Who is promising what on health ahead of the general election and who should nurses vote for? Difficult questions to answer, but here Nursing Times sets out some of what we know so far.
While Brexit may have inevitably dominated the early days after the calling of the snap general election, policies impacting on healthcare and nursing have increasingly come to the fore.
The campaign for health-related votes first saw a flurry of policy commitments from Labour, following a little later by the Liberal Democrats, with a few tricky interview moments for the Conservatives. However, as of this week, we now have their full manifestos to go with all the various speeches and pledges.
As mentioned, looking back a few weeks, Labour was the first to make a definite play for the votes of those with health and social care policies on their mind.
On 25 April, it announced a “three-point election guarantee” for the NHS, with a promise to scrap the 1% cap on pay rises, reinstate the student nurse bursary and enshrine safe staffing in law.
All of these policies would come with a significant price tag, though the party has said reversing the government’s reductions in corporation tax would cover their cost.
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In a speech, Labour health spokesman Jonathan Ashworth said: “We won’t make promises on behalf of the NHS without giving the NHS the resources and the tools to deliver those promises. The NHS under Labour will always get the funding it needs.”
A further official announcement set out a popular pledge to end hospital car parking charges for staff, patients and visitors.
More policies were revealed by a leaked draft of the party’s manifesto – either by accident or design. It included a widely expected guarantee on the future status of European Union staff working for the NHS after Brexit.
Other policies contained in the draft were to make it a criminal offence to attack health service staff, to ban zero-hours contracts, and to increase in health visitor and school nurse numbers – which have begun to fall dramatically recently.
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All of these pledges were subsequently confirmed in the final version of the party’s manifesto, which was launched on 16 May and followed a warmly received speech by leader Jeremy Corbyn at the Royal College of Nursing’s annual conference in Liverpool the previous day.
However, when asked by Nursing Times afterwards whether he would be able to guarantee a minimum salary uplift, Mr Corbyn would not be drawn on by how much he thought NHS nurse pay should increase. He said it should be for the independent NHS Pay Review Body to recommend the figure, but added: “I want nurses to be properly paid.”
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Meanwhile, the Liberal Democrat Party told Nursing Times at the beginning of May that its forthcoming manifesto would also include financial pledges to boost nurse pay and training.
It specifically highlighted five key election commitments, including investing in public health, social care, primary care and mental health. Controversially, it also said it will add an extra 1p on income tax to provide an “emergency injection of resources” to tackle the funding crisis.
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Liberal Democrat health spokesman Norman Lamb: “We urgently need to increase its funding and secure its long-term future, and the Liberal Democrats are prepared to take bold measures on taxation to achieve this.”
In addition, the party would guarantee the rights of EU nationals in the NHS and social care services to remain in the UK and continue its commitment to “true parity of esteem” for mental health.
It also pledged to establish an independent, cross-party body – called the NHS and Care Convention – that would engage staff and the public in a “national conversation” on policy.
Mr Lamb added: “One of the biggest challenges facing the next government is to rebuild trust with nurses and other NHS staff who are feeling over-stretched, under-valued and demoralised. The Liberal Democrat manifesto will contain firm commitments on nurses’ pay, as well as funding for training.”
These ideas were subsequently fleshed out in an announcement on 8 May, followed by party leader Tim Farron’s speech at the RCN and, of course, their manifesto.
Most high profile among these new commitments was an election pledge to end pay restraint for nurses by lifting the 1% cap on public sector pay and up-rating wages in line with inflation. The plans, which would also cover other public sector workers, would lead to an estimated salary increase of £527 a year for nurses by 2021, said the party.
Meanwhile, in his speech at congress, Mr Farron added to this by promising that pre-registration nurse funding would be brought back in England by reinstating the £10bn investment that had been lost due to the government’s removal of bursaries.
Speaking to Nursing Times afterwards, he admitted that “in the short-term” the Liberal Democrats would not be prioritising the introduction of nurse staffing legislation in England. However, he said he would “for certain” commit to this at some point in the future – highlighting that it was his party in Wales that had sparked the development and introduction of pioneering safe staffing legislation there.
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As in previous elections, the party that has seemingly had the least to say on health policy is the Conservatives – at least until this week – preferring instead to concentrate on Brexit as its main focus in the early days of the campaign.
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Of course, as the standing government, it already has a range of health policies in place, though some commentators rightly predicted further measures to tackle the social care funding crisis.
