'Protection is the word du jour as manifestos fall short on healthcare'

A recent Ipsos poll named the state of the NHS one of the two biggest voter concerns in the run up to July 4, while even NHS chief executive officer Amanda Pritchard admits that it is struggling.

Pritchard’s assessment that the NHS is "damaged but it is not destroyed" is a sentiment that anyone who has tried to get a GP appointment in recent months might share. But if the health service is in critical care, are any of our political parties pledging anything that will get it back on its feet?

The answer is sadly not. Scrutiny of party manifestos reveals a lack of investment planning rather than a course of treatment that will get our sickly patient out of the ICU.

And since there’s little hope from whoever is in Downing Street, anyone who is planning to use the NHS in the future (and let’s face it, that is all of us), should be taking personal action now.

Simply because they’ve been in power for the past 14 years, the Conservatives can claim that nobody has ever invested as much in the NHS as they have. That’s how national budgets work in an inflationary environment, but it doesn’t mean that the situation within the NHS has improved.

Despite a worsening position on the ground, Rishi Sunak has positioned his manifesto as building on a successful 14 years of Conservative investment and support for our healthcare system.

However, voters are unlikely to be convinced by such chestnuts as the '40 new hospitals' from Boris Johnson’s manifesto, which make another appearance, or by the £35bn of notional savings that are coming from IT and other productivity improvements.

Wherever you place your X in the box tomorrow, there will be insufficient cash for health.

There’s a recommitment to a cap on the amount individuals pay for social care cap from 2025, but no mention of the extra needed to fund this since post-pandemic inflation. 

There are also noises about more doctors and nurses, but without increased financial commitment, it is hard to see how the Conservative plan will turn the NHS supertanker back in the right direction.

Anyone expecting fireworks on healthcare from ‘prime minister in waiting’ Keir Starmer has been sorely disappointed by his manifesto.

It focuses on the positive, cutting waiting lists by using spare private capacity and promising 2mn more procedures under the NHS, but there is little detail on how the private and NHS staff – who, let’s not forget, are often the same people – are going to find the time to do this.

What’s more, 2mn is a drop in the ocean given the number of people waiting, and the rest of Labour’s claims are somewhat nebulous – ‘train more doctors and nurses’ is useful, but how, when, and with what cash?

Despite committing to £7bn in additional annual funding for the NHS, Liberal Democrat healthcare plans would still leave our healthcare system with a material shortfall.

The Lib Dems' pledge to create an independent pay body means that the bulk of this expenditure would go on wages, despite their belief that it could fund 8,000 new GPs and guarantee access to an NHS dentist for all.

Ultimately, despite more spending, the Lib Dems plans would still leave us with a worse NHS than was promised by the Tories before the pandemic.

This brief rundown of the main manifestos reveals one thing: wherever you place your X in the box tomorrow, there will be insufficient cash for health.

With around 0.2 per cent CAGR difference in NHS funding between the Conservatives and Labour over the next parliament and 0.5 per cent between the Lib Dems and the Conservatives, nobody is committing to anything but a significant shortfall compared to planned spending under the 2018 NHS spending plan in inflation-adjusted terms.

In short, to misquote D:Ream, things can only get worse.

With this bleak situation on the horizon, we should all be taking our future health into our own hands.

That means that when clients are having discussions with their financial advisers about future planning and investments, they should include the assumption that their later years will require them to either have a healthcare savings account to pay for private care, such as orthopaedics, or private medical insurance to help cover urgent care outside of the pressured NHS sector.

They might also want to register with one of the local private GP services currently mushrooming across the country, because we cannot see things getting better in primary care any time soon.

Paul Major is manager of Bellevue Healthcare Trust plc