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General election 2019: What do the pledges mean for nurses?

Feeling snowed under this Christmas? Nursing in Practice has sifted through an avalanche of general election pledges to present a breakdown of what the political parties are promising nurses and the wider NHS.

The NHS in general

Conservatives: Invest £34 billion per year in the NHS by 2023/24 - including £4.5 billion for primary and community care as part of the NHS Long Term Plan.

Labour: A £26 billion ‘rescue plan’ for the NHS (in real terms) per year by 2023/24 – including £2.5 billion to overhaul the primary care estate.

Liberal Democrats: An extra £35 billion over five years by putting 1p on income tax, ringfenced for spending on the NHS and social care – particularly on workforce, mental health and prevention. In addition, £10 billion invested into equipment, hospitals, community, ambulance and mental health services buildings.

Greens: Increase funding by at least £6 billion per year each year until 2030.

What does this really mean?

The Conservatives will bring the biggest NHS cash boost in modern memory - at least according to them. But fact-checking charity Full Fact pointed out that in real terms, £34 billion equates to £20.5 billion a year, less than spending in 2004/5 and 2009/10. The Health Foundation also raised concerns that the funding boost – equating to a 3.3% on average per year – is below the 3.4% needed to maintain current standards and ‘far short’ of the 4% needed to deliver the NHS Long Term Plan. 

Labour’s plan - which equates to 4.3% extra a year on average for the NHS - was comparatively better received by independent thinktanks and bodies, with The King’s Fund calling it ‘comprehensive’ and the Health Foundation saying it was ‘welcome’. However, the success of a funding boost would be reliant on sufficiently increasing workforce numbers.

Nursing workforce

Conservatives: Deliver 50,000 more nurses, introduce a new NHS visa that would offer fast-track entry and reduced visa fees for doctors, nurses and allied health professionals and improve staff morale with more funding for professional training.

Labour: Recruit 24,000 extra nurses, midwives and allied health professionals, as well as 4,500 health visitors and school nurses. Invest an extra £1 billion a year into training and education budgets whilst also putting safe staffing limits into law for all staff.

Liberal Democrats: Produce a national workforce strategy, and improve retention with continuing professional development, better support, and more flexible working and careers.

Greens: Invest an extra £1 billion in nurse education, create a safe staffing law that reinstates the health secretary’s duty to ensure there are enough healthcare staff including nursing.

What does this really mean?

The Conservative pledge for 50,000 more nurses faced criticism for including 18,500 existing and returning nurses, who could either be retained or rejoin the register.

Meanwhile, Labour’s promise to hire more nurses is welcome but irrelevant if they don’t provide detail on how they might retain existing staff.

The Royal College of Nursing (RCN) has welcomed pledges from Labour and the Green party to address safe staffing law and urged other parties to do the same after campaigning for new statutory duties to be introduced. 

The student nurse bursary

Conservatives: A £5,000-£8,000 annual maintenance grant for nursing students, with the higher ends of funding reserved for regions or disciplines struggling to recruit such as mental health.

Labour: Reinstate the student nurse bursary including tuition fees for nurses, midwives and allied health professionals.

Liberal Democrats: Reinstate the student nurse bursary, but starting with specialties with particularly acute shortage such as mental health and learning disability nursing.

Greens: Reinstate student nurse bursaries including tuition fees.

What does this really mean?

The RCN has stressed that restoring the nursing bursary must be for the cost of living and tuition fees alike, but the Conservatives and Liberal Democrats have only covered cost of living. Likewise, it calls for financial support for all nursing students, rather than those in areas with particularly acute shortages as the Liberal Democrats have proposed.

General practice and primary care

Conservatives: Deliver 50 million more GP surgery appointments by 2024/25, along with recruiting 6,000 more GPs and 6,000 other primary care workers such as nurses, physios and pharmacists.

Labour: Deliver 27 million more appointments with GPs a year by increasing GP training places from 3,500 to 5,000 per year.

Liberal Democrats: End the GP shortfall by 2025 by training more GPs, making greater use of nurses and other clinical staff, and using phone and video appointments ‘where suitable’.

Greens: Construct new community health centres focusing on preventative care.

What does this really mean?

Labour has not set a specific date by which the extra appointments with a GP should be delivered. However, the Conservatives – who also include appointments by nurses and other staff in their figures - have a target.

Pledges from all parties on how staff members will be boosted have been welcomed by various health think tanks and bodies but detail is thin on the ground even though the NHS is reliant on workforce, not just extra cash.

Social care

Conservatives: Increase social care funding by £1 billion each year. Ensure no one needing care has to sell their home to pay for it.

Labour: Additional funding for the existing system. Introduce a £10,000 ‘lifetime cap’ on personal contributions towards care costs. Free personal care ‘for all older people’.

Liberal Democrats: Raising £7 billion a year by putting 1p on income tax, ringfenced for spending on the NHS and social care.

Greens: An additional £4.5 billion a year to fund councils to provide free social care to people over 65.

What does this really mean?

In his first speech as prime minister, Boris Johnson vowed to ‘fix the crisis in social care once and for all’, but some have questioned whether his manifesto would go far enough to fulfil this. For example, the Health Foundation called ‘the absence of any clear policy on social care’ a ‘shameful omission’.

The King’s Fund praised Labour’s social care pledges as ‘a significant step towards a fairer system’ but warned it is not enough to ‘solve all the challenges’ facing the service. The Institute for Fiscal Studies also raised concerns that Labour have not detailed how they would fund the adult social care cap.

The RCN also welcomed pledges from the Greens and Labour to provide free personal care for older people.

 

 

 

 

 

 

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