And there’s a reason why the health service is at the top of the list – the electorate knows exactly how high the stakes are as the NHS teeters on the brink of falling through a massive funding gap created by rising healthcare costs and an ageing population.
But it’s not only about money. The election will decide, also, what the NHS stands for. Will it depart from its founding principles, and head down the path of unrestrained privatisation, or will it take back its legacy as the cornerstone of the British welfare state?
Labour shares voters’ concerns about the NHS, and has made the health service one of the primary issues in its campaign. But what exactly are Labour’s plans for the NHS?
Fully costed plan
While other parties have made vast cash promises with no believable explanation for raising such exorbitant sums, Labour has committed to a promise it can keep – an immediate £2.5bn of extra funding per year for the NHS, to be laid out in its first budget.
Grahame Morris, a Labour prospective parliamentary candidate for Easington noted that this is what makes Labour stand out among the rest.
“Talk is cheap,” he said. “But Labour is the only party which has a fully costed plan.”
Morris explained that the £2.5bn will be raised using specific measures that Labour will immediately move to implement once it takes the reins this year, including a Mansion Tax on properties valued over £2m, a levy on the profits of tobacco companies and a crackdown on tax avoidance.
The extra money raised through these three revenue streams will be pumped directly into the health service’s most urgent needs.
“Many hospitals are dangerously understaffed,” Morris noted. “We urgently need more doctors, nurses and other ancillary staff to keep up with growing demand for the health service in order to make it fit for purpose for the 21st century.”
The £2.5bn will go toward meeting this need for more staff by adding 20,000 more nurses and 8,000 GPs.
Value NHS staff
But Morris notes that ensuring a sustainable health service will mean more than training and adding new staff.
“We have to make sure that the staff we do have is valued,” he said, echoing shadow health secretary Andy Burnham’s commitment to no more real terms pay cuts for health workers.
Burnham noted in a recent health debate at the British Medical Association that the present government has failed miserably in “looking after the staff that you have.”
“[The coalition government has done this] by giving them years of freezes and now this kick in the teeth denying them a one per cent pay rise,” he said. “At the same time, they’ve spent a fortune on agency staff and overseas recruitment.”
Burnham added that the Tories’ top-down reorganisation of the health service was to blame for staff pressures.
“There was no workforce plan to underpin the Lansley reorganisation,” he argued. “The workforce was not even a consideration at all, and we’re in this position now precisely because of that.”
Unite national officer for health Barrie Brown can attest to the workforce breakdown now occurring in the health service.
“Something that we’ve been hearing a lot from members is that increased workloads leads to stress, which does, in the end, affect the provision of services,” he said. “If staff are off sick, then they bring in other colleagues who are also stressed, or they bring in agency staff. The use of agency staff itself does not provide the best service and it costs hundreds of hundreds of millions.”
Frances Ridgway, a speech and language therapist, agrees.
“The pressure is to see new patients. This means people wait longer for treatment. Staff are trying to juggle all this and as a result, some are leaving or taking early retirement as they get burned out,” she said.
Brown argues the only way to take steps toward restoring staff morale is through establishing a genuinely independent pay review body that’s listened to, a pledge that Labour has committed to.
Repeal act and end privatisation
The cornerstone of Labour’s health policy is to undo the legislation that’s made privatisation of the NHS possible.
The controversial health and social care act of 2012 forced the NHS to tender contracts competitively, which then jumpstarted the quickening march towards privatisation.
Some critics say that repealing the act would mean yet another reorganisation of the health service, which could be just as disastrous as the one made under the coalition government.
Brown, however, argues that stripping the act doesn’t necessary entail a top-down reorganisation.
“Repealing the act isn’t about repealing the structure. There are certain things about the structure that was introduced, such as CCGs, which can be worth retaining,” he said.
“The repeal of the act is a repeal of ideology. It would be saying that we should no longer allow the NHS to be fragmented and undermined by private, non-NHS organisations running services.”
Brown added that repealing the act will also enable the health service to get on with integrating health and social care, which is part and parcel of Burnham’s vision for an NHS with a long-term sustainable future.
It’s a vision that Morris says is absolutely necessary.
“Personally I have an elderly mother and because services are so fragmented she’s in and out of hospitals instead of getting the support she needs at home,” he said.
“The coalition government often says it supports integration of services but again, talk is cheap when you’ve seen how they’ve made and continue to plan local authority cuts.”
Burnham noted that a future NHS demands integration.
“We will free up the NHS to integrate, to merge across traditional boundaries, from primary care to secondary care, from physical health to mental health and particularly from the NHS to social care,” he said.
“Yes, the NHS does need more money,” he added. “But the answer coming out of this election can’t just be who is going to wave the biggest check at the NHS. We can’t carry on with a hospital dominated model of care, where instead of spending a few pounds caring for people in their homes, we spend thousands of pounds unnecessarily keeping patients in hospital beds.”
Both Morris and Burnham noted that implementing a model based in the home means supporting carers, who are now among the least paid and least valued workers in society.
“We cannot carry on as a society sending out the message to those who work in care that looking after someone else’s mum, dad, brother or sister is the lowest form of work,” Burnham said. “It’s even lower than the minimum wage because you don’t get the travel time.”
Morris says it is precisely this Labour vision that, he notes, “will restore the NHS to being a world-class service, one that’s the envy of the entire globe.”
*Want to learn about the Tories’ plans for the NHS? Find out more here.