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Mental health ‘at risk of being crowded out’ during election debate

Paul Burstow, Senior Adviser

Attention-seeking parties competing in the general election will prioritise some, but not all, aspects of health and social care, writes Paul Burstow.

The general election is in full swing and all the parties are competing for attention and airtime. But what part will health play in the election?

Manifestos are yet to be published. But the battle lines are already being drawn. The competition boils down to how much more each party will spend day to day on healthcare and invest in new facilities and hospitals. Workforce has also featured with talk of more GPs and reinstating bursaries.

So far there has been far less said about plans for reforming social care in England. There are at least three questions that need to be answered: how much the current system is underfunded by, how much more would need to be spent to pay for a better system, and finally who pays and how?

Social care reform is the tin can that has been kicked down the road for 30 years or more. It is more than care for older people, it matters to people of all ages

Spate of retail pledges

In the 2010 and 2017 general elections, social care became a flash point in the campaign, with talk of death taxes and dementia taxes. With dementia such a big issue for families and the health issue that most worries people in their 50s it is hard to imagine that “fixing” social care won’t force its way into the election.

Mental Health featured prominently in the 2015 general election and over the last decade changing public attitudes and awareness has kept it high on political agendas. Mental health could be at risk of being crowded out this time. We’ve already seen a spate of “retail” pledges; from hospital building to regulation of the pharmaceutical industry, dominate the campaign.

In a pre-emptive strike the chief executive of NHS Providers, Chris Hopson, warned parties not to weaponise the NHS and called for a proper debate about what is needed in our NHS.

Unlike the 2015 and 2017 general elections, health is no longer the top issue

But polling from MHP Communications has found that these announcements are popular with the public, so the reductive campaigning style that characterises general election campaigns may continue for another four weeks.

Unlike the 2015 and 2017 general elections, health is no longer the top issue. Brexit is THE issue according to the polls. But that does not mean that Party campaigns won’t try to link Brexit and the NHS, they will! Much heat will be generated, and many claims and counter claims made.

Health to be on GE’s list

Taking a step back for a moment there are some clear global trends in the development of healthcare systems that it seems unlikely will be overturned regardless of the result. But they deserve proper debate and scrutiny.

For example, the emphasis on integration around the person, at place and at system levels will remain. Personalisation of healthcare, shared decision-making, social prescribing, supported self-care are here to stay.

Planning, designing and delivering healthcare at the scale of neighbourhood and place will stay too. It is also hard to see less emphasis being placed on system level collaboration to understand and act on the drivers of population health.

The language to describe these things, the level of central government prescription and local autonomy may vary but the direction of travel won’t.

Such a debate needs to consider whether each party’s overall policy mix will produce an environment conducive to wellness and wellbeing. With as much as 80 to 90 per cent of our health status shaped by factors other than access to health services – education, housing, income and so on – the health debate must be bigger than the NHS.

This article was first published on HSJ