General election outcomes: what might it mean for the NHS

1. General election outcomes: what might it mean for the NHS 2010 Ruth Thorlby Senior Fellow, King’s Fund

2. The Labour party “Top down reform was right for its time but can only go so far” (Andy Burnham speech to The King’s Fund September 2009)

3. No manifesto document • spending: 95% of the NHS budget is to rise in line with inflation in 2011/2012 • a “National Care Service” and free personal care to those “in highest care need” • the right to treatment within 18 weeks

4. Right to cancer tests results within one week • Choice of GP • NHS health checks every five years for people aged 40 to 74 • other policies include abolishing hospital car parking charges

5. Productivity • NHS as preferred provider • Big push on better care for long term conditions • Prevention • Care outside hospital/closer to home • Future direction of inequalities policy

6. Conservative Party • Draft manifesto on health published in January • Committed to a tax funded NHS, free at the point of use • Committed to increases in funding: • “real-terms increases in NHS spending” • Scrap “politically motivated process targets” • Focus on outcomes • Cut bureaucracy

7. Conservative party policy • Independent NHS board • Department of Public Health • HealthWatch • Moratorium on A&E/Maternity closures • Insurance for residential care costs • Changes to funding allocation formula • Health “premium”

8. Conservative party policy “If you look at the changes we are making to the NHS: • extending foundation trusts • opening up the supply of healthcare • GP commissioning • improving patient choice these are all changes that are grinding to a slow and tortuous halt under Labour.”

10. No draft manifesto but “blueprints” for reform published Feb/March • PCTs to be re-named ‘Local Health Boards’ and to be locally elected • abolition of Strategic Health Authorities • abolition of targets

11. Liberal Democrats • Entitlements for patients • Waiting times guarantees • Scrapping National Programme for IT • Staff ownership of organisations • Breaks for carers • ? Personal care for the elderly

12. Voting Intention: all giving an opinion vs. those “certain to vote” How would you vote if there were a General Election tomorrow? All giving a voting intention (78%) All certain to vote (52%) Other Other Con Con LD LD Lab Lab Conservative lead = +4 Conservative lead = +8 Base: All giving a voting intention = 777 unweighted, All certain to vote = 519 unweighted; data collected among 1,001 British adults 18+, 26th-28th January 2010 Source: Ipsos MORI Political Monitor

13. Voting Intentions Jan 03 – January 10 (all certain to vote) How would you vote if there were a General Election tomorrow? 2005 General Election Howard elected (Nov 03) Brown as PM (Jun 07) Cameron elected (Dec 05) 40% 32% 16% Source: Ipsos MORI Political Monitor Base: c. 1,000 British adults each month through June 2008; c. 500 British adults thereafter

15. 2.5% a year is 1.5 ppts below long run average No six year period in history of NHS with real reductions each year No six year period of zero growth in history of NHS

16. Consistent view it should be protected Q10 Which of the following statements best reflects your thinking about the NHS? % The NHS is crucial to British society and we must do everything to maintain it The NHS was a great project but we probably can’t maintain it in its current form Base: English adults age 16+ (c.1,000 per wave)

17. It will provide me with everything I need no matter what they cost 72% expect NHS to provide drugs no matter what they cost treatments no matter what they cost … = no limits on spending The NHS should provide the most effective drugs and treatments provided they represent good value for money The NHS should provide all drugs and treatments no matter what they cost The NHS should provide the most effective drugs and treatments no matter what they cost Base: British public, 18+ (1,001) 12-17 January 2006

18. The psychological contract Q Please tell me whether on the whole you agree or disagree with each of the following statements? % Agree % Disagree June 08 Britain’s National Health Service is one of the best in the world July 08 August 08 June 08 The NHS will be there for me when I need it July 08 August 08 June 08 My local NHS helps improve the health and wellbeing of me and my family July 08 August 08 Base: English adults aged 16+ (c. 900 per wave) N.B arrows represent significant differences in agreement from June-Aug 08 Source: Ipsos MORI NHS 60th awareness tracking August 2008

19. … and public want NHS protected Which TWO or THREE, if any, of the following main areas of public spending do you think should be protected from any cuts? The NHS/health care Schools Care for the elderly The Police Social services Defence Benefit payments Local authority services Overseas aid None of these Don’t know Source: Ipsos MORI Public Spending Index Base: All who think some services should be protected (773), 19-21 June 2009

20. King’s Fund election coverage • Hustings for politicians • http://www.kingsfund.org.uk/general_election_2010/index.html • Review of Labour’s performance in office • Outlines of party positions • Briefings for the media: • “Are there too many managers in the NHS?” • “Where did the money go”