To the surprise of the pollsters and it seems themselves, the Conservative Party won a majority at the UK’s 2015 general election, which saw the reappointment of Jeremy Hunt as health secretary.
For those working in and around the National Health Service, this lead to a speedy reappraisal of where they think the service will be heading in the next five years. One of the first to react was HSJ (Health Service Journal), which drew five conclusions as to what direction the NHS is now likely to move in.
1. All systems go for the NHS Five Year Forward View
With the support of the Prime Minister and chancellor George Osborne, NHS England chief executive Simon Stevens now has the all clear to progress with the plans for reform he first publicised in the autumn.
2. Changes seek an increase in productivity
In his reforms, Stevens recommends changes in a number of health services, including the creation of ‘multi-speciality community providers’ to replace traditional primary care, the centralisation of many hospital services and a reduction in workforce costs through improved technology.
Under a single party majority the implementation of such changes are likely to be accelerated.
3. No blank cheques
The Conservatives pledged to increase the NHS budget by £8bn per annum by 2020. This has been recognised by NHS leaders as the minimum amount needed to keep the service operational. However, the debate now begins as to how the government will fund this promise, with the Treasury seeking significant changes in productivity in return for increased spending.
Starting from now, Simon Stevens will be required to show progress in reducing inefficiency in the health service if there is to be a financial increase for the year 2015-16. This could include a reduction in staff costs and performance linked pay.
In the run up to the election, the Labour Party said it would increase NHS spending in this financial year. Jeremy Hunt, on the other hand, has indicated that this will not be required, which places further pressure on the NHS to meet their budgets.
4. Tweaking the Health Act 2012
While it is unlikely there will be major changes to the 2012 act, the government may try to sort out some of the practical problems the act created. This could include increasing the remit of Monitor in overseeing the providers regulation regime, and simplifying the devolvement and pooling of health and social care budgets.
5. Less for social care and local government
The Conservative government is likely to reduce local government’s role in health provision as well as cutting social care revenues, which could effect the NHS both directly and indirectly. Hunt has indicated that there would be an acceleration and extension of the Better Care Fund, which would allow the additional £8bn that has been promised each year to be shared across both the health and social care system.
It seems that under a Conservative government the next five years will continue to be a challenging time for the NHS.