NHS Confederation Election Briefing 2005

 This briefing is intended as a summary of the three main political party manifestos. The summary reflects the length and the language used in each party’s manifesto. Part one looks at each party’s manifesto and their key commitments for health. Part two looks at the key health related election issues and how the three parties compare.


Labour’s manifesto commits to improving on the work already done in the NHS, increasing investment and cutting waiting times even further, including so-called ‘hidden’ waits for diagnostic tests.

Patients will be given a choice of primary care provider, as well as choice in how they use a budget for their own social care.

Greater action will be taken on MRSA and more funding will go towards palliative care to improve cancer services.

Public health will also play a key role, with Labour pledging to hold consultations on a smoking ban in public places as well as establishing a system of food labelling to provide guidance on healthy eating.

Main points

Ø      Further streamlining measures to release an additional £250 million a year for frontline services by 2007 (over and above the £500 million reduction already planned)

Ø      Restatement of the 18 week waiting time pledge

Ø      Faster test results for cervical smears

Ø      Improving cancer waiting times for breast and bowel cancer

Ø      Consultation on new laws to enforce higher hygiene standards.

Ø      By the end of 2008, patients will be able to choose from any hospital that can provide that operation to NHS medical and financial standards.

Ø      Expand capacity and choice in primary care. Where GPs’ lists are full provision will be expanded by encouraging entrepreneurial GPs and other providers to expand into that location

Ø      By 2009 all women will have choice over where and how they have their baby and what pain relief to use. Every woman will be supported by the same midwife throughout her pregnancy.

Ø      In order to increase choices for patients with cancer, investment in palliative services will be doubled.

Ø      Development of personalised budgets in social care where people can decide for themselves what they need and how it should be provided

Ø      Development of a new generation of NHS community hospitals

Ø      Extend case-management for people with long-term conditions. Treble the investment in the Expert Patients Programme, and help more patients take control of their own care plans

Ø      Continue to invest in and improve services for people with mental health problems at primary and secondary levels, including behavioural as well as drug therapies

Ø      Provide safeguards for people with long-term mental health problems who need compulsory treatment coupled with appropriate protection for the public.


The Conservatives have focused on choice in their manifesto health commitments, allowing choice of hospital including the choice between private and state healthcare, offering to pay half the cost of private healthcare if patients opt to go private.

Targets are to be scrapped, primary care trusts to be reduced and strategic health authorities to be abolished, to allow more local control, with all hospitals being made foundation hospitals.

Sexually transmitted infections are a high priority for the Conservatives, as they have promised to launch a ‘tough’ campaign, similar to the HIV/Aids campaigns of the 1980s.

Main points

Ø      Will increase NHS budget by £34 billion a year

Ø      Radically reduce the number of Primary Care Trusts and abolish Strategic Health Authorities and cut number of quangos, inspectorates and commissions

Ø      Abolish centrally-driven targets

Ø      All hospitals will be able to be foundation trusts

Ø      Will bring back matron, who will have the power to close wards

Ø      Funding will follow the patient. Hospitals will be paid according to treatments.

Ø      Small community hospitals which have the support of local patients and GPs will not be closed by ‘bureaucrats’

Ø      Choice of hospital including providing a contribution to private care based on half the cost of an NHS operation.

Ø      A partnership scheme for social care

Ø      Boost respite for carers and give more choice and information about support available.

Ø      Dentistry – Introduction of a capitation payment and a low-cost monthly payment system

Ø      Introduction of health checks for immigrants (people coming to Britain for over 12 months from outside the EU).

Ø      Sexually Transmitted Infections campaign.

Liberal Democrats

In their manifesto the Liberal Democrats have pledged an extra £8 billion to be spent on health.

Their extra spending will go towards free personal care, eye tests, dental checks and more prescription medicines.

The Liberal Democrats have also promised to cut the number of civil servants and increase the number of doctors and nurses.

Centrally-imposed targets are to be scrapped and a ban on smoking in public places is one of the Liberal Democrats’ top priorities.

