UK Elections: Health

Facts

• Overview: The National Health Service (NHS), established in July 1948, offers free at the point of use medical care. Post-devolution, UK state-funded health care is divided by region into NHS England, NHS Wales, NHS Scotland, and the Health and Social Care Services in Northern Ireland. NHS England employs approximately 1.5M individuals, not including nearly 150K full-time equivalent staff in general practice, and over 24K dentists. According to the latest Office for National Statistics (ONS) data, total UK expenditure on health care in 2023 was approximately £292B ($372B), representing 10.9% of GDP. Health care spending grew 5.6% nominally but decreased by 1.4% after inflation adjustment from the year prior.¹
• Overview: The National Health Service (NHS), established in July 1948, offers free at the point of use medical care. Post-devolution, UK state-funded health care is divided by region into NHS England, NHS Wales, NHS Scotland, and the Health and Social Care Services in Northern Ireland. NHS England employs approximately 1.5M individuals, not including nearly 150K full-time equivalent staff in general practice, and over 24K dentists. According to the latest Office for National Statistics (ONS) data, total UK expenditure on health care in 2023 was approximately £292B ($372B), representing 10.9% of GDP. Health care spending grew 5.6% nominally but decreased by 1.4% after inflation adjustment from the year prior.²
• Overview: The National Health Service (NHS), established in July 1948, offers free at the point of use medical care. Post-devolution, UK state-funded health care is divided by region into NHS England, NHS Wales, NHS Scotland, and the Health and Social Care Services in Northern Ireland. NHS England employs approximately 1.5M individuals, not including nearly 150K full-time equivalent staff in general practice, and over 24K dentists. According to the latest Office for National Statistics (ONS) data, total UK expenditure on health care in 2023 was approximately £292B ($372B), representing 10.9% of GDP. Health care spending grew 5.6% nominally but decreased by 1.4% after inflation adjustment from the year prior.³
• Current state: In April 2024, 74.4% of patients were admitted, transferred or discharged within four hours of arriving at A&E, down from 82.8% pre-pandemic, 93.4% in June 2015, and 97.2% in August 2010. As of March 2023, there were roughly 7.5M waits for procedures and appointments in the UK, with 6.3M waiting for care in England. In comparison, the waiting list was 4.6M pre-pandemic, 3.4M in June 2015, and 2.7M in August 2010. Ambulance services currently handle 24.4K emergency calls daily, with an average response time of 30 min 22 sec.⁴
• Current state: In April 2024, 74.4% of patients were admitted, transferred or discharged within four hours of arriving at A&E, down from 82.8% pre-pandemic, 93.4% in June 2015, and 97.2% in August 2010. As of March 2023, there were roughly 7.5M waits for procedures and appointments in the UK, with 6.3M waiting for care in England. In comparison, the waiting list was 4.6M pre-pandemic, 3.4M in June 2015, and 2.7M in August 2010. Ambulance services currently handle 24.4K emergency calls daily, with an average response time of 30 min 22 sec.⁵
• Current state: In April 2024, 74.4% of patients were admitted, transferred or discharged within four hours of arriving at A&E, down from 82.8% pre-pandemic, 93.4% in June 2015, and 97.2% in August 2010. As of March 2023, there were roughly 7.5M waits for procedures and appointments in the UK, with 6.3M waiting for care in England. In comparison, the waiting list was 4.6M pre-pandemic, 3.4M in June 2015, and 2.7M in August 2010. Ambulance services currently handle 24.4K emergency calls daily, with an average response time of 30 min 22 sec.⁶
• Health as an election issue: According to YouGov, as of June 24, 50% of UK adults see health as an important issue facing the UK, second only to the economy (54%). In comparison, June's Ipsos Issues Index places health as the most important issue at 41%, followed by the economy (33%), and immigration (30%). This statistic is reduced to 40% among Conservative supporters, while rising to 50% among Labour supporters.⁷
• Health as an election issue: According to YouGov, as of June 24, 50% of UK adults see health as an important issue facing the UK, second only to the economy (54%). In comparison, June's Ipsos Issues Index places health as the most important issue at 41%, followed by the economy (33%), and immigration (30%). This statistic is reduced to 40% among Conservative supporters, while rising to 50% among Labour supporters.⁸
• Conservative pledges: The UK Government's NHS England mandate, last updated in March 2024, outlines three key priorities. The first is to cut waiting lists and 'recover performance.' This includes aiming for 95% of patients needing diagnostic tests to receive care within six weeks by March 2025, and the failed target to discharge 76% of admitted A&E patients within four hours by March 2024. The second priority is to implement the NHS Long Term Workforce Plan, adding 15K new medical school training places and increasing GP and adult nursing training places by 50% by 2031/32. In tandem, the party’s manifesto announced an intention to “cut waste and bureaucracy,” reducing NHS managers by 5.5K. The third priority is to 'deliver recovery' via data and technology, aiming for 95% of NHS and foundation trusts to have electronic health records by March 2025 and updating the NHS App. The party also intends to implement a smoking ban for those born after Jan. 1, 2009.⁹
• Conservative pledges: The UK Government's NHS England mandate, last updated in March 2024, outlines three key priorities. The first is to cut waiting lists and 'recover performance.' This includes aiming for 95% of patients needing diagnostic tests to receive care within six weeks by March 2025, and the failed target to discharge 76% of admitted A&E patients within four hours by March 2024. The second priority is to implement the NHS Long Term Workforce Plan, adding 15K new medical school training places and increasing GP and adult nursing training places by 50% by 2031/32. In tandem, the party’s manifesto announced an intention to “cut waste and bureaucracy,” reducing NHS managers by 5.5K. The third priority is to 'deliver recovery' via data and technology, aiming for 95% of NHS and foundation trusts to have electronic health records by March 2025 and updating the NHS App. The party also intends to implement a smoking ban for those born after Jan. 1, 2009.¹⁰
• Conservative pledges: The UK Government's NHS England mandate, last updated in March 2024, outlines three key priorities. The first is to cut waiting lists and 'recover performance.' This includes aiming for 95% of patients needing diagnostic tests to receive care within six weeks by March 2025, and the failed target to discharge 76% of admitted A&E patients within four hours by March 2024. The second priority is to implement the NHS Long Term Workforce Plan, adding 15K new medical school training places and increasing GP and adult nursing training places by 50% by 2031/32. In tandem, the party’s manifesto announced an intention to “cut waste and bureaucracy,” reducing NHS managers by 5.5K. The third priority is to 'deliver recovery' via data and technology, aiming for 95% of NHS and foundation trusts to have electronic health records by March 2025 and updating the NHS App. The party also intends to implement a smoking ban for those born after Jan. 1, 2009.¹¹
• Labour pledges: Labour's 'first steps for change' include cutting NHS waiting lists by adding 40K more evening and weekend appointments each week and increasing dental appointments by 700K annually. The party has promised to reform primary and social care by increasing the role of local community health providers and opening new referral routes. They plan to increase medical school places by 7.5K and nursing and midwifery placements by 10K annually. New jobs and placements, including 'thousands' of mental health staff, will be funded by scrapping non-dom tax status. Labour also pledges to implement a 'revolution in technology' using artificial intelligence, and to end 'unnecessary bureaucracy' in clinical trials.¹²
• Labour pledges: Labour's 'first steps for change' include cutting NHS waiting lists by adding 40K more evening and weekend appointments each week and increasing dental appointments by 700K annually. The party has promised to reform primary and social care by increasing the role of local community health providers and opening new referral routes. They plan to increase medical school places by 7.5K and nursing and midwifery placements by 10K annually. New jobs and placements, including 'thousands' of mental health staff, will be funded by scrapping non-dom tax status. Labour also pledges to implement a 'revolution in technology' using artificial intelligence, and to end 'unnecessary bureaucracy' in clinical trials.¹³
• Reform UK pledges: Reform plans to exempt all frontline NHS and social care staff from the basic tax rate for three years. They will use independent UK and overseas health providers to cut waiting lists. Private health care and insurance will see a 20% tax relief to ease NHS pressure. Training caps for UK medical students will be scrapped, and student fees pro rata per year will be written off over 10 years. Patients unable to see their GP within three days will receive a voucher, and a public inquiry will be held into excess deaths and vaccine harms. Reform estimates that their NHS pledges will cost the UK approximately £17B ($22B) a year.¹⁴
• Liberal Democrats pledges: The Lib Dems promise to create 8K more GPs and give every individual the right to see a practitioner within seven days or 24 hours if urgent. Prescription rights and public health advisory powers will be expanded for qualified pharmacists, nurse practitioners, and paramedics to free up GP time. They guarantee urgent access to NHS dentists and commit to establishing mental health hubs for young people in every community, extending the youth service age limit to 25. All cancer patients will start treatment within 62 days from urgent referral, and a Cancer Survival Research Act will mandate government coordination and funding for cancers with the lowest survival rates.¹⁵

