Incisive Health analysis of the 2019 Labour Party Manifesto

The Labour Party 2019 general election manifesto sets out a radical domestic programme that reimagines the role of the state in virtually every sector of the economy. But do the Party’s health and social care policies reach the transformational heights of the rest of the manifesto?

With the manifesto, the Party is gambling that after nine years of Conservative-led government, and three years of Brexit dominating the political debate, eye catching domestic policies can capture the public’s imagination.

In part, the boldness of Labour’s ambition can be read as an acknowledgement that the Party needs to do something dramatic to shift public perceptions. The latest polling points to a comfortable Conservative majority and Jeremy Corbyn is drastically more unpopular than any other political party leader has ever been heading into an election. Without a swing to rival the dramatic recovery during the 2017 election campaign, defeat looks likely, if not certain.

With nationalisations of water companies, energy companies, the railways, the National Grid, Royal Mail, and BT Openreach competing for space with a Green New Deal and retail offers including free tuition fees for students, free broadband for all and a 5% pay rise for all public sector workers – this is unquestionably the most radical manifesto from any major UK political party since the infamous (and actually slightly shorter) 1983 Labour Party manifesto.

The strategy to focus on everything but Brexit is partially borne out by recent polls. The NHS has overtaken Brexit as the issue most important to voters. However, on health, the manifesto is somewhat muted. Less revolution, more evolution.

On NHS revenue funding, the £26bn real terms ‘Rescue Plan’ will be welcome – but at ‘only’ £6bn more than current plans, Gordon Brown in 2002 this is not.

The commitment to refocus on preventative health aligns with the NHS’s own ambitions and the promised increased investment across sexual and reproductive health, addiction services, and screening, along with the commitment to regain the UK’s WHO measles status are likely to be welcomed by the health community.

For capital, the position is more ambitious. The pledge to invest £15bn in NHS capital budgets to “return NHS England to the international average of capital investment” is significant and reflects the increasing salience of bricks and mortar in the public eye. The commitment for £2bn of this investment to modernise mental health hospital facilities will be particularly appreciated by the sector. As will the focus on diagnostic and other equipment.  However, in this election of magic money trees, £15bn on capital is unlikely to stand head and shoulders above the pledges of other parties.

Social care sees a major uplift in funding to deliver the new commitment of free personal care to the elderly – costing £10.8bn by 2023/24. The social care system is in crisis and the additional funding, alongside the introduction of free personal care, entails a major investment and a radical shift in how the current system works.

The now familiar promises to “repeal the Health and Social Care Act” and “end and reverse privatisation in the NHS” make an appearance. But neither are as radical as some in the health community hoped for. The Act will be repealed, but there’s no mention of what will come in its place. Labour could have pledged to abolish not only CCGs but the commissioner / provider split entirely. On the question of ‘another top down reorganisation’, it seems that the Party’s pragmatists won out.

However, on life sciences, the radical spirit of the rest of the manifesto comes to the fore. The ‘Medicines for the Many’ announcement was the standout moment of Jeremy Corbyn’s Party Conference speech, and many of its headline components are included here too. A generics drugs company will be established. Compulsory licenses will be used if manufacturers do not offer “fair prices” for medicines. The NHS itself will lead a new focus on the development of genomic and cell therapies. These are activist policies that are aimed at disrupting not only the UK but, in some cases, the global medicines market.

The headlines from the Labour Manifesto are likely to focus on the Party’s plans to transform the UK economy. When all is said and done, however, some may wonder why they led on this. Health and social care are the two issues where the Labour Party can lead other parties in the minds of voters. Shifting the focus away from them may prove to be a wasted opportunity.