The section on “building a healthier society” in the Liberal Democrat’s manifesto shares much in common with the manifestos already published by the other parties. But taken overall, the Lib Dems offer the most coherent set of plans to improve our health and wellbeing.
Some similarities
There is cross-party consensus about the importance of prevention and promoting healthy lifestyles, the need for joined up health and social care, and that funding increases are required, though parties differ by how much and where funding will come from. The Lib Dems claim while in power to have “increased the NHS budget every year in real terms”, though funding increases have been lower than for any previous administration. Now, the party promises that funding for the NHS in England will be “at least £8 billion higher a year in real terms by 2020”, financed by tax increases and a hoped-for economic recovery.
Some of the specific policies in the Lib Dem manifesto also appear in those published by the other parties. Like Labour and the Conservatives, the Lib Dems believe DevoManc is a “good idea” before it’s even got underway. Like Plaid Cymru (and the World Health Organisation) they support a register of all clinical trials and better access to sports facilities. The Lib Dems would continue to push for a minimum alcohol price – along with Plaid Cymru and the Greens. And like Plaid Cymru, the Greens and Labour, they wish to halt privatisation of the NHS, even though they were instrumental in passing the Health and Social Care Act that hastened this process. The Lib Dems also prioritise the task of improving mental health in the party manifesto, as do the Greens.
Defining features
But the Lib Dems’ manifesto does have distinctive features. First, their section on health is more comprehensive than in other manifestos, with greater articulation of the key challenges that need to be faced. And the party is rivalled only by the Greens in terms of providing specific policies to address them. For example, while Labour and the Conservatives provide one-liners about the need to integrate health and social care, the Lib Dems devote a full page to the issue.
Plans to improve integration are consistent with the party’s long-standing agenda to decentralise decision-making and promote democratic accountability at local level. But they seem inconsistent with the intention to “join up health and social care at national level, shifting full responsibility for care policy and funding to the Department of Health”. It’s not at all clear what this means, and they do not elaborate.
Greatest prominence is given to tackling mental health problems, to redress the historical imbalance in favour of physical health. Although the Lib Dems’ mental health policies have been criticised for lacking detail, they set out more comprehensive plans than the other parties, promising to invest an extra £250 million a year in mental health, introduce waiting time standards, continue to roll-out provision of talking therapies, improve care for women and children, and develop strategies to make workplaces and daily life more “mental health friendly”.
Prevention better than cure
Like all parties, the Lib Dems recognise that prevention is better than cure, but in emphasising that “we must do all we can to help people stay healthy” they explicitly acknowledge that “health and wellbeing are affected by far more than just the quality of health and care services.” Following from this, the Lib Dems offer the fullest set of specific proposals to tackle the wider determinants of health, promising – among other things – to invest in better insulation of homes, reduce air pollution, restrict advertising of junk foods, impose an additional tax levy on tobacco companies, and promote healthy lifestyles through investment in sports facilities, cycle routes and a “Nature Act to increase access to green spaces”.
The Lib Dems also provide the most detail about how they will support informal carers and improve social care, including by full implementation of the Dilnot report and statutory licensing and training of staff.
The Lib Dems appear committed to developing future policy on the basis of evidence (the word appears eight times) and to fill research gaps by doubling funding into dementia, establishing a mental health research fund of £50 million and mandating reporting of all clinical trials.
Some of the Lib Dems’ plans will be difficult to implement (or resurrect, in the case of minimum alcohol pricing). They may well struggle to encourage “GPs to work together in federations”, which suggests yet another rebranding of similar models) in the tradition of total purchasing pilots, primary care trusts, and clinical commissioning groups. And while there appears to be general support for the principle of joint working across the NHS and local government or across health providers, the practical challenges of achieving this are substantial, as a history of failed past attempts testifies.
The Conversation’s Manifesto Check deploys academic expertise to scrutinise the parties’ plans.