Having come through the annual 'points mean prizes' QOF-fest, we're on to the next big event: the general election. This could have far-reaching consequences for all NHS staff. The opinion I hear most often refers to leaving the service alone long enough to allow staff to get on with the job, but this is not likely to happen. Depending on whom you listen to, we may literally not be able to afford to do this for much longer. Here is a brief digest of what the major political parties have planned for the NHS, should they be successful in May, although as we come closer to May a form of bidding war may develop:
Conservatives are promising to ring-fence the NHS budget, so spending rises in line with inflation. George Osborne also announced an extra £2bn a year for frontline health services - a 'down payment' on the £8bn annual shortfall. It later emerged that the £2bn sum includes £700m of underspend which was already allocated to the NHS budget. This money is for the whole of the UK and includes £300m funding for the devolved nations. The extra £2bn would be spent every year of the next parliament but where the money for the years beyond 2015/16 would come from hasn't been specified. £300m of the £2bn will be spent each year (for four years) on modernising GP surgeries across the UK, raised from the fines imposed on banks.
Labour are also promising to keep the NHS ring-fence. In addition they plan to spend an extra £2.5bn a year across the UK, paid for by a mixture of 'mansion tax', a clamp-down on tax avoidance measures and a windfall tax on tobacco companies. The promised £2.5bn will not be available in the first year of the new parliament, as it will take time to raise the new revenue and it may not be available until 2017-18. It is estimated that the mansion tax would provide £1.2bn of the promised £2.5bn. Again, a proportion of the extra money would be allocated to the devolved nations. Specifically, Labour promises resources for 3,000 more midwives, 5,000 more care workers, 8,000 more GPs and 20,000 more nurses.
The Liberal Democrats have promised to meet all of the £8bn extra that is reportedly needed by 2020. This money will mainly be raised by the economy recovering in line with current projections made by the Office for Budget Responsibility, and would go alongside continued efficiencies and reforms in the NHS. They promise that (once they have dealt with the structural deficit) they will link the amount of money going into the NHS to the growth of the economy. In the shorter term, the party has set out some commitments to extra spending which include an extra £1bn a year. Half of this is pledged to their party's priority - mental health services.
UKIP is currently the only main party not pledging any extra cash to the NHS; instead it promises to reprioritise what the NHS does. The party has made no commitment to keep the NHS ring-fence and has hinted that they would remove it. Nigel Farage has said the idea of replacing the NHS with an insurance-based system is "a debate that we're all going to have to return to". Specific policies include: keeping the NHS free at the point of delivery, ensuring all migrants and visitors have NHS-approved medical insurance as a condition of entry to the UK, saving an estimated £2bn per year; spending £200m of this saving on ending hospital car parking charges.
Do you think any of these promises can save the NHS in the long-term?
What would you do?
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