#healthdebate trends on twitter as political parties discuss the NHS and social care

Health representatives from the Conservatives, Labour, Lib Dems and UKIP spent the morning answering questions from healthcare professionals in a Question Time style debate ahead of the General Election taking place on Thursday 8 May 2015.

The debate was organised through a partnership between the British Medical Association (BMA), The Health Foundation Inspiring Improvement, The Kings Fund, Nuffield Trust, National Voices and the NHS Confederation.

Working with media partner The British Medical Journal (BMJ) the debate was chaired by Sarah Montague from the BBC, explored topical issues surrounding the NHS and social care in England and the whole UK, including funding, staffing, the privatisation of the NHS, integrating health and social care and mental health.

Speaking on behalf of the Conservatives was Secretary of State for Health, Jeremy Hunt, for Labour Shadow Secretary of State for Health, Andy Burnham, for the Lib Dems Minister of State for Care and Support Norman Lamb and for UKIP the party’s deputy health spokesperson, Julia Reid.

At the end of an intense 90-minute debate the four politicians were given the opportunity to spend one minute talking about their party’s vision for the future of healthcare but spent the majority of the debate answering questions from the audience that included health professionals such as clinical commissioners and GPs.

Person-centred care

Jeremy Taylor, chief executive of National Voices, a coalition of health and social care charities in England, asked how they intend to make patient involvement with their care a reality, highlighting that only 5 per cent of patients currently have a care plan.

Mr Lamb said: “Joined up care is all about the individual and not the institution that forgets all about the patient and that is why we are keen on developing the personal health budget to give control over money spent to the person and shift our role from paternalistic to helping.”

Mr Hunt wants people to have a dedicated doctor or clinician who are responsible for their path of care and said: “They need to know where the buck stops and who the doctor is that can formally hand over their care and who is accountable. This is the real way to put people in control.”

Mr Burnham said: “It is a big change from patient-centred to person-centred systems to support and empower the individual and I want to make this a fundamental constitutional right to a person-centred care plan.”

Social care funding

Mr Lamb wants the whole system to focus on preventing illness and to place public health centre stage, suggesting a ring fenced budget may be the answer.

Dr Reid wants to see ring fenced funding for social care, calling local authorities ‘cash strapped’ and saying they are having to take money from other areas to support the NHS, with social care being one area that is losing out.

Mr Burnham said the NHS could be protected by creating a Social Care Commission and Health and Well-being Board which will see councils make health and well-being the centre of everything they do.

Mr Hunt wants to see health dealt with in a more coordinated way, using childhood obesity as an example where local authorities should be working in a more coordinated way with schools and health clinical commissioning groups to address the obesity issue.

Saying no to real-term pay cuts

Dr Porter from the BMA wanted to know whether any of the parties would be able to commit to stopping any more real-term cuts for NHS staff members.

After explaining their plans to introduce 8,000 new GPs, 20,000 nurses and 3,000 midwives, Dr Reid said she felt a real-term pay cut would be unfair.

Mr Hunt described the decision to create real-term pay cuts for NHS staff in the last Government as the hardest decision he had to make as Secretary of State, saying NHS staff ‘work so hard I believe because of the commitment to patients’ but argued that increasing pay should not mean that staff are having to be laid off. Although not being able to say ‘No’ to any more real-term pay cuts, he said the Conservatives gave staff the best chance of getting a better pay deal and were committed to getting more and better staff working in the NHS.

The Labour shadow secretary said Jeremy Hunt got it ‘drastically wrong’ when he promised workers a one per cent pay increase for NHS staff who were seeing a ‘fortune going to agencies and oversees recruitment.’ He said ‘yes in principle’ to stopping more real-term pay cuts.

Lib Dem minister Mr Lamb described a situation where there is ‘something of a trade-off between pay and number of staff’ claiming that £18-20bn of efficiency savings were made through wage restrictions in the last government but said the government must keep up with increasing wages in other sectors to ensure people are still attracted to work in the NHS. He said 10 per cent of doctors under 50-years-old want to quit and enrolment onto courses are down by 10 per cent.

Mr Burnham said GPs are being left demoralised and are going abroad. He said: “We have to turn it around and make younger doctors see that they can be involved with integrated care and hospitals to retain GPs and get people to return to the profession.”

Dr Reid blamed an influx of people when there was not an appropriate infrastructure in place to cope with more patients as having led to patients no longer being able to see their family doctor and described having to queue to see her doctors.

Calls for a referendum on tax

An audience member asked if the parties would consider a referendum to let the public decide how much tax is spent on the NHS. Mr Hunt called the General Election the chance for the public to decide how much is spent, highlighting the £8bn pledged to the NHS by the Conservatives that has not been raised through taxes.

Mr Burnham said: “The health budget is £150bn a year and it is time to debate how we find it but we say it will come from the mansion tax. In the end the country must decide on a different way to fund social care and how we will all be cared for in later life.”

UKIP want referendums every two years on topics of local importance and the Lib Dems expressed nervousness about the idea of a referendum on the subject but claimed their idea of a commission to engage the public will be successful.

Mr Lamb claimed a big worry for him in the Conservative plans is that funding is all based on cuts and not taxes on the wealthy, but Mr Hunt said they had successfully found £2bn in the current financial year on the basis of a strong economy.

Equal treatment for mental health patients

An audience member asked how the parties would improve services for mental health patients.

Mr Lamb believes the country is within grasp of genuine equality between mental and physical health services in the five-year period. He said: “We can’t justify how a person who is diagnosed with cancer has a right to be seen within a time frame but a teenager experiencing their first episode of psychosis has no same right.”

Mr Burnham believes improvements for mental health have gone backwards and for children’s mental health in specific the cuts to mental health have to stop. Labour believe people should have the right to counselling and therapy rather than medication and they should have immediate access to therapy such as bereavement counselling.

Mr Hunt said: “There is progress to be made in mental health and it has been underinvested in. We should have an integrated care with a holistic approach, more funding to bring down waiting times and more done to tackle the stigma of mental health . We can be the most stigma-free country.”

The General Election will take place on Thursday 7 May 2015.