As a former advisor to Matt Hancock, I know only a joined-up health policy can save the NHS
The big challenge for the government remains that no quick fix is available
“The NHS is this One Nation government’s top priority,” the Prime Minister said at a victory rally on Friday morning. Hours later, the NHS released its worst performance data ever. There is a big job to do.
Whilst many are calling this the Brexit election, the importance of the NHS to the result should not be overlooked. Indeed, it was the most cited issue of importance in a poll by Lord Ashcroft of some 13,000 voters on election day.
Whilst Labour’s campaign focused on the supposed sale of the NHS to Donald Trump through a US-UK trade deal, the Conservative campaign adopted a more localised approach. Health Secretary Matt Hancock visited 125 seats, working with candidates to show how more money for the NHS nationally would translate into new equipment, services and support locally. The election result would indicate that the latter strategy was the one that cut through.
Having now broken through Labour’s red wall of northern seats, the new administration looks set to make a perhaps even more audacious move. A move to try and make the NHS a Conservative issue, wrapped in patriotism, community and heritage – and with increased funding.
This strategy can be traced back to a red bus and a referendum. The need for Leave politicians to show that exiting the European Union would deliver domestic benefits naturally saw Brexit and the NHS conflate in the Leave campaign. Johnson’s first Downing Street speech in July showed a marked boldness on health, including commitments to fix access to GP appointments and social care (both yet to be delivered, of course). The first few weeks of his tenure in Number 10 saw a blizzard of health announcements, from new hospitals to an artificial intelligence lab.
Now the Prime Minister is clear that those voters who elected him to “Get Brexit done” must be rewarded – and the NHS is central to this.
An existing set of proposals – namely the five-year NHS funding settlement and ten-year plan secured by Theresa May and built by NHS CEO Simon Stevens – will be the bedrock of this reward. First will come the NHS Long Term Plan Bill, a move that Number 10 strategists have been discussing for a while and which will present an immediate problem for a divided Labour party (voting against new money for the NHS is not a good look).
The legislation will enable greater co-operation across the health service, and cull some of the problems that have arisen from the Lansley Act. The message, underpinned by the new investments, will negate privatisation and promote a narrative of “patients first”.
The bill will also likely see ministers held more accountable for service performance and strategy. The vision of an independent NHS as set out under Lansley has never fully materialised; now, there will be far closer political engagement in the oversight and management of the service. One of the first tests here will be planned changes to the NHS waiting times targets.
The big challenge for the government remains that many of the problems the NHS faces are deep-seated and complex; no quick fix is available. The NHS funding settlement will deliver some improvements, but unless ring-fenced capital, workforce, social care and public health budgets are aligned, the NHS will continue to struggle. You cannot improve cancer diagnosis rates without the latest equipment, nor shorten waiting lists if social care is not effectively staffed.
If the government is truly to “take back control” and deliver for the NHS in the next five years, a broader strategy is needed. Otherwise, poor NHS performance may be someone else’s problem after the next election.
Richard Sloggett is a former special adviser to the Secretary of State for Health and Social Care and a Senior Fellow in Health and Social Care at Policy Exchange