Would you buy community care from these men?

The first half of the campaign for next month’s General Election
has been dominated by the release of party manifestos. Claire
Laurent examines the policies of the major UK parties and their
implications for the future provision of the community care of the
nation.

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 other parties.

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
alike.

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 hope.

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 year.

“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 seek work.

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.

Putting Wales first

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 community ownership schemes.

Scotland blazes a trail

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
post-code 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 offending careers.

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.