Radical departure or more of the same? Labour’s health plan reads more like a compilation of previous manifestos than a new doctrine for the NHS
Incisive Health analysis of what the Labour general election manifesto tells us about the party's thinking on health.
Although Labour’s leadership will point to a small rise in the polls, the gap with the Conservatives looks insurmountable, suggesting a Conservative landslide. Labour’s manifesto might therefore be significant less in terms of its likelihood of implementation, but more in terms of what it says about the direction of the Labour Party's thinking on health.
Now the manifesto has actually been published (as opposed to just leaked), it is worth considering what does Labour actually think about health and is it proposing a radical alternative on the NHS? The Clause 5 meeting to approve Labour’s manifesto did apparently see some heated debates on national security and education, leading to amendments to the leaked draft. However, it does not appear that the NHS was a significant bone of contention. Short of some design work and a bit of proofing, the changes to the leaked draft are minor.
Labour may continue to reiterate that the NHS is its greatest priority, but it does not appear to be a policy area where there is much difference between the Corbynites and those who have opposed his leadership.
It is striking how little of the manifesto is new. In contrast to other areas of policy, there is actually very little which is identifiably Corbynite. Instead, the manifesto comes across as a compilation of previous efforts, from the doorstep-friendly 1997 vintage (even the title of the manifesto borrows from Tony Blair), to the large spending commitments reminiscent of the 2001 and 2005 election platforms. There is even a reprise for Andy Burnham’s 2015 call for a ‘national care service’.
Jon Ashworth’s tenure shadowing the health brief has been characterised by a dogged determination to focus on the practical problems experienced by patients and staff, in contrast to debates about structures and processes. So we see a series of pledges to fix practical problems on issues such as rationing, drugs pricing, public health, recruitment and retention and protecting whistle blowers. There are also commitments to see though action on cancer services and to place mental health front and centre (both of which may sound familiar to the Conservatives’ offering).
Perhaps predictably for an opposition party, there is also a commitment to halt hospital reconfigurations pending an independent review. Reminiscent of the Conservatives’ moratorium on hospital closures in 2010, this is a policy designed to play well in the marginals, but it does represent a conservative rather than transformative approach to the NHS.
What is missing, however, is any form of new world view on the future of the NHS. This is not a vision of radical shake-up. It is curious that the Corbynite determination to change society does not appear to extend to the NHS. From a health perspective, this is a more of the same manifesto.
There are of course some nods to the left. Labour’s leadership is clear about what it is opposed to. Pledges to “reverse privatisation” and repeal the Health and Social Care Act are repeated and continue to play a prominent role in Corbyn’s stump speech. Labour also promises a new duty on the Secretary of State to ensure that “excess private profits are not made out of the NHS at the expense of patient care.” Quite what this would mean in practice, we may never know.
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