Health Policy December 19, 2019
NHS top priority for Boris’ new government

By Daniel Male - Accountable Care Journal

With the echoes of Black Rod still ringing in Central Lobby from nine weeks ago, Her Majesty the Queen outlined the priorities of Boris Johnson’s new government with slightly less pomp and ceremony than usually accompanies a Queen's Speech.

The agenda laid out today is one of delivery, and with a new majority of 78, the Prime Minister has a clear path to turn his promises into reality. Parliamentary deadlock can no longer be used as an excuse for lack of progress.

The Government has committed to enshrining extra healthcare funding in law, reaching up to £33.9bn by 2023/24. Alongside this, the Government has proposed a new visa to “ensure qualified doctors, nurses and health professionals have fast-track entry to the UK,” that hospital parking charges will be removed for those in 'greatest need' and that Ministers will continue with reforms to the Mental Health Act.

That the NHS is a core focus should come as no surprise. Big promises were made throughout the election campaign and the message from voters was that the NHS is their priority. In this context, Boris Johnson has rightly responded with key policy commitments to address struggling services.

With vacancy rates increasing, widespread consensus on the need for more NHS funding in England to support services, and long-overdue plans to reform the Mental Health Act, these announcements have been understandably welcomed. Similar to Brexit, the ambitions of these policies are simple in nature, but achieving them will be anything but.

Nick Ville from the NHS Confederation called for the sector to be “realistic” about how the extra investment is used, and to set “an appropriate budget in the 2020 Spending Review”. Meanwhile, a humbled Labour Party said the Government would be judged on how it makes up for “years of underfunding”.

Time to deliver 

Trust in politicians is at an all-time low – this is understandable. With a significant amount of political capital to spend, the Government will need to show that their agenda is more than simply 'getting Brexit done'. Having affirmed many policies in the Queen’s speech nine weeks ago and in their subsequent election manifesto – the pressure to deliver is higher than ever.

The funding plan, for example, is nothing new. Nor will it make too much difference being enshrined in law other than easing the minds of those doubting the reliability of Boris Johnson's word.

The 100,000 vacancies across the NHS is a mountain to climb. The NHS People Plan, set to be published 2020, is sure to include measures to recruit more staff from overseas, including from the EU where recruitment has fallen significantly since the 2016 referendum. This must also include retention and career development improvements to reduce the number of staff leaving the health service.

Richard Murray, Chief Executive of the King’s Fund, called for the Government to be honest with the public about what immediate outcomes they can expect. “The new NHS Visa is a welcome but limited response to the need to recruit international staff to meet pressing workforce shortages,” he said.

What about social care?

The Government also announced a plan for “long-term reform” of social care. Given the magnitude of the issue, the focus on social care is welcome. However, this is a promise that has been made time and time again. Perhaps with a new parliamentary majority and significant electoral breathing space, the urgent needs of the sector will finally outweigh the political risk of taking action.

The promised “long-term reforms” will indeed be for the long-term and will need some heavy thinking if a sustainable solution is to be implemented that makes up for years of stagnation on the issue and an increasingly ageing population. This, combined with workforce shortages, a lack of leadership around the use of digital technology, and spiralling costs, does not make for simple work.

Dr Jennifer Dixon, Chief Executive of the Health Foundation, said there was “no time to waste” with increasing numbers of people requiring social care services. She called for “fundamental reform” to be “the immediate priority”.

Of course, addressing the perceived ‘crisis’ in social care is not only about sustaining funding for existing services. Social care is a core part of the new prevention agenda; to ensure people remain in better health for longer and fewer individuals are admitted to hospital.

Due to the number of issues in both sectors, this Queens Speech is the tip of the iceberg in health and care. If the new Prime Minister is serious about addressing these pressing challenges, he needs to take a deep breath and be prepared to take risks. However, with an enthused majority of 78, parliament is no longer the biggest obstacle to be manoeuvred for progress to be realised on this ambitious agenda.

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