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by GK Strategy 27th June, 2017
3 min read

Has The Election Actually Changed Anything In The World Of Health And Social Care? Five Things To Watch

While it might feel that the general election has significantly altered the political landscape, with Labour on the resurgence and Theresa May now without any clear mandate, has all that much practically changed in government?

Political pundits are doing their best to whip up a sense of unprecedented, unforeseen, seismic shifts and uncertainty, but for those operating in Whitehall the pre-election status quo remains for the moment.

The impending marriage of convenience between the Conservatives and DUP means another Conservative government, the same Prime Minister (for now) and a virtually identical Cabinet including the same Health Secretary (against all odds).

Although significant NHS legislation and big decisions are off the agenda, we can expect more of the same in terms of patient safety, targets and transparency – in keeping with Jeremy Hunt’s agenda over the past five years.

So has anything actually changed in the world of health and social care?

  1. Power to NHS England: The inevitable resignations of Theresa May’s Chiefs of Staff, Fiona Hill and Nick Timothy – the latter being blamed for the social care manifesto disaster – has shifted the relationship between No.10 and NHS England. Prior to the election, their relationship could be described as, at best, adversarial and the general consensus was that the NHS England Chief Executive would be gone and replaced with a more ‘on-message’ leader. A weakening of No.10 could embolden Simon Stevens to speak with greater confidence about the funding challenges that lie ahead. Acting as a point of relative stability will also give him more leeway in driving forward the implementation of the Five Year Forward View through local Sustainability and Transformation Plans (STPs), which provides the platform for additional money to be spent on digital, estates and workforce.
  2. New Ministers, new priorities?: Among the 13 seats the Conservatives lost were two Health Ministers – Nicola Blackwood, Minister for Public Health and Innovation, and David Mowat, Minister for Community Health and Care. Replacing them, but with remits not yet confirmed, are Jackie Doyle-Price, MP for Thurrock, and Steve Brine, MP for Winchester. A change in personnel usually signals a shift in personal priorities, but with Hunt likely to have had a say in the new appointments, significant policy deviations are far from impending. Furthermore, during the election campaign Doyle-Price backed the closure of a minor injuries unit and the sale of NHS land at Orsett Hospital, indicating her support for recommendations in the Naylor Review despite political wisdom dictating that MPs shouldn’t back local hospital closures. This opens the door to more private-public partnerships which Naylor claims will be necessary to deliver a cost-efficient and sustainable NHS.
  3. Revised Portfolios: Despite May proving unable to follow through with her widely expected major reshuffle, she may still rejig ministerial portfolios, particularly within the Department of Health (DH). The life sciences portfolio would be best to sit fully within Lord O’Shaughnessy’s remit, rather than being inexplicably split, and social care should have a dedicated Minister. A DH Minister with sole responsibility for social care could restore some public confidence in the Conservatives’ competence in this area. Whether somebody would be willing to take on this job remains a major sticking point.
  4. Social care crisis isn’t going away: Particularly after the embarrassing social care U-turn following the publication of the Party Manifesto, the Government will have to invest time and money in ensuring the future sustainability of the sector and earning back some of their lost credibility. Social care proved to be a hugely important issue for the electorate during the election campaign, with plans to fund the sector dividing the nation and subsequently contributing to May’s election failure. A renewed focus in this area is inevitable and additional funding will be targeted at local authorities, but whether this money gets passed onto those who need it most is a different question.
  5. Don’t ignore the opposition: Labour’s surprising result has undoubtedly strengthened their hand in applying pressure on the Government around health and social care. Prior to the election, wide predictions of Labour decimation limited business and NHS engagement with the Official Opposition, but this should now change. If Labour are able to apply effective pressure around a number of their own manifesto pledges, this risks a wholesale change in the direction of travel for the NHS. The promotion of competition, innovation and private providers in the public health sphere could take a back seat if Jeremy Corbyn keeps his Party united.

Undeniably, the length of Theresa May’s tenure is uncertain. However, with no clear successor ready to grasp the poisoned chalice of negotiating the Brexit deal, the likelihood of her lasting longer than initially imagined is increasing daily.

At the same time, Labour have never been in a better position to challenge the Conservatives’ health agenda since finding themselves in opposition.

Labour’s vision now rejects the core assumptions that have been prevalent in the NHS since Tony Blair’s victory in 1997. Their opposition offers a significant risk to those private providers already operating in the public sector and limits future opportunities for business growth.

The Prime Minister’s “strong and stable” brand is tarnished, but regardless of her future, the domestic health agenda under Hunt and Stevens looks set to continue.

 

To learn more about the future health & social care landscape, chat to our consultant ella@gkstrategy.com

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