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What will the general election mean for health services?

7 May is going to be an important date for everyone in the NHS. Whatever your role – doctor, psychiatrist, mental health nurse, allied health professional, biomedical scientist – it's almost inevitable that your working life will, sooner or later, be significantly affected by the result of the general election, whether the government is formed by one, two or more political parties.

The election coincides with a 'pivotal time' for the NHS, according to the highly respected think-tank, The King's Fund. In the introduction to its September 2014 report, Priorities for the next government, Chief Executive Chris Ham sums up the challenges: "An unprecedented funding squeeze has left the NHS on the brink of financial crisis, while reductions in local government funding have led to significant cuts in social care services. The next government must ensure that the focus on improving quality of care in the wake of the Francis report is sustained. It will also need to set in train a transformation of services to meet the needs of patients more effectively. Looking further ahead,the big question is how to provide adequate funding to meet future demand for health and social care."

What can we expect?

So, what do we know so far about where the main UK parties stand on health policy? Have any of them put forward radical ideas to address the challenges? Have they guaranteed extra spending or proposed new funding models to deliver a health service which can confidently face the demands of a growing and longer-living population?

"The next Conservative Government will protect the NHS budget and continue to invest more," declared Prime Minister David Cameron in his 2014 conference speech. The party has promised to ring-fence the NHS budget, so that spending rises in line with inflation, and have also committed to a real-terms increase in spending from 2015-2020. In his Autumn Statement, Chancellor George Osborne pledged an extra £2 billion per year for frontline health services from 2015-16. 

Other Conservative commitments include: all patients to have access to a GP from 8am to 8pm, seven days a week by 2020; 5,000 more GPs to be trained by 2020; and a £95,000 cap on redundancy payments to NHS and other public sector staff earning more than £27,000 per year.

As for Labour, they want 'whole person care' to be a guiding principle of the NHS. "The model I am proposing could create a firmer financial base under acute hospitals trusts where they can sustain a back-stop, local A&E service as part of a more streamlined, re-modelled, efficient local healthcare system, " said Shadow Health Secretary Andy Burnham in a speech to the King's Fund. He went on to cite the example of Torbay, where the NHS and local council have cooperated to provide one point of contact for coordination of health and care needs: "Occupational therapists visit homes the same day or the day after they are requested; urgent aids and adaptations supplied in minutes not days."

Labour's annual £2.5 billion 'time to care' fund will pay for 20,000 nurses, 8,000 GPs, 5,000 care workers and 3,000 midwives. The party also plans to repeal the parts of the Health and Social Care Act that relate to competition and make the NHS the preferred provider of services, as well as guaranteeing appointments with a GP within 48 hours.

The Liberal Democrats are the only party to have published a 'pre-manifesto'. They've also given a preview of the front cover of their full manifesto, which carries a promise to provide 'quality health care for all' by investing £8 billion to 'improve our NHS and guarantee equal care for mental health'. 

"Not only will the Liberal Democrats protect the NHS Budget in real terms, we will raise an extra £1bn for it every year, by ending three different tax breaks which benefit the highest earners," announced Deputy Prime Minister Nick Clegg at the 2014 Lib Dem Party Conference.This includes a commitment to provide an extra £500 million for mental health services to improve access and reduce waiting times. With staff shortages and cuts, treatment from experienced mental health professionals such as psychiatrists, psychologists and psychotherapists has been difficult to access for many, particularly young people "...for the first time ever, we will introduce national waiting times for patients with mental health conditions," said Clegg. "...So if you are waiting for talking therapies to help with your depression, you will be seen within six weeks – 18 weeks at an absolute maximum – just as if you are waiting for an operation on your hip."

Despite their leader's widely reported personal views about possiblyintroducing an insurance-based system, which 'triggered a debate' within the party, UKIP has now pledged to keep the NHS free at the point of delivery. Launching the party's health policy in February, Health Spokeswoman Louise Bours also promised to increase frontline NHS spending by £3 billion per year and elderly social care by £1 billion per year, as well as injecting £130 million to £650 million per year into dementia research and care over the life of the parliament. "We and the British people are fully committed to looking after the NHS," confirmed Ms Boors, "and the vast majority of those working in the NHS are fully committed to looking after the British people."

The Greens are the only party proposing an additional tax to bring NHS funding into line with the approximate EU average. They also want to abolish prescription charges and expand free NHS dentistry. As for mental health, they share many of the Lib Dems' aspirations to improve services and access, but their outline health policy also emphasises the importance of improving staff morale: "The Green Party recognises that many people working with those with mental health difficulties, such as mental health nurses, social workers and support staff, work long hours, in difficult conditions, on relatively low pay and often with insecure job tenure. We would seek to improve the conditions and pay as well as the status of these important roles. This would aid in the retention of staff and, as a result, in providing continuity of care."

There's also a new political party specifically focused on health policy. Formed in 2012, the National Health Party comprises 'doctors, nurses, paramedics and ordinary people who've come together to defend and improve the NHS'. Their proposals include: halting unnecessary hospital closures, supporting local A&E and maternity provision, stopping privatisation of NHS services, putting responsibility for healthcare back with the Health Secretary, funding the NHS to G7 levels and reversing government cuts.

Other voices

However, open discussion about the general election has not just come from the political parties. Everyone from trade associations to charities and lobby groups have been setting out their wish lists for the new parliament. The Royal College of Speech and Language Therapists has published its manifesto asks, which 'offer constructive, and cost neutral, solutions to current policy problems'. The Society of Radiographers has launched A manifesto for tomorrow's NHS, which sets out its aspirations for diagnostic imaging and radiotherapy services. The Mental Health Foundation's Prioritising Mental Health Research manifesto details what political parties can do to make mental health research a priority during the general election and in government. And Mencap's Hear our voice: the change we want to see 2015-2020 presents the views of people suffering from or affected by mental health issues.

There's even been an impassioned plea to political policy makers from one of the country's leading actors. Speaking at a St David's Day march to celebrate the NHS and its founder Aneurin Bevan, Michael Sheen, who has famously played ex-PM Tony Blair three times, said that all political parties has drifted into a 'morass of bland neutrality'. "You must stand up for what you believe," he implored, "but first of all, by God, believe in something."

Other organisations have concentrated on encouraging their members and supporters to get out and vote. The CSP, which represents physiotherapists, has an online form for members to email their election candidates with four key questions. And the BDA, the Association of UK Dietitians, is urging people to make sure they are on the electoral register so that they can exercise their democratic right to vote.

As for reviewing the new government's plans for health and social care policy soon after the election, occupational therapists will have a chance to do just that at their annual conference, which takes place in Brighton from 30 June to 2 July.

Are you a clinical or allied health professional, or a biomedical scientist, with views on the issues raised in this article? Please leave your comments below.

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