Intended for healthcare professionals


What does Boris Johnson’s victory mean for the NHS?

BMJ 2019; 367 doi: (Published 17 December 2019) Cite this as: BMJ 2019;367:l7001
  1. Martin McKee, professor of European public health
  1. London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
  1. Martin.McKee{at}

Don’t look to the manifesto for answers

It’s always difficult to predict what a new government will do. The 2012 NHS reorganisation, arguably the largest change since 1948, came as a surprise to many. But this time predictions are especially difficult, for three reasons. First, even before the election, the prime minister’s promises were demonstrably false. He will not get Brexit done, at least not in the way that he claims—with a tariff and quota-free trade agreement with the EU—by the end of 2020. The government will not build 40 new hospitals.1 And the promised 50 000 new nurses include 19 000 already in post.2

Second, the Brexit process will continue to dominate the machinery of government for several years, leaving little space for anything else.3

Third, the Conservative parliamentary party in 2020 will be radically different from that of 2019. Political parties do change, sometimes dramatically, even if the names stay the same. Harold Macmillan would later condemn Margaret Thatcher’s programme of privatisation as “selling the family silver.” Under Jeremy Corbyn “Blairite” …

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