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Lib Dem manifesto confirms tax plan to fund health service

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The Liberal Democrats unveiled their election manifesto today, which includes pledges to reverse cuts to public health funding and incentives for community clinicians to work in deprived areas.

Central to the party’s policies on health and social care is a previously announced “five-point recovery plan”, which includes a 1p rise on income tax to raise an extra £6bn to be ring-fenced for NHS and social care services.

“Our longer-term objective will be to bring together NHS and social care”

Lib Dem manifesto

Under the plan, the extra investment would be directed at “priority” areas including social care, primary care and other out-of-hospital care, mental health and public health.

Longer-term, the Lib Dems would seek to develop a dedicated health and care tax, possibly based on a reform of National Insurance contributions, which would bring together spending on both service into a shared budget.

“Our longer-term objective will be to bring together NHS and social care into one seamless service – pooling budgets in every area by 2020 and developing integrated care organisations,” stated the manifesto – titled Change Britain’s Future.

The document includes a range of measure to support staff, which the manifesto described as “our health and social care services’ greatest resource”.

It confirmed a Lib Dem pledge to halt the public sector pay freeze for NHS workers. The party has said it would upgrade salaries in line with inflation leading to an estimated wage increase of £527 a year for nurses by 2021, as previously reported by Nursing Times.

It would reinstate student nurse bursaries, guarantee the rights of European Union health and care staff, and “protect NHS whistle-blowers”, said the document – commitments also made this week in the Labour Party manifesto.

In addition, the Lib Dems promised to “support innovation in how organisations can empower staff and patients”, which would include “learning from innovative social enterprises delivering community and mental health services”.

Crucially, the manifesto promised a national workforce strategy to ensure “we never again experience a shortage in the numbers of GPs, hospital doctors, nurses and other professionals that the NHS needs”.

Meanwhile, the document included a range of pledges on mental health – a priority area for the party in recent years.

“We know that not enough resources reach frontline services and that in the fight for parity of esteem there is still a very long way to go,” said the manifesto.

Policies aimed at improving access to services and boosting quality include moves to ensure “no one in crisis is turned away” with new waiting time standards and “better crisis care” in A&E departments, in the community and by phone.

“We know that not enough resources reach frontline services”

Lib Dem manifesto

The Lib Dems also promised the party would ensure that “all frontline public service professionals” received better training in mental health.

They also said they would support the roll-out of NHS England’s Liaison and Diversion programme, which helps identify and support people with mental health problems, learning disabilities, substance misuse and other issues when they first come into contact with the criminal justice system.

The current NHS England plan is to ensure that all areas of England have access to Liaison and Diversion teams, which include specialist nurses, by 2021.

A key goal will be to move towards more joined-up health and social care services, said the manifesto.

“We need services that fit around people’s lives, not ones that force them to fit their lives around the care they need,” stated the document.

“This will become increasingly important as our population ages and the number of people living with long-term conditions grows, it said.

“It is also more cost-effective to support people to be able to live at home rather than endure lengthy stays in hospital,” it added.

The Lib Dems said they would “finish the job” of bringing in a cap on the cost of social care and move towards “single place-based budgets for health and social care by 2020”.

They also promised to “eliminate perverse incentives” by moving away from payments for activity and introducing tariffs that “encourage joined-up services and promote better outcomes for patients and better preventative care”.

Other measures include ensuring those who work in the care sector are properly trained and suitable to practice by bringing in a statutory code of conduct backed by a “care workers’ suitability register”.

The Liberal Democrats also promised to provide “more choice at the end of life” and to move towards free end-of-life social care.

In order to improve access to community health services, the party said it would provide national support to struggling GP services in order to prevent mass closures.

Liberal Democrats

RCN Congress 2017

Tim Farron addressed this year’s RCN congress in Liverpool

In addition, the party promised to promote easier access to GPs, expanding evening and weekend opening and encouraging online, phone and Skype appointments, and support GPs to come together to provide services outside normal opening times.

It said it would use innovation funding to promote “GP-led multidisciplinary health and care hubs”, including mobile services to keep people out of hospital.

The manifesto also repeated the party’s idea for a “patient premium” that would see GPs and other community clinicians given incentive payments to work in disadvantaged areas.

On public health, the Liberal Democrats said they would publish a National Wellbeing Strategy “which puts better health and wellbeing for all at the heart of government policy”.

They also promised to “keep public health within local government, where it is effectively joined up with preventive community services” and “reinstate the funding cut from public health budgets by the Conservatives”.

Manifesto pledges include a new public health campaign to promote ways people can improve their own mental resilience described as “the wellbeing equivalent to the Five-a-day campaign”, and a new “wellbeing premium” to reward employers who take steps to boost workers’ health.

Other manifesto pledges on health and social care include:

  • Establish a cross-party health and social care convention, which would include health professionals, to review the longer-term sustainability of health and care finances and workforce
  • Introduce a statutory independent budget monitoring agency that would report every three years on how much money the system needs to deliver “safe and sustainable” and future costs
  • End out-of-area placements for those with acute mental health problems
  • Tackle stigma against mental illness building on the Heads Together campaign supported by the Duke and Duchess of Cambridge
  • Change the standard of proof in coroner’s courts to make it easier for coroners to rule someone took their own life
  • Give the NHS a legal duty to identify carers
  • Evaluate the work of hospices with view to “putting them on a more sustainable financial footing and allowing them to expand their services”
  • Make pre-exposure prophylaxis for HIV prevention available on the NHS
  • Develop a strategy to tackle childhood obesity
  • Introduce mandatory targets on sugar reduction for food and drink producers
  • Implement the recommendations of the O’Neill report on antimicrobial resistance to ensure responsible prescribing and investment in diagnostics and innovation
  • Review the rules for exemption from prescription charges to ensure they are fair to those with long-term conditions and disabilities
  • Ensure any changes to the way pharmacies are funded do not leave local areas without “reasonable access to a community pharmacist”
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