Devolved Elections: Health and Social Care Decisions

On Thursday 5th May 2016 voters across the UK will be heading to the polling stations for the numerous elections that are taking place, from elections for Mayor of London and the London Assembly, to the elections for the Scottish Parliament, the Welsh Assembly, the Northern Ireland Assembly, two parliamentary by-elections in Ogmore (Wales) and Sheffield Brightside, elections for Police and Crime Commissioners across England, and 124 local elections up and down the country.

For health and social care in particular however, the Scottish and Welsh elections could have real impact on services.

In 2006, the National Assembly for Wales was given the power to legislate in a range of areas including health and health services.

In Scotland, voters will be electing Members of the Scottish Parliament (MSPs) and health and social services are also devolved matters. This means, the election outcome in both Wales and Scotland will have an impact on how services are run and what issues are prioritised. So, what is each party offering and what are the likely outcomes?

Wales

In Wales, the elections have seen 17 consecutive years of Labour rule. The Party has been attacked by all their opponents specifically on their health record. Labour is accused of record-breaking budget cuts, longer waiting times and hospital downgrading across Wales. So what solutions are the other parties offering?

The Welsh Conservatives are promising no more cuts or closures and to better support elderly care, by pledging a real terms increase in NHS expenditure every year for five years, they would also cap weekly care costs and protect up to £100,000 of assets should an individual move into residential care.

Plaid Cymru, the national party of Wales, have put early diagnosis of cancer at the top of their agenda, and would also reduce waiting times by training and recruiting 1,000 extra doctors and 5,000 nurses. Importantly, they would shake up the NHS by integrating primary, adult social care and primary care into a new community NHS.

The Welsh Liberal Democrats have pledged to increase the number of nurses in hospital wards, improve access to GPs and establish and NHS commission to review the future of health services.

UKIP (who are likely to gain seats in South West Wales) would assign an individual nurse to everyone given a cancer diagnosis, and would look to implement local elected health boards, improve ambulance waiting areas and recruitment of NHS staff.

Labour’s own pledges are a new fund for life-threatening illnesses, improving diagnostic rates and advocate health and social care integration.

As it stands, Wales is likely to have a Labour-led coalition government or a Labour minority government by Friday (the loss of a single seat would mean they were in a minority). A coalition would likely be with Plaid Cymru (although they would need to agree on a controversial M4 road proposal first). From a health and social care perspective, a coalition Government where Plaid’s community NHS plan which chimes in with Labour’s pledge for health and social care integration is implemented, could really change the way health and social care services are provided at the community level.

Regardless, having suffered so much criticism, Labour will likely put their efforts towards improving their poor health record in the coming term even if they govern as a minority, as they could otherwise face defeat in the following election if Welsh voters still feel that they are receiving health and social care services that are of a lesser standard than their English and Scottish counterparts.

Scotland

In Scotland, the picture is slightly different, with the Scottish National Party (SNP) coming in to the elections with a slim majority, and their work on health and social care has not been criticised as Labour’s has in Wales - but this doesn’t mean health has not featured strongly throughout the election campaign.

The Scottish Conservatives said they would prioritise investment in the NHS but would reintroduce prescription charges, which they claim would raise £65m by the end of the Parliament.

Scottish Labour would use the new powers of the Scottish Parliament to protect the NHS budget, would guarantee an appointment at a GP surgery within 48hrs and would extend the minor ailment service in community pharmacies. Importantly, the party also pledged it would guarantee social care packages are put in place within a week for those who need them.

The Scottish Liberal Democrats pledged to recruit, train and retain more GPs and increase the proportion of NHS funding allocated to primary care.

At the moment, all of the polling data indicates that the SNP are likely to win another overall majority with increased support, while Labour will be hoping to recover some seats but face one of the worst results in recent time. From a health and social care perspective, the likely SNP win mean a reshaping of the NHS to include an increase in NHS revenue budget by £500 more than inflation by the end of this parliament including £1.3bn in health and social care partnerships, reforming primary care and increasing the numbers of GPs.

As we know from last year’s General Elections, it’s not as easy to predict outcomes as we once thought, so I’ll be watching the election closely, the results are bound to have a huge impact on health and social care in Wales and Scotland for years to come.