• Education
• World events
Hullabaloo
Elections
Governing parties tend to have greater detail and a track record while the
Opposition aim to paint big pictures.
But at this election healthcare has three experienced lead figures with a good
grasp of detail.

8. Hullabaloo
Elections

10. • Major support for the NHS – 89% of the public agree Government should support a
national health system that’s tax funded, free at point of use and available for all citizens.
• Over 4 in 10 (43%) think the NHS has neither improved or deteriorated over the last 5
years. 26% think the NHS has got better over this period. 28% think it has got worse.
What do the public think?

11. What do the public think?

12. While people support the funding principle of the NHS they are less attached to the NHS as
their preferred provider of care. 43% do not have a preference between receiving NHS
funded care from the NHS, a private company or a charity/social enterprise.
What do the public think?

13. Just over half of the public (51%) think the NHS often wastes money.
What do the public think?

15. Agreement is rare, but….
• There are areas of broad agreement on the NHS:
• The need for continued increases in funding.
• The important of integration between health and social care.
• Quality and standards.
• Personalisation of care.
• The impact of an ageing population.
• The role of prevention.

17. Additional funding - £2.5B Time to Care
Fund
Repeal of parts of Health and Social
Care Act
NHS as preferred provider
NHS exemption from EU procurement
and competition law
‘Whole person’ care
10,000 extra nurse training places and
5,000 care workers
Child mental health priority
Tax on tobacco companies to pay for
faster cancer test results
Additional funding - £2bn in 15/16
NHS absent from top 5 pledges
Commitment to NHS Five Year Forward View
Continuation of multiple providers
Cap on redundancy payments
More GPs and 7 days a week access
Stronger commissioning preferred over choice
DH as defender of public interest not ‘hands on’
delivery
UK Parties – healthcare policy comparison
Additional funding £8B extra per
year by 2010
Health one of 5 pledge areas
Invest in mental health – equality of
esteem
Mergers no longer under
Competition and Markets Authority
Strengthened Health & Well-being
Boards

18. Ending hospital car park charges
Compulsory insurance for all new
immigrants
Diverting funding from central facilities
to community health centres
Abolishing Foundation Trusts
And the smaller parties
For the devolved unionist and nationalist parties healthcare is
broadly an issue for their own elections or an issue for horse trading.

19. The legacy of Greater Manchester?
• Greater Manchester gaining full control of its £6 billion health
and social care budget could be a ‘game changer.’
• The devil is in the detail. If there is a full transfer of
responsibility - the reform is huge and with risks attached.
• The Conservatives see it as an ‘exciting development’ - it could
reduce waste & costs. Any blame can be delegated to.
• Labour seem to be floundering – it fulfils their integrationist beliefs BUT
they’re very concerned it could fragment the NHS.
• All the main parties will examine the detail & want a robust process &
accountability measures that put patient care first.
• All eyes will be on Manchester – it could set a major precedent for other
cities?

21. Healthcare in the UK is
always political
(The NHS) cannot survive
five more years of David
Cameron. Douglas
Alexander MP Labour
Election Chair
..a future Conservative government
will have no greater priority than
to protect, support and invest in
our NHS……
(Labour) know this government
increased the NHS budget despite
the financial mess Labour left
behind. Jeremy Hunt MP
Conservative Conference 2014
Labour introduced patient
choice of hospital treatment.
But they left out mental health.
Labour introduced payment by results
to pay hospitals for the work they do.
But they left out mental health.
Liberal Democrats will not stand by
and let this continue.
Norman Lamb MP Lib Dem
Conference 2014

22. ‘Few PMQs in this parliament have been as
brutal as today's. Ed Miliband led again on
the NHS, Labour's strongest suit (and the issue
that polls show is of greatest importance to
voters), questioning David Cameron on his
failure to save A&E units from closure.
Cameron responded by immediately
challenging Miliband on his refusal to deny
that he vowed to "weaponise" the health
service, demanding that he apologise. At this
point, the session descended into one of the
ugliest encounters yet between the two men.’
New Statesman 28/01/15
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23. Possible areas for health debate or
political attack
• The role of the private sector and “privatisation” of the NHS.
• Cancer waiting times and other statistics from Labour-run Wales.
• Labour’s legacy of Mid Staffs.
• The public’s distrust of the Conservatives on health issues.
• A & E waiting times.
• Affordability of the Cancer Drugs Fund.

25. • The NHS is viewed by Labour as the manifestation of its collectivism and remains its
strongest policy area. It is a living breathing example of the difference between them and
the Conservatives.
• Andy Burnham may plan a leadership contest if Labour are not in Government after May
in which he could hope to have major union backing – this helps explain his strong
rhetoric.
• The Lib Dems struggle to have an ideological or political ‘unique selling point’ on NHS beyond
championing the role of local government.
• Lib Dems regularly restate Beveridge as their own.
What drives policies?

