This is an ‘In Focus’ piece from Community Care magazine analysing
the election manifestos of the main parties, including Scotland and Wales.
(This article is long – it may be advisable to read a printed version).
Five promises outlined on a credit card-sized "pledge card"
kick-started Labour’s election campaign.
Two of its pledges are aimed directly at health and social care, but they
are not new. The promise to recruit 20,000 extra nurses and 10,000 extra
doctors builds on those first made in the NHS Plan last July. The government
clearly recognises that this recruitment is critical if New Labour is to
realise its ambitions to modernise the NHS.
A stable economy has meant record investment in the NHS, Tony Blair told an
election campaign press conference, making it possible to rediscover "its
founding mission provide quality health care to every family regardless of
their ability to pay".
Pledges to retain the pensioners winter fuel payment of £200 and to increase
the minimum wage to £4.20 have also been trailed earlier. And it is likely that
the manifesto will build on similar announcements, making it clear that
"the work will go on" without relying on eye-catching new policies.
Long-term care is unlikely to get much of mention, with ministers probably
painfully aware that, despite having set up the Royal Commission to look at the
issue, the government has now shelved most of its recommendations.
Much has been done over the past four years to improve the lives of "hard
working families" with the emphasis of support for those who work. It is
highly likely that promising initiatives such as Sure Start and New Deal will
continue to develop along familiar lines. A key question remains about whether
the manifesto will do much to address the widening gap between those on benefit
and those in work.
Tax increases for either basic rate or higher rate taxpayers have not been
mooted, as they were for the 1997 election. But the Prime Minister has given a
strong indication at morning press conferences that there will be no direct tax
increases. However, with a strong economy the pledge to keep mortgage interest
rates and inflation as low as possible, together with sound public finances,
sounds attractive, if a little bland.
Meanwhile, "freedom, justice and honesty" are the watchwords of
the Liberal Democrat campaign. Commitment to ending the postcode lottery in the
NHS and to paying for all long-term personal care are policies that address
some of the most important issues in the social care arena.
And openness about adding a penny on income tax to fund public spending sets
the party apart from the criticism of "stealth" taxes levelled at
Cutting NHS waiting times is a strong theme, with a commitment to providing
training places for an extra 4,600 doctors and 27,500 nurses and midwives over
five years. Promises to provide 10,250 extra professionals allied to medicine,
such as occupational therapists, will be welcomed by patients and social care staff
Unfortunately, it is not yet clear whether social workers will come under
the section of "low paid nurses, midwives and other low paid
professionals" who will benefit from an immediate £1,000 salary hike – in
the interests of staff retention.
There will be 10,000 more hospital beds over five years and a promise to
review the criteria by which private finance initiatives (PFI) are judged in
order to create a level playing field between different financial options. PFI
was launched under the last Conservative administration and New Labour accepted
the baton with enthusiasm, but there have been rising concerns among those in
the NHS about the long-term implications for the health service.
Priority will be given to the most needy – with a scorecard system brought
in to take account not just of clinical need but also the needs of the patient
– the idea being to give doctors objective guidelines to determine priorities.
Promises to restore free NHS dental and eye checks will inevitably be welcomed,
as will the injection of an extra £500m over five years into dental services to
guarantee everyone access to an NHS dentist.
In the broader environment, every home will require an energy efficiency
audit before sale, to promote warm homes, reduce winter deaths due to fuel
poverty and reduce carbon dioxide emissions.
Long-term Liberal Democrat aims include increasing funding for mental health
services and local authority social services budgets.
The latter, according to the manifesto, would provide "more community
care places, improve preventive and rehabilitation services, give further
support and respite to carers and provide more social workers." We can but
Common sense may be the theme of the Conservative manifesto, but what does
it do for social care?
Aiming to cut taxes by £8 billion by 2003-4, the Conservative manifesto
promises to give more money back to people apparently without making painful
cuts in public spending.
Money will be saved by cutting bureaucracy and reducing benefit fraud.
