How will the NHS fare after the general election?
This week Prime Minister Theresa May dropped a bomb into the UK political arena by calling a general election for 8 June, supported by a majority of MPs.
At once, this contradicted her regular promise not to call for a national vote before 2020 and sent the media into a frenzy over what it all meant.
What does it mean for the health service and the industry?
There will certainly be upheaval — but that is a given in today’s NHS. Will it cause delays to implementation of reconfigurations already going on under sustainability and transformation plans (STPs)? Will any of the fussing, fretting and planning that has taken place since the Five year forward view (FYFV) was published three years ago mean anything in a year’s time?
Despite NHS organisations pleading for the political parties to make this election about the NHS, it will inevitably be about Brexit, not least because that is what Theresa May and the media want. Is that a risk for her? The Brexit referendum was quite close; if the Prime Minister wants it to be about Brexit, it may galvanise remainers to come out in even greater numbers this time to vote for whoever is against it.
If she consolidates her power with an increased majority, she will have a stronger mandate. Will she impose more austerity on an already creaking health service? Will there be a new round of politically driven NHS reforms? Will she sweeten the Tory manifesto with the promise of extra money for the health service to garner more votes and appease critics? Will health service employees from EU countries be allowed to remain and work in the UK? Will pay rates in the NHS be increased in order to encourage them to stay in the UK?
On an economic level, exporters are likely to suffer difficulties post-Brexit because of tariffs and regulation, which will likely reduce national prosperity and incomes. This probably means less revenue for the Exchequer, weakened sterling and lead to further cuts for the health service. It may become harder to find funding for expensive, innovative medicines.
Most importantly for policy, the central document of the past three years, the FYFV, is running coterminously with what was the expected term of the current government — until 2020. Financial planning for the DH, NHS England, trusts, CCGs and everyone else is based on that and that impacts industry business. So, what happens to all the reconfigurations going on now, all the STPs, all the vanguards, accountable care organisations and all the other plans, if new ministers with new ideas are put in place, or we get a hung parliament? What happens if, during the campaign, MPs of all political hues jump on the ‘save our hospital’ bandwagon? What happens to reconfiguration then? What happens if there are personnel changes in key leadership positions. Could Simon Stevens become ‘collateral damage’?
There are many questions but few answers for NHS staff, managers, patients and the industry.