Election 2017: Health policy issues of second-most importance to voters

Photo: PA

And as June 8 approaches health correspondent Geraldine Scott highlights the key debates facing health and social care.

Health and social care is an issue which affects us all, whether now or in our old age. So it is no wonder the topic ranks so high in importance in what people care about for this general election.

As well as usual tussles over NHS funding, Brexit has added an additional perspective to the healthcare battle this time around, as the EU workers who contribute to the system look for reassurances their rights will be protected.

Mental health is also a key issue for voters, as more and more people are affected and worries over the amount of cash pumped in swell.

Election issues. Photo: Archant Graphics Unit (Image: Archant Graphics Unit)

But perhaps the most burning issue for many is the impact on social care.

Susan Ringwood, chief executive at Age UK Norwich, said the landscape was 'complex'. She said: 'We know it's an issue which does concern older people and their families.'

On Monday, Theresa May announced a Conservative government would consult on a possible cap on social care costs, as the Tories' manifesto proposals which were branded a 'dementia tax' by general election rivals and poll ratings toppled.

Previously, the party announced no one's assets would dip below £100,000 due to the costs of care, but a cap at how much would be paid was not set. Previously, the floor was set at £23,250. Now, the Prime Minister has said there would be a cap, but no figure has been announced.

Under the Tory plan the family home will for the first time be taken into account when working out how much an individual must pay towards social care in their own home, as well as residential care.

Individuals receiving care at home will be able to defer payments until after their death, as residential care-users already can, so that they do not have to sell their home during their lifetime.

This policy was of significant concern to older people, said Mrs Ringwood.

'We know of people who really are concerned about leaving something to their family, to the extent they don't spend on themselves,' she said. 'But often children are saying no, spend it on yourself.'

Chief executive of AgeUK Norwich & chairman of Dementia Action Alliance Norwich Susan Ringwood. Picture : ANTONY KELLY

Meanwhile, Labour promised to increase social care budgets by £8bn over the lifetime of the parliament. The party said this will fund a 'real living wage', paid travel time and access to training for care workers without cutting quality of care. Labour would also lay the foundations for the eventual creation of a national care service alongside the NHS and seek a consensus on how its £3 billion-a-year cost should be funded, possibly through wealth taxes, employer contributions or a new social care levy.

Lib Dems would put 1p on the rate of every band of income tax to raise £6bn a year for the NHS and social care, and would consult on a possible dedicated health and care tax.

Any new investment would be welcomed by Tim Allard, executive manager at Norfolk Carers, which offers support to unpaid carers. He also warned the value of informal family caring was increasing, with one estimate saying if all hours of unpaid care were replaced by the state it would cost £132bn. He said: 'The overall conclusion is clear: health and care could not function without unpaid family carers.'

The Lib Dems also promised a cross-party health and social care convention on the long-term-sustainability of health and social care. And their longer-term objective is to integrate the NHS and social care, with budgets pooled in every area by 2020. The party would introduce a statutory independent budget monitoring agency for health and care, reporting every three years on the system's current and future needs.

Photo: Yui Mok/PA Wire

Mr Allard added: 'Locally, spending on for example advice services and housing related support is under threat, leaving unpaid carers having to plug the gap. It will put greater pressures on the system and on individuals and families across Norfolk. These cuts have a knock-on effect.

'The more funding and services that are cut for vulnerable people, the more friends, families and communities have to take on care. Carer's Allowance is the lowest benefit of its kind, just £62.70 a week. We hear from carers having to cut back on essentials like food or heating just to make ends meet.'

Mrs Ringwood added: 'We do need to find a solution to funding, and I'm concerned about the view older people are somehow benefitting, they've paid into the system for 40 or 50 years. I'd encourage older people to look at the proposals and see what they think is best for them.'

Brexit

Whilst the general election has been dubbed by some as the Brexit election, the UK exiting the European Union could have consequences on health and social care.

Cross-border patient entitlements, the regulation and supply of medicines and devices, and cross-border co-operation are all key points brought up by those on both sides of the fence.

Dr Tim Morton, chairman of the Norfolk and Waveney Local Medical Committee, and a GP in Beccles. (Image: Archant)

But perhaps the most significant is the potential impact on health and social care workforces. Around 60,000 of the NHS 1.2m workforce are from other EU countries, compared to around 90,000 of the 1.3m workers employed in social care. Since the EU referendum the number of EU nationals registering as nurses in the UK has fallen by 90pc.

