"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan

Thursday, 14 January 2010

Conservative Draft Manifesto 2010: Dissection Part 13

An analysis of the Conservative Draft Manifesto 2010.

"we will weight public health funding so that extra resources go to the poorest areas with the worst health outcomes through a new 'health premium'."

One of the most important principles of the NHS is that care is given according to clinical need. When you abide by that principle, it also means that you have to target resources at the places with the most healthcare need. While poverty often means less healthy, the cause is a public health issue: eat more healthily, take more exercise.

It is internationally accepted that most healthcare resources are used in the last five years of life - regardless of age at death. It makes sense to target resources at the areas of need and conversely, affluent areas often have a higher proportion of the elderly than deprived areas, and so this means that they may actually need more NHS funding. Targeting poorest areas for acute NHS funding (as opposed to public health funding) necessarily means reducing the acute NHS funding to other areas and this may well mean reducing the funding to the areas that actually need the funding.

The problem with this policy is that it is misplaced. Funding should be targeted at the areas with the most need, and not to areas which are chosen for political purposes. One of the principles of the NHS is that healthcare should be according to clinical need, and this Conservative policy shows that it pays no attention to that principle.

This policy looks like a headline grabbing policy with not much thought behind it.

"In the long run, we will introduce a new per-patient funding system for all hospices and other providers of palliative care so that proper support for sick children and adults can continue."

Palliative care is a huge issue and there needs to be a lot more thinking in this area. End of life care is an emotive issue and it has knock-on effects to other NHS services, for example, the availability of beds in hospitals.

The 2009 Conservative health policy document does not have any details about this policy so it is unclear what is actually planned.

"[we will] give patients with chronic illnesses or a long-term condition access to a single budget that combines their health and social care funding which they can tailor to their own needs."

This policy was discussed in the Darzi Report ("High Quality Care for All" and "Personal Health Budgets: First Steps"). Clearly it is a Labour policy in progress, and yet another policy that David Cameron intends to take as his own with no acknowledgement of the origin.

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