General Election Special

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With all three parties shaping up for the General Election on May 7th, cross-party consultants from health and social care specialists, PLMR forecast what might happen depending who’s in Downing Street after the vote.

Labour: Is the future integrated?

By Rhiannon Evans-Young, Account Executive at PLMR (Rhiannon is a Labour activist in her spare time)

Since the first headlines on the crisis in A&E were splashed across the papers this January, Labour has put Health and Social Care at the forefront of its electoral strategy.

With Andy Burnham MP at the helm, Labour are positioning themselves as the protectors of the NHS – the only party who can deliver the reforms needed to safeguard its future. With Labour polling far ahead of the Tories when it comes to the NHS, this is a tactic likely to be championed strongly between now and May.

A key facet of Labour’s Health and Social Care policy hinges on integration. With an ageing population, a chronically under-funded care system and disjointed services, Burnham and his Shadow team see the creation of National Health and Care Service as the solution.

At a recent Labour Party reception, Burnham referred to the neglect of the social care system as a “failure of modern politics”. Through integration, Labour hope to see services start to communicate with each other, ensure the most appropriate care is provided in the most appropriate setting and, crucially, take pressure off A&E departments and other NHS services.

For care providers, integration would mean access to the additional funding the sector very much needs. Investing in adult social care would allow Local Authorities to provide rates for care which truly reflect the cost of providing care, leading to a strong and stable sector for older people. With a rapidly ageing population and one million Britons expected to be living with dementia by 2025, Labour believe that unless we act now, we are leaving the adult social care sector teetering on the edge of collapse.

For patients, an integrated health and social care system would spell the end of being pushed from pillar to post when trying to achieve a diagnosis or secure the right care. Rather than having to deal with a range of different people, explaining your needs to each one, Labour aim for a system where every user has one point of contact, streamlining and simplifying the system.

Labour are very clear in their message that competition and fragmentation would have no role to play in the British health and social care system under their watch.  Despite pledging to not reverse any of the wholesale restructuring made by the current Government (to prevent further disruption for health workers) they are committed to reducing the role of private contractors and ensuring services are properly resourced.

As we enter the short campaign, Labour will continue to highlight their credentials as the party which can save the health and social care sector. They will strive to paint a picture of an uncaring Conservative Government who have attempted to privatise the NHS and who have neglected social care. Whether a future Labour Government’s plans for a revolutionary integration of health and social care will be successful is another question entirely, one which will be sure to engender excessive scrutiny from politicians, healthcare professionals and the general public alike.

 

Conservatives: It’s the economy, stupid. And nothing else.

By Leon Emirali, Account Manager at PLMR 

(Leon stood as a Conservative Party candidate at the recent council elections in the London Borough of Sutton)

Don’t be surprised if David Cameron doesn’t mention health and social care even once in the lead up to the Election. The economy has improved since 2010, and the Tories don’t want to talk about anything else.

The Conservatives’ election strategy is deeply underpinned by private polling carried out extensively by their Australian election guru, Lynton Crosby. Whilst the Conservatives’ poll well on their management of the economy, their stewardship of the NHS and general provision of healthcare is less favourable.

Despite this, George Osborne’s plans to devolve decision-making on healthcare to a ‘Greater Manchester Mayor’ are bold and could signal a serious step-change in the way health and social care is commissioned and integrated if the Conservatives remain in Government.

If David Cameron can win a majority for his party, it will be intriguing to see who takes up the role of Care Minister. In coalition, Lib Dem Norman Lamb has been widely praised in the role as the senior governing party have let him get on with it. There appears to be no obvious fit in the Tory ranks for a natural successor. 

Whilst it would be unfair to say the Conservatives ‘don’t care about care’, they are playing to their strengths ahead of what will be one of the closest General Elections for decades.

 

Liberal Democrats: Forcing Through Better Care

By Nathan Hollow, Account Manager at PLMR

(Nathan stood as a Liberal Democrat candidate at the recent council elections in the London Borough of Merton)

In just under two months the nation will go to the polls in what looks set to be the most unpredictable general election in generations. It is very likely a Coalition Government of some variety will be returned in May, and the Liberal Democrats will very much hope to remain part of it. But having been in Government for five years, and having had responsibility for social care throughout – first under Paul Burstow, and latterly Norman Lamb – what are the Lib Dems plans for the sector if they retain their seat at the Cabinet table?

One of the core issues for the Lib Dems, and a key differentiator with the other parties, is mental health – the party has even gone as far as to place the issue on the front cover of the manifesto, promising to ‘invest £8bn to improve our NHS and guarantee equal care for mental health’.  As the only party to commit to filling the NHS funding gap, Mr Burstow detailed how this additional money will result in an extra £500million a year, every year, being spent on mental health care, so that “cumulatively by the end of the Parliament an extra £2.5bn a year will be spent on mental health.”

These extra resources will go towards addressing the many issues with CAMHS, which Care Minister Norman Lamb described as “dysfunctional”, as well as improved mental health access standards, which will“ratchet up over the life of the next Parliament” until they fall more in line with physical health standards. 

For social care, further reform is planned with Lib Dem policy closely aligned to the findings of the Demos Commission on Residential Care – unsurprising given Paul’s Chairmanship of that Commission.

Following the Greater Manchester announcement, integration of health and social care spending at the national level is top of the agenda for Lib Dems. Calling the Manchester project “very exciting” and “reflective of the idea which sits behind the Better Care Fund”, Mr Burstow highlighted Lib Dems would look to greatly expand the Fund so that is encompasses, “all of adult social care, primary care, acute care and mental health” by 2018.  There are also plans for the creation of a “new department for health and care” immediately after the election, as well as an independently chaired, non-partisan “fundamental review” that will look at funding of the health, care and housing systems.

As a sector he describes as “tragically low status” and one that must become a “valued sector where there are career pathways”, there are also plans for a greater national focus on care worker training, pay and professionalisation.

On training, the forthcoming Care Certificate scheme is a “good start, but needs to go further”. He would like to see clearly set national training standards with a genuinely accredited and transferable qualification. He also criticises the “huge gulf” between entering the sector as a care workers and being a nurse, calling for a “qualification at the intermediate care level”, similar to the former State Enrolled Nurses, so that “individuals have a choice of going into management in the sector or allied professions or nursing.”

Alongside enhanced training he would also like to see enhanced pay – indeed the two go hand-in-hand. This translates into plans to give the CQC the power to inspect the commissioning practices of local authorities whose practices are contributing to poor pay and conditions in the sector. Communities Secretary, Eric Pickles (Conservative), has so far blocked this from happening – Paul’s response, “we would want to force that in the next government”.

With enhanced training and pay there will also be greater responsibility for care workers, including the introduction of a “statuary code of conduct for care workers”, breaches of which would “effectively result in someone being stuck off and unable to work in the sector.” For residents and families this measure will bring greater peace of mind; for providers this means more bureaucracy and the potential for many more public relations headaches much like NMC rulings are currently.  

There are also plans for greater transparency at the local level, with local authorities having to clearly detail how they set their rates for care. Meanwhile, providers would have to outline the breakdown of their costs so as to ensure “staff are paid fairly”.

Ultimately, however, given the Lib Dems woeful national poll ratings, which Mr Burstow has “given up following”, the key question will be whether Paul and a sufficient number of his colleagues are re-elected in order to deliver on these policies. YouGov’s Peter Kellner predicts they’ll have around 30 MPs once the dust has settled , which given the rating of the other parties, could well be enough to put either Mr Cameron or Mr Miliband into Number 10. The ‘King Makers’ may well find themselves in Government for another five years.  

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