Nuffield Trust response to Conservative Party manifesto

Responding to the Conservative manifesto for government, Nuffield Trust Chief Executive Thea Stein said:

“The Conservative manifesto today represents a continuation of the current government’s plan for NHS and social care, which has some stable proposals on staffing and boosting mental health provision, but ultimately these steps so far have not been delivering a rapid turnaround on waiting times and access or reversing record low patient satisfaction with the health service.

“The Conservatives' social care plans reconfirm their commitment to the laudable aspirations set out in the 2021 white paper, but fall far short of the ‘bold action’ Rishi Sunak spoke of in his speech. A complete absence of any new funding for social care and no plans to create detailed implementation plans leave warm words about attracting people to the workforce and supporting unpaid carers sounding hollow.

"A commitment to a multi-year settlement for local authorities should be welcomed but, with no source of sustainable revenue identified, a big question mark hangs over the recommitment to implementation of the care cap by October 2025. Given the state of local authority finances and the fact that the original money earmarked for the cap has been redirected into day-to-day running costs, it is difficult to see how this promise can be fulfilled.

“On NHS funding, these appear to commit to keeping the NHS budget relatively flat in real terms, after three consecutive years of already very low growth or real-terms cuts. This funding squeeze will not be enough to help the NHS stand still, let alone, meet an ambitious pledge to meet NHS targets, like four-hour A&E waits and 18 weeks for treatment, within the next parliament. Funding for NHS dentistry is falling in real-terms and a continuation of the dental recovery plan is nowhere near the level needed to pull the sector back from the brink.

“The Conservatives have set out to raise funds by reducing the number of NHS managers, which seems ill thought through and unstrategic, but this funding will be dwarfed by the huge sums to meet its bold commitment to hire 92,000 additional nurses and 28,000 doctors – with the increases in those two staff groups likely to cost in the region of £12 billion annually even at current salary levels when factoring in overheads. The proposal to improve working conditions is important but lacks clarity and investment, and therefore it is difficult to ascertain whether it will be able to help keep more NHS staff from leaving the workforce.”