Parties clash on NHS funding pledges and promises to tackle the workforce crisis



The NHS is proving – once again – to be a real battleground in the general election campaign.

The Conservatives have announced that 50 million more appointments in GP surgeries will be created every year under a Conservative majority Government.

Health Secretary Matt Hancock announced a package to increase the number of NHS staff, improve international recruitment and retention of domestic staff, and train an extra 500 GPs a year from 2021-22.

He said: ‘These additional appointments, by 2024-25, will be made possible by the delivery of 6,000 more GPs and 6,000 more nurses, physiotherapists and pharmacists.’ 

But Labour has retaliated with a ‘rescue plan’ for the NHS in England, pledging an extra £26bn of funding a year paid for by higher taxes on companies and ‘the wealthiest in society’. £1bn of this would be spent restoring the training bursary for nurses, and recruiting 24,000 extra nurses, midwives and allied health professionals. Labour has also committed to expanding GP training places to create millions more appointments with family doctors.

Applications to study nursing in England are down by 29% since the bursary was axed by the Cameron Government in 2016, and the latest vacancy statistics for England show 43,617 nursing vacancies, leaving 12% of full-time nursing posts now unfilled.

The Conservatives have also pledged to invest an additional £4.5 billion in primary and community health services as part of the £33.9 billion long-term plan for the NHS. Mr Hancock said: ‘This is the first time in the history of the NHS that real terms funding for primary and community health services is guaranteed to grow faster than the rising NHS budget overall.’

Mr Hancock said the Government would also support practices to reduce waiting times through modernising systems and adopting best practice, and ensure reforms to address doctors’ pensions, which cause many GPs, senior hospital doctors and senior nurses to turn down extra shifts for fear of unexpected high tax bills.

Currently, there are 307 million appointments per year in GP surgeries. This announcement represents over a 15% uplift in appointment numbers.

According to a report in INews, the Health Secretary's promise is likely to be met with incredulity throughout the health profession. In 2015, his predecessor Jeremy Hunt pledged that the Government would deliver 5,000 more GPs by 2020 – taking the total to around 40,000 – yet within a few days he said the figure was the ‘maximum’ that was achievable and that there would have to be ‘flexibility’ on the commitment.

Figures from NHS Digital show that when Mr Hunt left the Department of Health in July 2018, there were only 162 more GPs in the NHS than there were when he made his original commitment.

Meanwhile, the Labour Party’s pledge would give the health service £5.5bn more a year by 2023-24 than the £20.5bn the Conservatives have promised, representing the biggest boost to health spending since Labour was last in power between 1997 and 2010.

Labour is promising free prescriptions and [hospital] car parking, as well as increasing NHS capital budgets by £15bn over a parliament to rebuild dilapidated hospitals.

On mental health, Labour said it wanted a new £2bn mental health fund that would end unsafe dormitory wards and to roll out a fleet of crisis ambulances. Another £2.5bn would overhaul the primary care estate – premises and infrastructure – so GPs can deliver better local care in their communities.

Commenting on the Conservative Party’s announcement on GP appointments, Richard Murray, Chief Executive of The King’s Fund said: ‘The latest GP Patient Survey shows that once people can get into their local surgery their experience is overwhelmingly positive but for many getting an appointment in the first place is the problem. These new commitments to improve capacity and access in general practice are welcome but the success of these measures will hinge on the ability to recruit and – more importantly – retain enough GPs and professionals such as physiotherapists and pharmacists.

‘The volume and intensity of GP workloads is driving many to either reduce their hours or leave the profession altogether. While more GPs than ever are being trained, overall GP numbers are falling, with 6% fewer full time equivalent GPs in September 2018 than in 2015.

‘If the next government wants to improve the care and support available to patients and the public, they must first tackle the workforce crisis.’

Responding to Labour’s NHS funding announcement pledge, Anita Charlesworth, Director of Research and Economics at the Health Foundation, said: ‘The Labour Party has pledged to provide a 4.3% annual uplift to the health care budget over the next parliament. This would see health spending rise at a faster rate than any previous government over the NHS’s history, apart from the Blair/Brown years when health spending grew by 6% a year. This would be a step change after almost a decade of austerity. Labour’s plans would see NHS England’s budget for the day-to-day running costs of front-line services increase over and above what is currently planned. It would also provide generous settlements to regenerate the NHS’s ailing infrastructure and invest in training new doctors and nurses. And it would reverse the significant cuts made to the public health grant in recent years, although stop short of growing it in line with wider NHS spending.’

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