Intended for healthcare professionals


Manifesto promises on health and social care

BMJ 2019; 367 doi: (Published 03 December 2019) Cite this as: BMJ 2019;367:l6773
  1. Hugh Alderwick, assistant director
  1. Health Foundation, London, UK
  1. Hugh.Alderwick{at}

More delay on social care would prolong major public policy failure

In an election that was supposed to be about Brexit, the NHS has taken centre stage. Politicians have pledged more cash, more doctors and nurses, and millions more general practice appointments. But what do the promises add up to? The parties’ manifestos give us a clearer picture of what—beyond the campaign rhetoric—a new government might mean for health and care in England.

Overall investment promised by the three main parties varies. Labour is most generous—committing to 4.3% real terms annual increases in the Department of Health and Social Care’s budget over the parliament. The Conservatives promise least (3.1%), and the Liberal Democrats fall somewhere in between (3.8%). These differences will shape what the health system can offer. Independent estimates suggest that maintaining current standards of care will require spending increases of around 3.4% a year,1 while 4.1% is needed to improve care in the way described in the NHS long term plan.2

Some parts of the health budget will fare worse than others. The public health grant—covering sexual health, children’s …

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