What will the Lib Dems and the Tories do on health then?
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First a little bit of good news – there was a high profile mention of old people which didn’t include the usual implication that they are a drain on the rest of us or create only problems which we have to solve – the largest of which is financial, just at the time when finances are at their most parlous for decades.
In his first speech on the steps of Number 10 David Cameron said ‘I want to make sure that my Government always looks after the elderly, the frail, the poorest in our country’. I’m not implying that shows there are clearly deep blue waters separating them from Labour or their coalition partners. Neither of them was likely to say ‘I want to make sure that my Government ignores and abuses the elderly, the frail and the poorest in our country’. But a positive mention was made and more may flow from that.
Both Liberal Democrats and the Conservatives state stoutly that they are in favour of the NHS and waggle their spears at the usual bete noires of management waste. Quangoallergy still exists and it seems it will lead to some chiseling off of various parts of the quangocracy through structural reorganisation.
It is not clear to me where the really fundamental disagreements could occur in welding these unlikely partners together on a health platform. I may be being dim. It happens. Both are concerned to protect and expand front line services – daring to believe this is possible might be naïve, but I’ll go with the 'fingers crossed' school of resource allocation for now. Both mention cancer treatment, mental health care and dementia services but in slightly different ways.
The devil is in the detail and we have no new detail to go on, yet. Some things will surely be shelved or modified, but what, or how isn’t clear – and may not be until the emergency budget or a spending review which takes the new politics into account.
Here’s a silly thing. The Conservatives do not mention alcohol but are a bit worried about obesity and smoking. So if you’re a Tory you could be fat but not drinker or a smoker. The Liberal Democrats do mention excess alcohol as a health issue but aren’t apparently bothered about obesity or smoking. Both are worried about mental ill health. The Tories, unexpectedly and commedably, use a measure of men’s ill health – reduced life expectancy - as an indication of the inequalities in health that still need to be tackled.
Both parties want to rearrange the face of the Department of Health. It must have done something bad in a past life. The Liberal Democrats plan to halve its size, the Conservatives want to change it to the Department of Public Health.
I detect tension in the Conservatives' commitment to respecting the clinical decisions of doctors and nurses whilst also cutting back on the administration managing care. I can see that this may be possible but I can also see that doctors and nurses are at great risk of being squeezed in the middle – expected to meet greater demands, to higher standards but with fewer resources, more management load and consequently less capacity with which to deliver them.
The Liberal Democrats aren't helping. They want to make GPs email accessible, a change which perhaps should not be attempted until progress has been made revolutionising mental health services. Those GPs will need asylum from all those emails.