Sources: ¹ons.gov.uk, ²Full Fact, ³kingsfund.org, ⁴Bma, ⁵England, ⁶Nuffield Trust, ⁷ipsos.com, ⁸yougov.co.uk, ⁹gov.uk, ¹⁰healthmedia.blog.gov.uk, ¹¹public.conservatives.com, ¹²labour.org.uk, ¹³The Labour Party, ¹⁴assets.nationbuilder.com and ¹⁵Libdems.

Narratives

• Tory narrative, as provided by telegraph.co.uk. Labour will inevitably use the NHS as a platform to attack the Tories, but this won't solve the system's underlying rot. The government has only ever increased health expenditure during their tenure, and the impact of COVID was destined to cripple the service irrespective of party politics. Labour's policies are broad, vague, and don't even begin to solve the NHS's issues — Starmer isn't the man to fix this crisis.
• Labour narrative, as provided by The Mirror. Starmer's plan to tackle the NHS backlog provides hope that the health system can once again function effectively if given the right attention. Once the pride of the nation, the service has been crippled under Tory governance. Labour has a track record of looking after the NHS, and Starmer is determined to make sure his party will be no different when in government.
• Reform narrative, as provided by GB News. Hysteria over privatization of the NHS has long held the UK's health sector hostage. Decades of fear-mongering mean that reasonable solutions that have been adopted successfully by a multitude of developed countries have been rejected in favor of ideology and tribalism. Whether Labour or the Conservatives win the election, an immediate and radical conversation must be had over increasing NHS private sector capacity.
• Progressive narrative, as provided by Socialist Worker. Neither the Tories nor Labour can be trusted to ensure workers who dedicate their lives to public health services are paid fairly for their vital contributions. With both major parties publicly opposed to NHS strikes, it is more important than ever that the entire public workforce comes together and compels the political elite to recognize the immense value that they bring to the country.