Main points

Ø      Free personal care

Ø      Quicker diagnosis for serious conditions

Ø      Free eye and dental checks, fewer prescription charges

Ø      Complete NHS plans on recruitment of doctors, nurses, therapists and scientists by 2008.

Ø      Abolish targets

Ø      Reform of NHS dental contracts so that dentists are encouraged to do more NHS work and implement Personal Dental Plans will set out frequency and treatment.

Ø      Encourage regular health ‘MOTs’

Ø      Personal care plan for those with long-term conditions.

Ø      Introduce new legislation for mental health to safeguard the rights and welfare of those with mental health problems.

Ø      End inappropriate age discrimination, e.g. breast cancer screening for older women

Ø      Improve public health through funding for school meals, restriction of advertising of unhealthy food during children’s television, ban smoking in all public places.

Conservatives Labour Liberal Democrats
MRSA The Conservatives wants to give matrons the power to shut infected wards. Hospitals will be required to publish information on hospital acquired infections. And there will be greater support, recruitment and training for infection control teams. The Government has issued guidance requiring hospitals to revise their cleaning contracts, with the option of bringing services back in-house. It aims to halve the number of blood-borne MRSA infections within three years. All frontline staff will undergo compulsory training on infection control. Every hospital would have to set up an infection control feedback system to locate problem areas and to complete an audit of wash-hand basin facilities and alcohol hand rubs. The Healthcare Commission will review the provision of isolation rooms and produce a timetable for providing appropriate isolation facilities.
Bureaucracy and targets The Conservatives believe that leadership and strong management will thrive if bureaucracy doesn’t get in the way. Targets in the NHS would be abolished as the Conservatives think they distract practitioners from clinical priorities. The Party would abolish strategic health authorities and reduce the number of primary care trusts. The number of quangos and inspectorates would also be reduced. Labour supports targets in the NHS, though it claims that many have already been met and the rest will be streamlined. By 2008, patients should wait no more than 18 weeks from GP referral to the start of treatment – two weeks for cancer patients – and no longer than 48 hours for a GP appointment. The Party would keep ‘useful’ targets, but scrap those it thinks are ‘political’ in order to give hospitals more flexibility in clinical decision making and to ensure ‘the sickest are seen the quickest’. Hospitals would have more autonomy than foundation hospitals currently have. The number of quangos would be reduced and inspection arrangements simplified. Commissioning of health will be a function of the local authority with SHAs abolished.
Paying for and delivering health The Conservatives are committed to matching Labour’s spending plans for the next three years and promise to raise spending by a further £34 billion a year by 2010.  Savings would be made from abolishing SHAs, cutting PCTS and reducing the number of quangos and inspectorates. All hospitals would be Foundation Hospitals and free to hire staff, set their own employment policies and borrow to invest. Independent providers will have the right to supply. Hospitals will be paid according to the treatments they deliver rather than through centrally-allocated budgets. GPs will be responsible for commissioning and will be able to manage budgets on behalf of their patients. Out-of-hours GP services will be integrated with other primary care services such as ambulance, walk-in centres and NHS Direct. Labour has pledged an extra £23 billion – equivalent to a 7.2 per cent annual increase – until 2008. It also plans to save £500 million by cutting the number of quangos.  Access to healthcare services outside hospitals will be extended, to fit more easily around people’s working lives and take pressure off A&E departments and GP surgeries. More walk-in centres will be provided and NHS Direct maintained. Up to 15 per cent of NHS work will be undertaken by the private sector to boost capacity. Plurality of providers in primary care will be extended. There will be a new building programme for community hospitals.