Labour and the Lib Dems have both guaranteed the rights of EU staff working in health and care services, while the Conservatives promised to make the issue of retaining those staff a 'priority' in negotiations.

Mental health

As leading charities call on all parties to keep mental health at the top of their agenda, reports earlier this year revealed the number of people seeking help for mental health issues had risen from 500,000 a year to 1.7 million since 2010.

Labour have promised to improve children's mental health, alongside a new Index of Child Health which will measure progress against international standards in four sectors plus extra funding for child and adolescent mental health services.

The Conservatives promised a new Mental Health Treatment Bill with the aim to bring a 'sweeping reform' of mental health legislation in the UK. It promises 10,000 more NHS mental health trust staff, and mental health support in schools.

The Lib Dems have promised £250m more funding over five years for depressed pregnant women and mothers and new waiting time standards for people in crisis.

General practice

At the national conference of the Local Medical Committees - which represent grassroots GPs - last week Theresa May was warned she needed to tackle the pressures facing GPs in England, as one top doctor warned the service was on the 'brink of collapse'.

Dr Chaand Nagpaul, chairman of the British Medical Association's GP committee, said the government was 'turning a blind eye to the spiralling pressures' affecting the entire health and social-care systems - a view echoed by GPs in our region.

Labour's manifesto promises to increase funding to GP services to 'ensure patients can access the care they need', as well as halting pharmacy closures and reviewing provision.

Whilst the Lib Dems would look to expand evening and weekend opening to meet the needs of local patients, encouraging online, phone and Skype appointments. They also promise national support to GP practices.

The Conservatives said every patient in England will have access to seven-day GP services by 2019 - a year earlier than promised in its last manifesto - but a plan to recruit 5,000 extra GPs by 2020 as previously promised seemed to have been dropped.

And the party has recommitted itself to several policies made ahead of the 2015 election and since, including a 'new GP contract to develop wider primary care services', named GPs and plans to expand online and phone consultations.

The manifesto also suggested a Conservative government would increase capital funding for practice premises.

Tim Morton, chair of the Norfolk and Waveney LMC, said: 'While many of the measures in the manifestos of the political parties may sound promising, if the NHS is to survive under any government, it needs long-term, credible and sustainable investment plans to deliver the fully funded and supported NHS that supports staff and patients alike.

'Currently the NHS and particularly general practice is at breaking point, so the promise of any additional investment would be certainly a welcome move because without general practice the bedrock of the NHS it is unlikely to survive.

'In 2015 the UK spent £10bn less than other leading European countries on health - a gap that must be closed. In England, the gaping hole in NHS finances will soon hit £30bn a year, which will have a devastating impact on patients who are facing unacceptably long delays in care, and staff who are working under impossible and unsustainable conditions. The crisis in recruitment and retention of NHS staff is as important as the crisis in funding.'

What the manifestos say

Conservatives

• Increase NHS spending by a minimum of £8bn in real terms over the next five years

• A new GP contract and changes to the contract for hospital consultants

• Retain the 95pc A&E target

• No one will have to sell their home to pay for care costs in their lifetime while a person's assets would not be allowed to dip below £100,000 as a result of paying for care. On Monday, Theresa May said there would also be a cap on how much a person would have to pay.

• Means test winter fuel payments

• Build and upgrade primary care facilities, mental health clinics and hospitals

• Recover the cost of medical treatment from non-UK residents

• Make it a priority in Brexit negotiations that the 140,000 staff from EU countries can carry on their contributions to the NHS and social care

Labour

• One million people to be taken off NHS waiting lists by 'guaranteeing access to treatment within 18 weeks'

• Free parking in NHS England for staff, patients and visitors will be funded by increasing tax payments on private medical insurance premiums

• Scrap NHS pay cap and commit to £30bn in extra funding over the next parliament

• Ringfence mental health budgets and ensure all secondary school children have access to counselling

• Increase funding to GP services

Lib Dems

• 1p rise on income tax to fund £6.3bn boost in spending on NHS and social care

• Waiting time standards for mental health to match physical health care

• Better integration of health and social care systems

Green Party

• Roll back privatisation of the NHS

• Introduce mental health training in the public sector and bring mental health care in line with physical health care

• Invest in social care for the elderly and those who need it

Ukip

Ukip's manifesto is due to be officially released today, Wednesday.