• Tory manifesto commits to “enshrine in law” the NHS long-term plan within three months
  • This would include NHS England’s proposals to remove competition law and help create ICS partnership boards
  • More nurse recruitment and retention promised, including new maintenance grant
  • No new proposals on social care

Compulsory competition would largely be removed from the NHS and the law changed to give integrated care systems more formal powers within three months of a new Conservative government taking power, the party has said.

The new legislation would also “enshrine in law” the £20bn increase in the NHS budget announced last year.

The party’s general election manifesto, which was published today, also says the Conservatives would fund “50,000 more nurses” by 2023-24.

The document states: “Within the first three months of our new term, we will enshrine in law our fully-funded, long-term NHS plan.”

HSJ understands the Conservatives mean by this that if they form a new government, it would bring forward legislation which would write last year’s funding settlement into law, alongside legal changes NHS England has proposed linked to the NHS long-term plan, and backed by representatives from the wider health and social care world.

The NHS England proposals, which HSJ understands the government would base the legislation on, include:

  • Scrapping the “section 75” Health and Social Care Act 2012 procurement regulations and removing the NHS from public procurement law;

  • removing the role of the Competition and Markets Authority in NHS mergers and pricing;

  • allowing all NHS organisations, including foundation trusts, to work together across integrated care systems or provider groups by delegating decisions and budgets to joint committees;

  • formally merging NHSE and NHS Improvement – which in practice will mean abolishing Monitor and the NHS Trust Development Authority, with whatever responsibilities and powers are being kept given to NHSE.

  • A new power for NHSE/I to set annual capital spending limits for foundation trusts.

The manifesto commits a new Conservative government to securing “50,000 more nurses”. HSJ understands that this figure constitutes 14,000 trainees, 12,500 overseas recruits and 5,000 from the nursing apprenticeship scheme. The balance would be made up by retaining 18,500 nurses, through flexible working offers, who otherwise would have left the NHS, according to the Conservatives.

The party has U-turned in large part on its 2015 decision to scrap the bursary for nursing students, saying they will now receive “a £5,000-£8,000 annual maintenance grant every year during their course to help with their cost of living”.

The cost of boosting nursing numbers is estimated at £759m in 2020-21, rising to £879m, and the government would fund these in addition to NHS’s current financial settlement.

Following government-backed proposals from NHS England last week to address the NHS pensions crisis in the remainder of 2019-20, the manifesto states the Conservatives would “within our first 30 days… hold an urgent review, working with the British Medical Association and Academy of Medical Royal Colleges to solve the problem”.

The manifesto reveals a new Conservative government would launch a £500m fund to give patients quicker access to new medicines – effectively an expansion of the existing “cancer drugs fund”.

The manifesto also contains a commitment to provide free hospital care parking to “those in greatest need, including disabled people, frequent outpatient attenders, parents of sick children staying overnight and staff working night shifts”. This will be paid for by an additional £90m each year, and £250m capital has been allocated for “NHS car parking”.

Pledges in the manifesto which have previously been announced include:

  • A £2.4bn investment over four years from 2021-22 to increase the numbers of doctors and other clinicians working in primary care;

  • Capital funding for schemes and seed funding for a further 34 projects;

  • Preferential immigration status for NHS staff;

  • A pledge to double investment in dementia research.

The manifesto includes no new proposals on social care.

Updated 10.50am 25 November to correct the proposal from NHSE in relation to directing foundation trust capital spending.