Prime minister Theresa May was quizzed – now famously – in a BBC interview on 30 April with Andrew Marr on nurses’ pay and suggestions that nurses were being forced to use food banks, but avoided making any commitments on either. She also ran into criticism for failing to attend, or send a minister, to the RCN congress this week.
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However, since then, we have had the full Tory manifesto, which was published on 18 May – the last of the big three parties to reveal their hand.
It was trailed by a controversial pledge to reform funding of long-term social care, by adjusting means testing and scrapping a proposed cap on all individuals’ lifetime costs.
Ms May said the proposals reflected “a commitment to get to grips with the great challenges of our time and to take the big, difficult decisions”.
However, several days later, the prime minister was suddenly promising to introduce a cap on care costs, after her proposals for social care funding sparked a collapse in her party’s poll lead.
The manifesto itself pledged to ensure that the NHS and social care had the nurses, midwives and other healthcare staff they needed, though it did not provide details on how it would ensure an adequate supply of staff.
It also promised to prioritise negotiations so EU staff can “carry on making their vital contribution to our health and care system” following Brexit, an issue the government has been pressed on repeatedly by unions and other organisations, like NHS Employers.
“We cannot continue to rely on bringing in clinical staff instead of training sufficient numbers ourselves”
Conservative Party election manifesto
But it acknowledged that “we cannot continue to rely on bringing in clinical staff instead of training sufficient numbers ourselves”, saying it would “continue to bear down” on immigration from outside the EU.
The party also said that, if re-elected, it would reform the “outdated” system of professional regulation for healthcare professionals, referring to a series of changes it has previously said it wants to make to the operation of the Nursing and Midwifery Council and other regulators.
Meanwhile, it said it would support health service clinicians to develop their skills, and encourage the development of new roles to create “a diverse set of potential career paths” for the workforce – references no doubt to its new cadre of apprenticeships and the nursing associate role.
In addition, NHS employees’ entitlements to flexible working would be strengthened and quicker access would also be provided to mental health and musculoskeletal services for staff, while the party pledged to take action to reduce bullying rates in the health service.
A previously announced commitment to recruit up to 10,000 more mental health professionals by 2020 was reiterated in the manifesto, as was the party’s plan to introduce the first Mental Health Bill for 35 years to improve mental health treatment.
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Looking towards the smaller parties, Plaid Cymru has done most to reveal its hand so far. The party, which will contest for control of the Welsh Assembly in the election, published a 50-page manifesto on 16 May.
The document, which the party dubbed an “action plan”, includes five main pledges on health and social care, the most interesting of which is to recruit an additional 5,000 nurses to work in the Welsh health service over the next 10 years.
We are currently awaiting news from the election camps of the Green Party, the Scottish National Party and the UK Independence Party.
However, as seems to be the fashion these days, many organisations have put out their own “manifestos”, in which they have called on all three parties to tackle issues close to their agenda.
The RCN, for example, has used its manifesto to call on party leaders to “put patients before politics” with accurate and costed pledges on the NHS.
Janet Davies, RCN chief executive and general secretary, said: “The last thing public services need are sums that do not add up. Slogans on buses and un-costed wish-lists let patients down.”
“We are currently used as a pawn in every election campaign”
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Among its priorities, it has called for the future government to ensure safe staffing levels, better pay for nurses, and the right to remain for EU nursing staff after Brexit.
It also got its voice heard in Andrew Marr’s high profile interview with Ms May, later criticising the prime minister for failing to adequately reply to questions on nurse pay.
Inevitably, Unison and Unite have urged their members to vote for Labour, as both unions are affiliated to the party. A theatre nurse and one of Unison’s past presidents is in fact hoping to win a marginal seat in the West Midlands.
Eleanor Smith, who works at Birmingham Women’s and Children’s Foundation Trust, is the new Labour parliamentary candidate for Wolverhampton South West.
Last September, she addressed the Trades Union Congress in Brighton on the government’s controversial decision to scrap the student bursary, describing it as a “massively retrograde step”.
However, while the political parties and their supporters continue to vie for power, our recent pre-election survey indicates they will have to work hard to shake off a negative feeling among many nurses.
“Politicians always preach what suits NHS, but when they come to power it’s a different thing,” said one respondent, while another said: “We are currently used as a pawn in every election campaign.”