The health service barely rated a mention in the recent C4 and ITV leadership debates, with each candidate carefully skirting around any mention of the NHS or social care. No bragging this time about the 40 new hospitals, the 6,000 extra GPs or the 50,000 new nurses that have long been a part of Johnson-era Tory messaging.
And given the electorate the candidates were targeting – currently just their own party’s MPs, but soon set to include the wider Conservative Party membership (older, more affluent and more middle class than the rest of the UK population) – it’s unlikely they’ll be any more forthcoming on such a politically sensitive topic.
But during the C4 and ITV debates what actions, if any, have the remaining four candidates actually committed to on health-related matters, and how have they voted on such issues in the past? Let’s take a look.
Badenoch did her best to stick to the party line during the debates, but admitted the NHS was in crisis, admitting that she struggled to find a dentist in recent months to fix a chipped tooth.
She didn’t directly address her plans for health and social care in her campaign launch speech in the days leading up to the debates, but gave a hint earlier this year when she dismissed evidence of a care funding crisis for councils, telling a Commons committee, “We think the funding is at the right amount.”
Badenoch’s parliamentary voting record shows she has consistently voted for reducing central government funding of local government, and that she has never rebelled against her party in the current parliament.
The foreign secretary made no concrete policy announcements during the debates, save for repeating her pledge to scrap the proposed health and social care National Insurance levy, a tax designed to improve social care and to help the NHS deal with the backlog of patients waiting for treatment following the pandemic.
Truss has notably claimed that the NHS “remains off the table” in any post-Brexit trade deals, but her voting record suggests a more questionable approach to healthcare: in the House of Commons she has consistently voted against paying higher benefits over longer periods for those unable to work due to illness or disability, and has almost always voted against restricting the provision of services to private patients by the NHS. Truss has never rebelled against her party in the current parliament.
The minister of state for trade policy’s leadership campaign launch video had to be edited a couple of times – most notably for mistakenly featuring a scene from a Spanish hospital instead of an NHS site – but Mordaunt’s campaign did include at least one policy innovation, albeit one unlikely to have an immediate impact: the establishment of a taskforce to address the ‘paralysis’ in accessing NHS services. Quite how the recommendations of that taskforce would be paid for is unclear, though, because – like most of the other candidates in the debate – she is likely to abandon the health and social care NI levy if elected prime minister, according to the Sun.
Other policy innovations featuring in the Portsmouth North MP’s campaign are equally less than impressive, not least her slightly inane claim that medical innovations were rarely used in the NHS – a claim which has sparked ridicule in the medical profession.
Centralised lists of GPs and dentists – another Mordaunt idea, and one she promoted during the TV debates – so that patients having difficulty getting a local appointment can look further afield, sounds sensible but fails to acknowledge a supply crisis that is national in scale.
More radically, perhaps, Mordaunt could have pushed the practice of homeopathy, which she has advocated for more than a decade. Although it didn’t feature during her debate presentations this month, as long ago as 2010 the MP supported an early day motion in the House of Commons criticising the BMA for voting to withdraw NHS support for homeopathy.
On the question of privatisation, Mordaunt seems to be on firmer ground ethically, telling campaigners in Portsmouth last September that the principles of the NHS “would not be up for grabs”. More worrying, perhaps, is her opposition to mandatory covid jabs for health and social care workers, and the black marks on her recent Commons voting record.
She has voted against smoking bans, always voted to reduce central government funding of local government, and consistently voted against restricting the provision of services to private patients by the NHS.
The chancellor made no specific new commitments regarding health and social care during the two debates, but was of course keen to stress that the country could trust him to look after the NHS – citing his determination to stick with the health and social care NI levy (which he introduced) and to resist the politically expedient option of cutting taxes, at least in the short term.
But despite his obvious pride in his parents’ careers (his father was a GP and his mother was a pharmacist) and his promise that as prime minister he would “focus a lot on improving the outcome of public services”, Sunak’s voting record betrays a similar cynicism to that of his rivals in the debates.
He has consistently voted for reducing central government funding of local government, consistently voted against paying higher benefits over longer periods for those unable to work due to illness or disability, and consistently voted for a reduction in spending on welfare benefits.
The defining message from the TV debates – bar Rishi Sunak’s lone stand – was that more tax cuts were needed, disregarding their potential impact on the NHS, and it was sobering to note that none of the participants in the C4 debate even mentioned the health service in their closing statements.
Before the debates, the 11 candidates initially involved collectively announced £330bn in tax cuts, more than the entire NHS budget, according to the Labour Party. As some commentators have suggested, these cuts must either be met by increased borrowing – unlikely to happen under a Sunak administration – or be matched by reductions in spending on public services.
But with nine out of ten NHS leaders saying their efforts to reduce waiting lists are already being hindered by a lack of investment in buildings, a workforce in crisis and a failure to ensure that social care is appropriately supported, the remaining leadership candidates must surely adopt a more realistic approach to the nation’s health.
As NHS Confederation chief executive Matthew Taylor said after the second TV debate, “What the NHS and the public really need from politicians right now is a realism reset and a promise to level honestly with them.
“We need a proper acknowledgement of where the last 10 years of austerity have left the NHS… That honesty means [acknowledging] the crumbling buildings and ill-equipped and outdated estate, 105,000 staff vacancies at the last count, and a social care system in desperate need of repair and very far from being fixed.”
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