26. • The Conservatives struggle to be trusted on the NHS by the general public.
• Some of their core activists may agree with Nigel Farage that the future of the NHS is not
as a fully funded public institution.
• Jeremy Hunt could move. In spite of his stated desire to remain as SoS for Health – if he
keeps a steady hand at the DH he may expect a senior role in a new Conservative cabinet?
The politics behind the policies

27. • The polls repeatedly say it will be a hung parliament.
• The polls continue to give the SNP 40+ seats.
• The polls say Labour and Conservatives are even on share of the vote.
• But Conservatives have just opened a 2 point lead on 35%.
• The polls indicate that the Greens and UKIP might do well in share of vote.
Predicting the Election result?
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28. • Month on month the Conservatives have eaten into the Labour lead - now level pegging.
• The Conservatives are challengers in many Lib Dems seats.
• The Greens may take votes from Lib Dems and Labour.
• UKIP may take votes from Conservatives and Labour.
• Labour could be squeezed by Greens, UKIP and re-engaged Lib Dems.
• Labour core has been hit by austerity measures but as a group they have poor voting habits.
Themes underlying my prediction (1)

29. • Conservatives are well funded – Labour is not.
• Labour is struggling in the South and South East.
• The economy is strengthening with wages outstripping inflation.
• General employment is up.
• Ed Miliband and Ed Balls are not popular with the public.
• Labour may not be able to work with the SNP – to have a UK government reliant on Scottish
nationalist support could prove untenable.
• The Conservatives could work with the Unionists in Northern Ireland.
Themes underlying my prediction (2)

30. The polls 2012 – 2015
Opinium Research 20/02/15
Most polls only give a snap shot on a national share of the vote and these ignore
local contests.
It is an odd combination of local contests and national leadership that decides
elections.

35. My prediction:
the next Government will be …..
Conservative - possibly with Irish unionist support.
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36. What might this result mean for the NHS? –
a prediction
• Out of hospital services will slowly grow as acute budgets are stretched.
• Multiple providers will be embedded - the third sector will show a greater interest.
• Integration with social care will continue – but will be inconsistent. But possibility that further
cities could bid for similar powers to Manchester re. greater control of NHS/social care budget?
• Locally public health will be dependent on local government with PHE and DH reluctant to
dictate or intervene. Public Health England will continue to run national campaigns in strategic
areas: tobacco control, alcohol, obesity etc.
• Jeremy Hunt will be SoS until the first reshuffle when he will move to
Defence.

37. But what if there was another coalition?
Labour/ Lib Dem = very compatible - repeal of the competition parts of Health and
Social Care Act & extra spending on mental health.
Conservative/ Lib Dem = little change – Lib Dems would win emphasis on mental health
and role of Health and Wellbeing Boards.
Other political options are about supply and confidence not coalition.
This may lead to nationalist ‘horse trading’ from all three devolved nations – English health
bills and spending would require nationalist support – which in turn would require giving
ground elsewhere.

38. Making the respiratory case: what to do
after the Election
If my predictions are correct then there will be minimal change in the first year or so as the new Government seeks
to “neutralise” the NHS as a political issue. There may therefore be a number of reviews and consultations.
The detail / efficacy of Greater Manchester’s control and delivery of the £6bn health and social care budget will be
monitored closely by all Parties.
National tobacco control policy will continue with the implementation on restrictions on packaging and smoking in
cars with children.
Substantive action should be driven at a local level and demonstrate ability to:
• Save money & deliver effective care.
• Work out of hospital in community settings.
• Engage with multiple providers and in collaborations.
• Support early intervention – especially in frail older people.
• Offer patient satisfaction and personalisation where possible.
• Provide solutions that are attractive to Health and Wellbeing Boards and CCGs.

39. Nationally make use of the recent APPG report on respiratory issues to push for change :
• Restate the health and economic data re burden of lung disease.
• Stress cost effective policy and NHS service solutions that show respiratory specialists and partners working
together to deliver results.
• Within this show well-funded and co-ordinated respiratory management prevents readmission to A&E.
• Work with GPs, local authorities and partners to promote case for pulmonary rehabilitation
Making the respiratory case: what to do
after the Election
• Push for national roll out of pilot breathlesness/COPD awareness programme – early
detection pays
• Children’s respiratory health needs specialist and joined up care that acknowledges
child’s age, parent/carer and family as influencers in compliance
• Smoking cessation advice / greater COPD diagnoses – for patients with severe mental
health issues.

40. Thank you for watching.
Any questions?
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