By Steve Carne, Jun 21 2017 08:00PM
Hung up as they all are on outdated economic myths and being labelled as the party of “tax and spend” all the three main parties’ 2017 Manifestos fail to provide enough NHS and social care funding to pull the NHS and social care out of their current crisis.
The urgent need is to provide enough funding so that the NHS survives as a health service that is free at the point of need provides the full range of care and treatments to everyone, based on their clinical need. This has ceased to be the case as a result of successive governments’ underfunding of the NHS since 2010.
Social care should also be fully publicly funded and provided and available to all who need it in order to live independent decent lives - not just as a means-tested, privatised, residual service for those with “substantial” needs.
This requires adequate funding. But none of the three main parties’ 2017 Manifestos commits to this.
Given their “austerity” record over the last two Parliaments, it’s not surprising that the Conservative and LibDem manifestos offer little in the way of increased NHS and social care funding.
However, it’s disappointing that Labour have also failed to commit to enough NHS and social care funding to pull the services out of crisis.
The Labour Party manifesto commits to an extra £30bn NHS funding - more than current (Conservative) plans over five years, or £6 billion a year up to 2020/1.
The Conservatives commit to an extra £8bn in real terms (ie protected against inflation) in 2022/23 than is planned in 2017/18, although doctors and Sally Gainsbury, senior policy analyst at the Nuffield Trust, point out this figure is reached through the deployment of smoke and mirrors. SMOKE & MIRRORS
The LibDems commit to £6bn more than current plans for health and social care in 2019/20. WHO IS MOST GENEREOUS?
The way the Health Foundation analyses it WHAT THE MANIFESOTS MEAN
and although the Labour party’s commitment is the most generous:
“all three parties’ funding plans fall significantly short of the anticipated spending pressures. This will leave a funding gap, which will need to be filled either by a continuation of the drive for very high rates of efficiency and productivity growth in the NHS, or by scaling back what the NHS delivers.”
None of the Manifestos confess to scaling back on what the NHS delivers. So the assumption has to be that they all believe that the NHS will have to fill the funding gap by so-called “efficiency savings” that are at the same kind of level as required by the 5 Year Forward View Plan. For Labour the funding gap by 2022/3 would be £17bn, for the Tories it would be £22bn. Ok it's less but it's still the same philosophy - CUTS.
It looks like the more things change, the more they stay the same.
All 3 main parties make similarly inadequate funding commitments for social care
The Centre for Health and the Public Interest 2017 Election briefing note on Social care funding manifesto commitments finds that all 3 parties are proposing policies that won’t alleviate the social care crisis but will potentially benefit around 100K people, all with significant assets. And their social care manifesto commitments won’t do anything to alleviate the pressures on the NHS which arise because of a lack of adequate social care.
The CHPI Election briefing note points out that a substantial amount of public funding is needed for social care to: “become a service which enhances the lives and independence of our older people.”
But: “The 3 main parties are committed to keeping social care as a residual service for only those with substantial needs.”
This is despite the fact that reducing social care to a minimal service is:
“...a major reason why hospital A&E departments are regularly overwhelmed and why hospital beds cannot be freed up..”
All three main parties have responded to the social care crisis with Manifesto commitments to:
“provide some additional funds to just about maintain a highly restrictive service, and protecting the assets and wealth of a small number of richer older people.”
They have all signed up to the 2011 Dilnot report - LINK TO REPORT - which proposed to keep means-tested social care, with a cap on an individual’s liability to pay at a certain level, beyond which the state will pay; and an increase to the amount an individual can keep before having to contribute to the cost of their care.
The 2013 Dept of Health impact assessment on the Dilnot Report says it would benefit an additional 100,000 people who would receive care they would otherwise have to pay for.
Because the purpose of the Dilnot report was to expand state-funded social care to those currently deemed too wealthy to access it, the 2013 impact assessment showed that the scheme would disproportionately benefit the rich at the expense of the poor.
Yet The Green Party 2015 Manifesto costed free social care for the elderly at around £9bn/year. This could be paid for by a combination of NHS cost savings (as a result of reducing A&E use and bed occupation; and from savings resulting from ending NHS marketisation and privatisation); cuts to other areas of public spending (eg corporate welfare including fossil fuel corporate subsidies, which costs taxpayers around £85bn/year http://renewal.org.uk/files/Farnsworth_final.pdf ); and increased revenue from a variety of fiscal measures including a wealth tax, Robin Hood (financial transactions) tax and a crack down on tax dodging.
However this would not deal with people with disabilities aged 18–64 years who receive long term social care - 285,000 people in 2015/16. Means-tested and largely privatised, this accounts for 48% of adults social care funding. http://www.health.org.uk/sites/health/files/Election%20briefing%20NHS%20and%20social%20care%20funding.pdf We would argue that ALL adults social care should be publicly funded, provided and run and free at the point of need.
Contrary to economic myths put about by all three main parties, adequate funding of NHS and social care is both affordable and economically beneficial. We need to persuade the politicians.