Comments on the health and care pledges within the Conservative Party's manifesto from Sarah Woolnough, Chief Executive of The King's Fund.
On bolstering primary and community care, Sarah said:
‘A key component of the health and care policies in the Conservative manifesto is the aim of shifting more care into the community, which will help to diagnose illnesses earlier, support people to manage their conditions, and help reduce pressure in the NHS. This is the right direction of travel, but the specific actions in the manifesto to achieve this shift fall short of the challenge.
‘Building 100 new GP surgeries and modernising an additional 150 would be good news for some patients but is a drop in the ocean of what is needed to improve access in primary care. There are 6,300 GP surgeries across England, down from 7,600 in 2015, and the number of fully trained, full-time equivalent GPs has fallen by 1,800 from 29,400 in September 2015 to 27,600 in April 2024.
Commenting on the other NHS pledges within the manifesto, Sarah said:
‘Elsewhere, the manifesto includes some positive health and care policies such as more community diagnostic centres, re-committing to delivering the New Hospital Programme, and ramping up productivity. The pledge that the NHS will be meeting all waiting time standards by the end of the next parliament is certainly ambitious, but the manifesto lacks detail on how this monumental task would be achieved.
‘Overall, the NHS pledges in the Conservative manifesto are a welcome collection of initiatives, but they don't add up to the transformational change needed to improve performance and reverse the downward trend of public satisfaction in the NHS.
On funding the health and care policies, Sarah said:
‘Funding some of these pledges by cutting the number of NHS managers risks cutting your nose off to spite your face. The NHS already has a lower ratio of managers compared to other industries. Achieving an efficient and productive health service requires experts who can streamline processes and create the environments for clinicians to focus on what they do best - delivering patient care.
‘Public polling shows some support for raising taxes to spend on the NHS. The latest British Social Attitudes survey found that, when asked about government choices on tax and spending in the NHS, 48% chose ‘increase taxes and spend more on the NHS', 42% chose ‘keep taxes and spending the same', while only 6% chose ‘reduce taxes and spend less on the NHS'.
On the re-commitment to the Tobacco and Vapes Bill, Sarah said:
‘Perhaps the most consequential health pledge in this manifesto is the welcome re-commitment to introduce a phased smoking ban. The smoke-free generation law would be a real game changer for the nation's health.
On immigration policy, Sarah said:
‘Since its founding in 1948, the NHS has relied on overseas recruits to staff services and the same is now true for social care. A healthy pipeline of homegrown staff would be more sustainable and secure, but until NHS England's workforce plan starts to bear fruit, and until there is a workforce plan for social care, services will continue to rely on international recruits and attempts to curb overseas recruitment could impact patient care.
On social care reforms, Sarah said:
‘The social care system is under intense pressure with care providers close to financial collapse, a workforce crisis, and too many people's care needs going unmet. It is positive to see a re-commitment to much-needed social care reform with the October 2025 roll out of a cap on the lifetime care costs a person has to pay, as the government has previously promised. To meet that challenging deadline for implementation, there will need to be sufficient local authority funding and capacity to get the reforms off the ground.'
Notes to editors
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The King's Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible health and care is available to all.