FTI Consulting UK Public Affairs Snapshot – Better, faster, stronger or a healthy dose of reality?

After 14 years in government and amid record NHS waiting lists and ongoing industrial action, the Conservatives had no choice but to address health policy in their manifesto, while hoping that it wasn’t the issue that dominated the electoral conversation. While Rishi Sunak often cites his response to the pandemic as one of his crowning achievements, the Tories want this to be the tax election, pinning a label of unaffordability on Labour’s plans for the NHS and government more widely without secret plans to raise taxes.

Conversely, Labour has been understandably eager to make the NHS a focus election issue.  With a widespread view that the NHS is broken, it provides ample ammunition to criticise the Government, and slots neatly into the party’s broader narrative of Tory failure and the need for change. But Labour too is boxed in by a fragile economic outlook and a commitment to fiscal responsibility that makes any implication of a return to ‘tax-and-spend’ public services out of the question.

The Conservative manifesto contains several pared-back pledges on healthcare, no doubt influenced by the realities of trying to fix the NHS whilst in Government. This includes continuing to increase NHS spending above inflation in each year of Parliament, and delivering 40 new hospitals by 2030, a promise initially made in Boris Johnson’s 2019 manifesto. The Public Accounts Committee has been highly critical of the progress of this pledge, arguing that 40 new hospitals would not be delivered by 2030, and that the Government was unlikely to even deliver 32. To add insult to injury, the Government definition of “new hospital” stands accused of being misleading – including as it does the refurbishment or expansion of an existing hospital. The devil always being in the detail, some health experts have found this pledge eyebrow raising in its lack of both ambition and achievability.

Meanwhile, Labour’s manifesto commitments for health and life sciences are built around the themes of better, faster and stronger. Their key pledge for health is an additional 40,000 NHS appointments a week (2 million a year), achieved by more weekend services and using spare capacity from the private sector. On the face of it, this might appear to be ambitious, but in reality it equates to just 2% of the total NHS outpatient appointments a year. Unless accompanied by significant structural reform in the NHS, the reality is that it is unlikely to make any substantiative difference.  

When it comes to the life sciences sector, Labour’s plans follow the direction of travel set out by the Conservative government’s Life Sciences Vision but supercharged. The party has listened to the calls from industry for a clearer procurement route to get products into the NHS and has pledged an NHS innovation and adoption strategy. Labour have also responded to the need for streamlined regulatory process in order to get medicines onto the market and accessible to patients more quickly. This will hopefully be a significant step forward for the life sciences industry in tackling the access and reimbursement challenges that have plagued recent years. Given the importance of UK trials to ensuring UK patients have access to innovative treatment options, the third area of focus for life sciences is clinical trials, which both parties have outlined their commitments to boosting.  

Looking at the polls for next week’s election, they are consistent and unanimous that it will be Labour who will form the next government. Therefore it is Labour’s commitments around health and life sciences that will be translated into government policy this autumn. However, the details of how the commitments will be funded and put into practice for the benefit of UK patients and industry remains to be seen. Shadow Health Minister Wes Streeting has said that the manifesto is just the start, indicating that he would have liked to include more ambitious commitments around social care had the economic conditions allowed it. This suggests that the Labour health and social care team is optimistic not only of improvements in the economic outlook, but that in such circumstances health funding will be a resulting winner in terms of new spending commitments. But be under no illusion other ministers in adjacent departments will all have their eyes on the same prize. The hope of patients, healthcare professionals and the scientific community across the UK is that better, faster, stronger for our NHS and life sciences sector becomes a reality.