Practice-based commissioning will be developed and more services will be created in primary care. There will be new walk-in centres for commuters and specialised diagnostic and testing services; improved out-of-hours services and high-street drop-in centres for chiropody, physiotherapy and check-ups.The Liberal Democrats would match government spending, topped up by free personal care funded through the proposed 50p tax rate for those earning more than £100,000 a year.  Diagnostics would be included in the tariff system for paying for health services, so that if a mutual or private provider can deliver tests and scans at reasonable cost they will be available to patients. More tests and scans will be available in GPs surgeries and pharmacies and within one-stop primary care centres. Waiting times for tests and scans will be published.ChoiceFree choice will be available for NHS patients in terms of care delivery.  Those facing long waits will have the option of going private, with 50 per cent of their costs underwritten. GPs will advise patients on the best hospital for their needs. Information will be available to patients on hospital infection rates, waiting times, treatment outcomes, and patient experience surveys.Labour wants more choice and information for patients about how, when and where they are treated in hospital. From the end of 2005, patients will have the right to choose NHS-funded care from at least four healthcare providers – and from any approved provider which meets Healthcare Commission standards from 2008. Independent treatment centres are viewed as crucial and a further 250,000 operations a year will be procured from the independent sector rising to a total of 500,000 by 2008. This will be roughly 7 per cent of operations for NHS patients.The Party wants patients to turn to their local hospital for treatment, although it has not ruled out allowing patients to opt for an alternative further afield.Long term conditionsNICE will develop standards of healthcare for the management of chronic conditions. Patients will be given full information and advice on their conditions and a full care plan. Direct payments will be possible where appropriate.Patients will have more control and choice over their individual care packages with direct payments for some services.Care plans will set out a course of treatment, where and when people will be treated and what other help such as social care they will receive.Mental healthA new Mental Health Bill will set out a framework of standards. Compulsory treatment will only be used as a last resort. The diversity of providers will be increased to bring prices down. The number of psychiatric care places for adolescents will be expanded.The current draft mental health bill will become an Act.Where there is compulsion there will be entitlement to appropriate care and independent appeal. The NSF will be reviewed to examine if new standards are needed. Patients will be allowed to nominate a person to act on their behalf and to have advance statements.Public healthParliament will appoint an Independent Commission for Public Health – public health will be the only centrally-driven policy. The number of residential rehabilitation places for young drug addicts will be increased ten fold. A code will be agreed to remove smoking from around 80 per cent of pubs. There will be an increase in sport and exercise in schools and local communities.Labour is committed to the policies proposed in the public health 2004 white paper. This includes personal lifestyle plans for children, a partial smoking ban in public places and more state support for people trying to give up smoking. A voluntary code will be introduced for advertising ‘junk’ food on television, school meals will be healthier and personal fitness trainers will be provided on the NHS. There will be more screening, particularly for sexually transmitted diseases and air-borne infections such as TB.Clearer ‘traffic light’ labelling on food and better labelling of alcohol would be introduced. There would be a full ban on smoking in public places and measures to encourage walking and cycling. Routine health checks or MOTs would be introduced to detect diseases at the earliest opportunity.Social careA partnership scheme will be offered so that people who pay for three years’ long-term care will be guaranteed free care for the rest of their lives. Free care will still be available to those without the means to pay for the first three years.  Red tape will be reduced for residential care homes and more respite care available for those cared for in their own homes.Labour wants to give people more control over their social care. The direct payments scheme, which gives individuals a budget from their local authority to buy in care at home, is to be extended to elderly and disabled people.The Liberal Democrats have promised to fund personal care for elderly and disabled people. They want to develop the direct payments scheme to give people control and choice over their own care. This would be backed up by greater support from trained advocates to help them chose the best care package.StaffingNurses will acquire responsibility for prescribing and could become specialists in the management of certain conditions. School nursing and community nursing will be expanded. There will be more support for career paths for clinical academics.The supply of healthcare workers will increase, work to retain existing staff improved and there will be planned and ethical international recruitment.The recruitment targets for additional doctors and nurses in the current NHS Plan would be maintained.DentistryThe Conservatives promise to return NHS dentists to the high street. The party would match Labour’s funding for recruitment. Capitation payment will be introduced for dentists and patients will be offered a low-cost monthly payment scheme for their dental care.A target has been set of recruiting 1,000 extra dentists by autumn 2005, many from overseas. They would undertake a fundamental review of the scope and resourcing of NHS dentistry.Dental and eye checks would be free. ‘Drill and fill’ contracts would be replaced with a new payment system bringing greater rewards for preventative work. Personal dental plans would set out how often patients should have check-ups and courses of treatment for more serious problems. Investment would be sustained to increase the number of training places for future dentists.