Certainly, the 6p off a litre of petrol will be welcomed by social care staff
relying on their own cars for work.
Like the Liberal Democrats, the Tories have been upfront about long-term
care, and their solution is to encourage people to put savings into a long term
care fund or to set up an insurance policy.
Pensioners will see their taxes cut, with taxes on savings being abolished
and the special age tax allowance being raised from around £6,000 to £8,000 a
"Welfare without the state" illustrates a greater move towards
welfare being tackled by self-help groups and charities.
Disabled people would be allowed greater savings before losing benefit and a
new agency will pay incapacity benefit and provide physiotherapy to help people
back to work. Lone parents with children over 11 will be required actively to
The emphasis on marriage in the manifesto would see the creation of an
Office of Civil Society to champion families, marriage and voluntary groups.
The married couple’s tax allowance will be reinstated but this time aimed at
parents of children under 11.
The working families tax credit will be paid as a benefit direct to the
caring parent and, for parents with children under five, there will be a £300m
tax cut by increasing the children’s tax credit by £200 a year.
The tax on the widowed mother’s allowance and new widowed parent’s allowance
will be scrapped.
The postcode lottery for new drug treatment will end, while tax penalties on
private health insurance will be removed.
The Conservatives have also put asylum at the top of their agenda, saying
that all new applicants will be housed in secure reception centres. Those whose
claims are rejected will be "quickly deported" by a removals agency.
Successive governments have failed to fight for Wales and its communities,
according to Plaid Cymru.
The Welsh nationalist party has pledged to fight the election campaign on
constructive policies that will promote better social care, health and
regeneration in Wales.
On social services, the party intends to provide long-term funding to help
towards recruiting more social workers in Wales where there is a vacancy rate
of 25 per cent. Plaid Cymru argues that this recruitment problem has meant many
of the recommendations made by the Waterhouse tribunal into abuse in children’s
homes in North Wales have still not been implemented.
The party is promising to assist professional career development for staff
in social care. Around 18 per cent of staff in the sector have no professional
qualifications and more training programmes would be set up with well-supported
campaigns aimed at recruitment and retention.
Funding for social services should not be met through the Barnett Formula as
it is at present, the party insists. The formula is based on population rather
than on needs, which, says Plaid Cymru, short changes the people of Wales,
where many poor communities have high demand for both social and health
services. Under Plaid more money would be targeted at social services and health
and would be calculated according to need.
Care for older people should be free, and like Scotland, Wales could afford
to provide free long-term care for its older people if the Barnett formula was
scrapped. The party argues that the principles underpinning the NHS mean that
the risks and costs of growing old need to be shared out among the community.
The problems of Wales’ run down and ageing housing stock would be tackled by
public investment and the party wants to see the transfer of public housing to
SCOTTISH NATIONALIST PARTY:
Social care, health, housing and criminal justice policies are all devolved
to the Scottish parliament. So what care issues will the SNP be raising in the
general election if any?
On day one of the election campaign proper, the SNP announced it was a
two-horse race in Scotland between it and Labour, with the most important issue
being public services.
The government still holds the purse strings in allocating the overall
budget to the Scottish parliament and the SNP will fight on a platform of
ensuring this is as generous as possible under the banner of protecting and
improving public services.
The SNP would push for free long-term care to be implemented fully across
the UK within an agreed timetable. The strategy would end bed blocking, support
care home owners and expand care to all those who need it.
A National Health Care Commission, chaired by a minister for health and
community care and involving members of the public directly, would be created
to drive the strategy for health and care services across the country with the
primary aim of ending the postcode lottery for services.
Regulation of care would go further than currently proposed, setting
standards relating to quality-of-life issues for service users which would
determine government investment in services, rather than the other way around.
In Scotland, 1,500 new nurses’ posts would be created increasing the number
given an active community role.
In criminal justice, investment would be increased in effective community
alternatives to custody, targeting young people at an early stage of their
The SNP’s social care manifesto is based on greater public investment in
public services. That is how they will vote in Westminster – if given the opportunity.