Incisive Health analysis of the Conservative Party’s 2019 manifesto

In previous elections the political strategy for the Tories on the NHS has been a simple one: keep it quiet. But in this election, the Tories are aiming at a group of voters they haven’t made a concerted effort to pitch to before: leave-supporting, Labour-leaning voters in the North of England. Voters who care about the NHS.

And so, alongside Brexit, the NHS is front and centre of the 2019 Conservative Party manifesto. There is more funding for the NHS – presented as £640 million a week (‘between one and two Brexit buses’, presumably). There are more staff, with 50,000 more nurses promised and 6,000 more GPs. And 40 new hospitals.

It should be said the veracity of some of these figures is disputed, as is the practicability of the ambition. The claim of 40 new hospitals has been rejected by many, for example, although CCHQ staffers are known to delight in stirring up controversy to amplify a message. (They claim, probably reasonably, that in the heat of the row the public are likely to hear only ‘new hospitals’.) The recruitment of more nurses and GPs will need to rely on a relatively open immigration system (hence the ‘NHS Visa’) which seems to conflict with sentiment elsewhere in the manifesto.

Fiscally, it is notable that the Conservatives chose not to match Labour’s spending commitment on the NHS – even though it ultimately amounted to ‘only’ around £6 billion a year more. Despite taking a safety-first approach to the manifesto, the Conservatives seem to be content, at least for now, to let Labour claim that they will spend more on the NHS – perhaps gambling that voters will always suspect Labour of wanting to spend more and that the Labour manifesto’s overall largesse will prove a turn-off for voters.

Beyond the high-level commitments, there are some targeted crowd-pleasers: the extension of the Cancer Drugs Fund to all innovative medicines, for example, and the carefully-worded commitment to end hospital car parking charges for those in ‘greatest need’. There is also a curious commitment to enshrine in law ‘our fully-funded, long-term NHS plan’ within three months of winning an election: health legislation is troublesome at the best of times, but such a timetable looks heroic alongside the Brexit issues which would undoubtedly still preoccupy any new Conservative Government.

It is on social care where health-watchers will be most disappointed. Although the pledge of extra funding will not go amiss, the long-grassing of a long-term solution continues with a pledge to seek a cross-party consensus. Those with longer memories will recall that the manifesto’s commitment to ensure no-one in need of care should have to sell their home was originally made by Tony Blair back in 1997, and yet we are still far from a definitive solution.

Is the manifesto enough to convince those target Labour-leaning voters? There are still a few weeks for people to make up their minds – a few weeks in which a NHS winter crisis may yet intervene, disrupting the Conservatives’ carefully-constructed messages.

And even if it does not, do the Conservatives not run a risk by deviating from their long-held strategy of keeping the NHS quiet? By talking about the NHS so much, after all, they naturally make it more important to the electorate – and in some recent polls the NHS has overtaken Brexit as the most important issue facing the country. Might the country not therefore judge the Party’s record on the NHS on the nine years since 2010, and the performance issues which have arisen?

We will find out the answers to these questions on election day.