Labour's ten-year plan

Ed Miliband

"We will save our NHS"

An at-a-glance guide

The Labour Party's health manifestoand ten-year plan for health and care pledged to:

Funding

  • Invest £12.5 billion in the NHS over the next Parliament from a £2.5 billion a year Time to Care Fund, funded by tackling tax avoidance, a new mansion tax and new levies on tobacco companies.

Efficiencies

  • Save £100 million from scrapping competition laws to invest in better GP access.
  • "Where the NHS owns assets or estate no longer used for health services purposes, ministers should actively seek to achieve value for taxpayer and consider disposal in order to release resources for front line."

Access

  • Guarantee GP appointments within 48 hours and cancer tests results within one week.

Workforce

  • Use the £2.5 billion Time to Care Fund to deliver increases in workforce:
    • 20,000 more nurses
    • 8,000 more GPs, 3,000 more midwives
    • 5,000 more homecare workers to work in integrated care teams
  • Introduce a new compact with NHS staff to support those who care for us and ensure all patients are treated with the highest levels of dignity and respect.
  • Ban zero-hours contracts.

Competition

  • Require all outsourced contracts over a value of £500,000 to include a profit cap, the default level of which will be set at 5 per cent. Commissioners would have the power to lower or raise this to take account of specific issues relating to a particular contract; however, they would have to be able to justify why they have done so.
    • Companies would then have to reimburse the NHS for any returns above the level of the cap – money that could then be put straight back into patient care.
  • Put rules in place to prevent cherry-picking, where providers reject patients with more expensive needs to try to gain larger returns from tariff-funded services.
  • Repeal the Health and Social Care Act 2012, replacing the competition framework with an NHS preferred provider framework, scrapping section 75 and removing  Monitor and the Competition and Markets Authority's roles as economic regulators.
  • Draw a clear distinction between not-for-profit and for-profit providers by giving voluntary sector organisations the benefit of longer and more stable arrangements.
  • Place tougher controls on trusts' ability to earn private patient income (PPI).
  • Ensure the Transatlantic Trade and Investment Partnership (TTIP) agreement cannot impose procurement or competition obligations on the NHS.
  • Extend the Freedom of Information provision to any provider of NHS services.

Payment system

  • Develop a more cost-reflective tariff system to ensure that prices paid better reflect patient complexity. 

Integration

  • “Integration cannot be imposed by top-down edict and timetables. It must be driven at local level and designed around local needs."
  • Labour's ten-year plan has a clear end-point: commissioning for the whole-person, for a single service, on the basis of a single year-of-care budget for those with complex needs. The journey to that end will be determined locally.
  • Develop a year-of-care tariff for those with complex needs, such as frail older people, which will cover all of a person’s care costs over a year. The accountable provider, which will have to pay more if clients deteriorate and need hospital care, will have a stronger incentive to invest in preventing problems.
  • Consult on ways the ambulance service can be better integrated with NHS 111 and GP out-of-hours working towards the vision of 24/7 access to health and care services.

Mental health

  • Ensure that the training of all NHS staff includes mental health.
  • Create a new right to talking therapies in the NHS Constitution.
  • Increase the proportion of the mental health budget spent on children.
  • Ensure that teacher training includes child mental health so that all teachers are equipped to identify, support and refer children with mental health problems.
  • Over the longer-term, the party will work towards further improvements in access to services. In Government, it will set out a strategy and timetable to deliver a waiting-time standard of 28 days for access to talking therapies, for both adults and children, and to ensure that all children have access to school-based counselling or therapy if they need it.

Local structures

  •  Support health and wellbeing boards  to become a vehicle for system leadership.

Role of NICE

  • Set up a wide-ranging review of the National Institute for Health and Care Excellence (NICE), which will look at reforming the NICE technology appraisal process and setting tougher rules on implementing NICE guidance.

Insight

On 27 January 2015, we attended the launch of the Labour Party's ten-year plan for health and care. Below are some insights from a Q&A session with the shadow health secretary, Andy Burnham, after the launch.
  • When asked about who might be the lead accountable care organisation, Andy Burnham said that, while there was a preference for the acute sector (which was still an option) to lead, the Forward view would mean Labour would not impose one specific model of care. He added that he envisaged a role for Monitor in this area.
  • With regard to funding of the Year of Care, Burnham said that the money would flow “as soon as possible” in the new Parliament. He believed that huge savings could be made from the agency bill (£2 billion currently paid to agency staff) and management consultants which had doubled since 2010 (now £650 million).
  • Burnham also said that Labour would not be planning a new national programme for IT.
  • Burnham stressed that he was “absolutely not against personal budgets”.
  • When asked about the future of clinical commissioning groups, Burnham clarified that they would be “here to stay” acting as the executive in function and health and wellbeing boards as non-executives.
  • On the likelihood of future reorganisations, Burnham assured those present that if it felt like a reorganisation then he would have lost. He added that there did need to be a shift from a medical to a social model.
  • Pharmacists and other community service providers would play a larger role in the future system.

Political parties' plans

Find out about ConservativeLiberal Democrat, Green Party, UKIPPlaid Cymru and SNP plans for health and social care.

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