Barring the unexpected, Boris Johnson will be our next Prime Minister. And this matters for all of us concerned about the NHS. Apart from his own priorities, he will bring a new Chancellor, possibly a new Health Secretary in England and, of course, continued uncertainty about Brexit and much else. Niall Dickson, chief executive of the NHS Confederation, reinforces what we need to make sure stays on the political agenda.
We have had a barrage of promises from both leadership candidates which should be treated with the usual caution, but which will at least provide some ammunition in the arguments ahead. Mr Johnson has said he will solve the current NHS pension crisis which is already damaging patient care and looks set to worsen with the growing need for consultants to do more shifts as we move into autumn.
We will continue working behind the scenes on this – with our NHS Employers’ hat we have made some progress under the current administration, but we really do need action from the Treasury to end this mess. A decisive move by the new Prime Minister would not go amiss.
Mr Johnson has also pledged to solve Brexit by the end of October. His appointment obviously makes a no deal more likely – though not inevitable. Almost any outcome is possible including another extension. But the service and industry need to prepare for no deal, and that will present challenges as we have been down this road before with preparations and plans that were never executed. Motivating all the players and getting them to commit time and resources could be harder this time round.
Again, we have been working behind these scenes with the Department of Health and Social Care to make sure other bits of government take the necessary steps to ensure the NHS supply chain.
And we must also prepare for a new round of policy arguments in pursuit of an agreement. The Brexit Health Alliance put forward a set of detailed objectives any deal had to fulfil and, to be fair to Mrs May, every one of them was answered in the current withdrawal agreement and political declaration. The task now is to make sure none of this is lost and indeed that these fine words are converted from shared aspirations into legally binding undertakings.
Meanwhile, there is a major job to be done to convince the new team of the urgent need to tackle the mounting backlog of maintenance and the huge constraints on innovation caused by the failure to invest through capital spending. The blunt reality is that we spend much less on capital than other comparable health systems - for the UK just to reach the OECD average we would almost have to double it. The Health Foundation research presented at Confed19 revealed that NHS trusts in England have suffered a 21 per cent reduction in capital funding in the last eight years. To bring us up to the OECD average would require around £3.5 billion extra next year.
Whether or not we have a new Secretary of State, the Department needs to do everything it can, supported by the two Conservative chairs of NHS England and Improvement, to win this argument, which is critical to the delivery of the Long Term Plan.
The other major area is social care – we have now had a dictionary of warm words from our political leaders on this and more commitments from both candidates. This is a moment for action and we will continue to press through our Health for Care Campaign and its petition which has now attracted more than 150,000 signatures.
Meanwhile the Mental Health Policy Group, which brings together the six leading national organisations in this area, including our Mental Health Network aligning, has written to both leadership contenders urging them to build on the commitments made by their predecessor.
Pressure is not always effective, but this is a moment to try and influence a series of critical policy decisions – not forgetting those around public health and training budgets.
Niall Dickson is chief executive of the NHS Confederation. Follow them on Twitter @NHSC_Niall and @nhsc