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Saturday 1 October 2016
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Election fever has led to manifesto mania – someone call a doctor

Sick of the election campaign yet?

It's more than possible. This week, the election campaign has intensified around the care of the sick, with an intense row over the targeting of cancer patients and Gordon Brown even launching the Labour party manifesto from a new PFI-funded hospital in Birmingham.

He wasn't the only one in manifesto mood of course – this week all the main parties launched their visions for Britain.

So what do they want to do with primary care?

Many of the aims, if not the means, are very similar. Each party is promising improved access to GPs, and "patient-centred healthcare" seems to be something of a uniform mantra among all parties, with politicians clamouring to "empower" patients and give them greater choice and more rights.

However, there are of course significant differences in how they would reshape general practice infrastructure.

As busy practice managers, you no doubt have far better things to do than read each of the parties' election manifestos. Fortunately, I have read them for you.

Below is a brief summary of each of the main three parties' pledges for primary care development, together with their manifesto healthcare slogans, as well as the response from Dr Hamish Meldrum, Chairman of the BMA.

See below and let us know what you think to these proposals, and who you agree – or disagree – with the most.

Labour – "world-leading healthcare: a patient-centred NHS"

Pledges affecting primary care:

  • Protected NHS spending and a greater move towards preventative care closer to home.
  • Give patients the right to choose a GP in their area (including near their place of work), ensuring access at evenings and weekends, with more services available on the high street.
  • Preventative healthcare through routine check-ups for the over-40s.
  • An "active role" for the independent sector.
  • PCTs to be held more accountable for local services.
  • Ensure "organisational stability" by making no changes to the structure of PCTs or SHAs.
  • Legally binding guarantees for patients, including the right to cancer test results within one week of referral, and a maximum 18 weeks' wait for treatment or the offer of going private.

Labour also says it would "scale down" the NHS IT programme, "saving hundreds of millions of pounds" – the party is committed to delivering up to "£20bn of efficiencies in the frontline NHS."

The manifesto also refers to patients' responsibilities, saying that "patients who fail to turn up for pre-booked appointments will not be guaranteed fast-track treatment."

What the BMA says:

"Patients deserve the right to have prompt treatment, but this must not override clinical priorities. Patients should always be treated on the basis of clinical need and not according to the latest target."

Conservative – "change society, back the NHS"

Pledges affecting primary care:

  • Increased NHS spending in real terms every year.
  • Ensure that every patient can access a GP in their area between 8am and 8pm, seven days a week.
  • GPs given the power to hold budgets and commission care, linking their pay to the quality of their results.
  • Decentralised power designed to "free health professionals from the tangle of politically-motivated targets that get in the way of providing the best care."
  • Detailed data would be published about the performance of healthcare providers so patients can choose the best performer.
  • NHS administration would be cut by a third and resources transferred "to support doctors and nurses on the frontline".
  • Create an independent NHS board to allocate resources and provide commissioning guidelines.

What the BMA says:

"The idea of being able to see a GP from 8am to 8pm, seven days a week, is bound to be popular, and patients deserve good access to GP services, but this shouldn't come at the expense of the quality of a patient's overall care, which is at risk if services become fragmented. It's also a luxury that we may not be able to afford in these financially straightened times."

Liberal Democrats – "your life"

Pledges affecting primary care:

  • Give every patient the right to register with the GP they want without being restricted by where they live, and the right to access their GP by email.
  • Payments linked to elected "local health boards" (which would replace PCTs) and payments linking GPs more directly to prevention measures.
  • Cut the size of the Department of Health by half, abolish Connecting for Health and SHAs, and limit the pay and bonuses of top NHS managers.

In a possible vote-losing sentence for this readership, the Lib Dems say NHS care should be "designed to suit what patients need, not what managers want." They say they would give local people more control over how their health services are run by:

  • Ensuring that local GPs are directly involved in providing out-of-hours care.
  • Reforming payments to GPs so that those who accept patients from areas with the worst health and deprivation scores receive an extra payment for each one they take.

What the BMA says:

"Enabling patients to register with any GP and not be restricted by where they live might seem attractive but there are many practical problems and it is important that continuity and quality of care is not damaged. The proposed system would be very bureaucratic and expensive to run, and a questionable priority during a recession when resources are scarce."

Summary
No doubt the party leaders will expand on these and their other health policies in the upcoming TV debates. Clearly there is a need for greater detail on aspects such as delivering greater access to GPs.

Whatever the outcome on 6 May, general practice looks set to be subject to tough political demands – but then, I hear you exclaim, what else is new?

General Election 2010

Labour Party Manifesto

Conservative Party Manifesto

Liberal Democrat Party Manifesto

What would be your manifesto for general practice? Your comments: (Terms and conditions apply):

"Empower patients to self-help before making an appointment with the doctor! There are numerous remedies available to BUY these days for the run-of-the-mill coughs, colds, headaches, sore throats, indigestion and even itchy bums! (yes, we've all seen the adverts) – the list goes on. These are the types of ailments people are presenting with these days. Or have I just hit the nail on the head?" – Andrea, Practice Manager, Staffordshire