Nuffield Trust response to Labour Party manifesto

Responding to the health and care proposals in the Labour Party manifesto, Nuffield Trust chief executive Thea Stein said:

“The Labour manifesto sets out commendable ambitions to drive down waiting times, improve GP access and reform social care. These are important aspirations but they are let down by a stunning lack of detail on exactly how the party intends to deliver these pledges and tackle some of the most profound problems facing our health and care services in 75 years.

Funding

“There is no detail on a broader funding settlement for an NHS already struggling to make ends meet, and no longer-term funding plans specified. In fact, the increases detailed in this manifesto would amount to annual real terms increases of just 1.1% if added to the 1% in extra yearly revenue spending the OBR projects – far below the historic increases the health service has had, and in effect leaving spend per head frozen in real terms when adjusted for an ageing and growing population.

“It should be noted that none of the three main parties’ NHS spending plans are credible. Our analysis shows that, even assuming all parties also raise the core revenue budget by 1% a year in line with OBR assumptions, these increases are compatible with the tightest period of funding in NHS history – 1.5% for the Liberal Democrats, 0.9% for the Conservatives, and 1.1% for Labour. This would mark an unprecedented slowdown in NHS finances, and it is inconceivable that it would accompany the dramatic recovery all are promising.

Social care

“It is good to see a commitment to a set of standards to drive consistency in care and the focus on reaching a fair pay agreement for the social care workforce is welcome, but this is overshadowed by the lack of a costed plan for social care, promised by Sir Keir Starmer just two weeks ago, and a seeming lack of recognition of the need for urgent action. The ambition of a national care service has little detail, isn’t well defined and there is no mention of a credible long-term funding model for social care. Unpaid carers – who deliver high-quality compassionate care for their friends and families every day – are notable by their absence.

GP and dentistry

“There is some positive detail in the Labour manifesto around promoting patients’ ability to see the same GP when they need to, something we have called for in our own work. Paying GPs to achieve this is a good approach. The focus on choice of appointment is welcome, but mandating that all patients have the right to a face-to-face appointment may make it harder for some people to get an appointment at all after years of falling GP numbers. It is positive to see the commitment to dental contract reform, something we have said is long overdue.

Workforce

“The party states its intention to deliver the NHS Long-Term workforce plan but with no detail on how, and what funding will be available to do so, and a deafening silence on how to solve the retention issues that health care employers are grappling with.

Waiting times

“The promise of 40,000 additional appointments to improve waiting times is ambitious but getting more weekend and evenings shifts out of exhausted staff will be hard. Investment in scanners is positive, but after years of neglect on capital spending, buildings and digital technology are also in a poor state. While using the private sector more is pragmatic, there is a question over how much spare capacity there actually is.”