Nuffield Trust responds to the Liberal Democrats' manifesto

The Nuffield Trust respond to the Liberal Democrats' General Election manifesto.

Press release

Published: 15/04/2015

Responding to the Liberal Democrats' General Election manifesto, Nuffield Trust Chief Executive Nigel Edwards said: 

Taken with the party’s welcome commitment to increase funding on the NHS by a total of £8bn by 2020 and their ambitious pledges on public health, the manifesto sets an encouraging tone for how the NHS and social care will be treated in any coalition negotiations. 

Nigel Edwards, Chief Executive

“The Liberal Democrat manifesto underlines the party’s commitment to preventing ill health, improving mental health and developing better care out of hospital. 

“Taken with the party’s welcome commitment to increase funding on the NHS by a total of £8bn by 2020 and their ambitious pledges on public health, the manifesto sets an encouraging tone for how the NHS and social care will be treated in any coalition negotiations.  

“We also strongly endorse the proposal that the Liberal Democrats will ensure that targets in the NHS are evidence-based and do not distort clinical priorities. We have raised concern about how the four-hour A&E target can distort behaviours inside hospitals in a way that is not in the interest of patients or staff.   

“But despite the funding increase, it is regrettable that the party’s own detailed funding plans suggest that the majority of this £8bn will not come on-stream until halfway through the parliament. Moreover, there remain big unanswered questions over how feasible it is to expect £8bn to pay for all the additional proposals in the manifesto.

“No mention is made of the significant efficiency savings of 2-3% per year outlined in NHS England’s Five Year Forward View to fill the NHS funding gap by 2020. Indeed the Forward View’s proposals to transform the NHS are not explicitly discussed in the manifesto, which is disappointing. The NHS will already be straining for an unprecedented £22bn of efficiencies exactly when the Liberal Democrats wish to invest in mental health, end of life care and avoiding hospital admissions. Yet evidence that investment in these interventions saves money in the short-term is limited. 

“The party’s extremely ambitious plan to pool all health and social care budgets by 2018 is concerning when we don’t know the outcome of Manchester’s experiment. While ending the fragmentation between these two services is the right aim, pooling these budgets across the country is fraught with difficulty and would make it hard to guarantee the £8bn the NHS needs as a minimum to break even. 

“The manifesto contains no discussion of further funding for social care, which has already experienced deep cuts since 2010. So the party is right to call for a Fundamental Review of NHS and social care funding this year.”

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