Both main political parties have launched their manifestos pledging extended 8am-8pm GP opening hours, free choice of hospital providers and an extension of foundation trusts.
On Tuesday, the Conservatives underlined their commitment to the principles of the NHS by repeating their pledge to increase health spending “in real terms every year”.
The manifesto pledges to “support an active role” for the private sector
They also pledge they will never change the idea that healthcare is free at the point of use and available to everyone based on need, not ability to pay.
The party’s previously mooted plan to turn the Department of Health into a department of public health has been set as a manifesto commitment, including establishing an independent NHS board charged with allocating resources and setting commissioning guidelines. Putting GPs in charge of local commissioning is also now a manifesto commitment.
But the party has left itself room for manoeuvre through an absence of detail.
In place of its original pledge to scrap targets altogether is a promise to “scrap politically motivated targets that have no clinical justification”. And the previous “moratorium on hospital closures” has turned into a pledge to stop “forced closures” of emergency departments and maternity services.
By contrast the Labour manifesto, launched on Monday, emphasises the “tough decisions” the government has made on tackling inefficiencies and includes the £20bn NHS saving target as a commitment.
The party has promised no “top-down reorganisation of primary care trusts or strategic health authorities” in the next Parliament.
It pledges to give foundation trusts financial incentives and other support to take over “underperforming” organisations.
Significantly, foundation trusts will also be freed to integrate not just with community services but also GP practices - a U-turn on previous DH policy that they should not control “list based” primary care services.
There is also a commitment to allow foundation trusts to increase their private services - a reference to the private patient income cap which the party looks set to relax or abolish.
In an attempt to end the mixed messages of the “preferred provider” row, the manifesto pledges to “support an active role” for the private sector, although it emphasises that support will be “particularly” for innovative services, rather than those replacing NHS providers.
Waiting time targets are being turned into rights that will come with new responsibilities for patients, who can lose their “right” to treatment within the specified time if they fail to turn up for appointments.