The Conservatives’ autumn conference came to an end this afternoon, the first it has held as the single governing party since 1996. Here are five messages NHS leaders can take from the jamboree in Manchester.
Seven day battle will go on
The battle will go on over junior doctors’ contracts and a “seven day NHS”. The health secretary upped the rhetoric in his keynote conference speech, describing the British Medical Association as “utterly irresponsible” for trying “to scare people into believing” he wants to cut pay. Many Conservatives are jittery about convincing outsiders they are not out to fleece bright young medics, and some senior Tories are among those raising concerns about this fight. But the “7 Day NHS” message was plastered on all official party posters, confirming the issue won’t be disappearing. The prime minister, who has made this his key health message, set annual targets for meeting seven day acute standards and said a new voluntary GP contract from 2017 would include extended GP access.
Financial tough talk
There will be little certainty about NHS funding prospects until the 25 November spending review, but conference mood music suggested the Treasury and Downing Street are of no mind to hand over more cash to the health service than the £8bn real terms growth by 2020 already committed. This could just be tough talk before in-year bailouts and capital transfers to sort things out become unavoidable. Mr Hunt stuck to the line that the £8bn would be sufficient, while making the case that the health service faced a financial challenge as tough as non-ringfenced departments due to rapidly rising demand and costs.
The three Es
Jeremy Hunt will continue his mission to make the Tories the champions of quality, safety and openness – versus a Labour Party characterised as willing cover up failure. This week he said the NHS needed to deliver “equity” of “excellence” as well as access – hence the need for rigorous quality inspection to persist. In fringe events he added a third “E” to his vision: “efficiency”. However, the NHS’s glaring deficit problem got no mention in Mr Hunt’s speech and it’s clear his heart lies squarely with reinforcing the patients’ champion message. “We should never waver in our commitment to high quality care in every corner of our NHS,” he insisted. We can expect to hear more on his plans for GP and clinical commissioning group metrics in the coming weeks.
Forward view thinking
The Five Year Forward View remains the government’s proxy NHS policy. The absence of any big new direction on the NHS (it got only a brief mention in David Cameron’s closing speech today) reflects top Tories’ backing for “the Stevens plan” as the party’s main health agenda. Mr Cameron’s announcement on Sunday of a new, voluntary, GP contract – while sold as a route to weekend opening – runs with the grain of the forward view’s new care model programme to spread large scale extended primary care providers.
The government-NHS England relationship took an intriguing twist, though, when Simon Stevens issued a pointed critique of government plans that would see overseas nurses deported, just hours after home secretary Theresa May had majored on anti-immigration measures in her speech and shortly before Mr Hunt’s own address. The politically savvy NHS England chief executive also spoke about the NHS’s role in the economy, its need for outside innovation, government prevention measures, and social care, in what looked very much like pre-spending review manoeuvring.
Care funding dilemma
Top Tories remain all for equity and excellent in a publicly provided NHS. But this is not the case for the social care system, and the problem of care funding is an urgent dilemma after several years of council cuts. There was no sign of a big move to solve this conundrum (such a policy may wait for the spending review anyway), although Mr Hunt declared, optimistically, that “we basically have to bring [health and social care] together in this Parliament”. His preferred answer to the care problem, though, was to point to the need for families to take older relatives into their homes, complaining that 6 per cent of Brits do so compared with 39 per cent in Italy and even more in Japan. “We’ve got to ask if more people are happy to have their older relatives living with them,” said the health secretary, in an indication of his vision of society beyond the NHS.