Health grabs limelight in UK election

Voters seem more concerned about NHI than Brexit

Britain’s snap election on Thursday was called to unblock the Brexit logjam, but much of the campaign has been dominated by rows over health care.

The state-run National Health Service (NHS) provides taxpayer-funded treatment for all. It is both criticised and defended.

For many voters, the debate on how to address its shortcomings is more important than Prime Minister Boris Johnson’s Brexit deal.

Naomi Fulop of the Institute of Epidemiology and Health at University College London said direct taxpayer ownership of the NHS and interaction with it gives the service a personal link that guarantees it as a perennial top election issue.

Mark Dayan, a policy analyst at the Nuffield Trust health thinktank, said: “There’s a national feeling of protectiveness towards the NHS, and that has become anxiety as performance has slipped.”

Johnson’s centre-right Conservatives and the left-wing Labour main opposition promise big NHS spending boosts over the next five years if they win.

“All the major parties are competing with each other to show how much they want to increase expenditure and address workforce issues that have been created over the last 10 years, rather than reorganising,” said Fulop.

“The disappointment is that none of the parties has a vision for health and social care in terms of how they’re going to be funded in the long term.”

A Labour government established the NHS in 1948, promising free health care for all “from cradle to grave”.

Labour’s main election thrust has been to allege that Johnson and his free-market Conservatives are plotting to sell off the

NHS to President Donald Trump and US pharmaceutical firms.

The Conservatives have dismissed Labour leader Jeremy Corbyn’s claim of a “toxic” post-Brexit deal with the US president as “conspiracy theoryfuelled nonsense”.

The governing Conservatives say the health service prices it pays for drugs and services it provides are “not on the table” in any future trade talks.

Trump also denies being interested. “If you handed it to us on a silver platter, we want nothing to do with it,” he said last Tuesday. But his denials have failed to disarm protesters, who marched through central London waving placards reading: “Trump, hands off our NHS”.

“The level of debate, the honesty about the situation we’re in and how we might address it are at a pretty low and depressing level,” said Fulop.

The wider election issue of how Brexit might affect NHS funding was “drowned out”, she said.

PLEDGES AND OUTCOMES

The Conservatives have promised to increase NHS funding by £34bn over parliament’s five-year term.

They promise 50,000 more nurses through better retention and new recruits; 6,000 more doctors; 50-million more general practice appointments a year; 20 hospital upgrades and 40 new hospitals.

Labour promises to increase spending 4.3% a year; free annual dental check-ups; £1.6bn more on mental health services and £2bn to improve mental health facilities, and a training bursary for nurses.

“We’ve seen the issue of NHS staffing climb up the agenda” in response to rising public concern, said Dayan.

“It used to be more just about throwing money about it. Now we see more discussion on the numbers of doctors and nurses.”

Overall, the department of health and social care’s total budget for the financial year 2019-2020 has been estimated at about £134bn.

Forbes magazine said in 2015 that the NHS had 1.7-million staff, making it the world’s fifthbiggest employer behind the US and Chinese armed forces, Walmart and McDonald’s.

But a recent study in the British Medical Journal found that Britain is lagging nine other high-income countries on health spending, outcomes and how much time doctors spend with patients.

The study found that Britain spent the least money per person on health care in 2017 ($3,825) compared with an average $5,700 for all other countries studied.

Spending, patient safety, and population health were all below average to average at best, the study found.

As for the workforce, Britain had among the highest proportion of foreign-trained doctors (28.6%) and nurses (15%).

Figures obtained by the Nuffield Trust showed that nearly a quarter of all UK hospital staff were born abroad, up from an eighth 20 years ago.

“The concern we have is that after Brexit, EU migration the last source for easy migration left may be shut off by more restrictive immigration policies, because the need to recruit from abroad hasn’t gone away,” said Dayan.

BRITAIN LAGS NINE OTHER HIGH-INCOME COUNTRIES ON HEALTH SPENDING, OUTCOMES AND HOW MUCH TIME DOCTORS SPEND WITH PATIENTS