Four healthcare policy areas to watch out for in the new parliament

The 2019 General Election result represents a seismic change to the British political landscape. Boris has got a whacking great majority of 80 MPs. Labour have suffered their worst electoral defeat since the 1930s, and the current Government has a clear mandate to implement their new policy programme.   

Aside from the endless talk of “getting Brexit done” and a potential realignment of traditional party allegiances, the NHS is one of the cornerstones of the Conservative Party’s domestic policy agenda. 

At Onyx Health we’ve been keeping a keen eye on the policy announcements that will have big implications for the pharma and healthcare sectors. We’ve pulled together the four key things we think the sector needs to watch out for in the coming parliament.   

1) The hospital building programme  

The Queens Speech boldly announced that the government will undertake “the biggest, boldest hospital building programme in a generation”¹ as part of the Health Infrastructure Plan. 

What’s the policy?   

• Building 40 new hospitals over the next ten years² – This reaffirms a commitment originally made in their manifesto, which includes six new hospital schemes with an immediate start, and another 21 schemes that have received “the green light”.³ 

What’s the verdict? 

• The devil’s in the detail – The details underlying the headline figure of 40⁴ reveal a more nuanced picture. There is only funding in place for six hospitals with an immediate start. The 21⁵ schemes that have been given “the green light” appear to constitute those that are in the pipeline without having specific funding attached. This still leaves 13 projects unaccounted for. There are significant question marks over how this building programme will pan out in practice.  

2) The NHS “people’s plan”  

One of the most prominent features of the Conservative Party Manifesto was the commitment to invest significant resources to boost NHS staffing levels in various areas.  

What’s the policy?  

This includes commitments to:  

• Recruit 50,000 more nurses, with students receiving a £5,000-£8,000 annual maintenance grant every year during their course to help with their cost of living.⁶ 
• 6,000 more doctors in general practice and 6,000 more primary care professionals.⁷ 
• The introduction of an NHS Visa – Qualified healthcare professional with an offer of work from the NHS will receive reduced visa fees and dedicated support to come to the UK with their families.⁸ 

What’s the verdict?  

• GP numbers cautiously welcomed – The increase in GP numbers has been met with cautious scepticism. Leading NHS figures have pointed out the government’s failure to meet its previous targets⁹, the need to improve retention within the sector¹⁰ and the lack of detail on how the investment will be put in place to make this happen.¹¹ 
• The 50,000 aren’t all new nurses – The overall 50,000 figure includes 19,000 existing staff who the government plans to retain within the service through enhanced pay and career development prospects.¹² This means that only 31,000 of the nurses represent new staff.¹³ 
• The nursing numbers aren’t enough – Analysis by the Kings Fund suggests that 5,000 extra nurses will need to be recruited from overseas to meet staffing requirements, which is substantially more than the Government’s proposals.¹⁴ This may, in part, be expedited by the introduction of the NHS Visa system, however it seems that greater numbers are needed to meet future demands.  

3) The NHS Funding Bill (2019-20) 

The bill applies to NHS England only and has already been put before parliament, receiving its first and second readings.  

This fulfils the Conservative Party Manifesto commitment to “enshrine in law our fully funded, long-term NHS plan”.¹⁵   

What’s the policy? 

• Legally binding funding increases – This will include a £33.9 billion increase in cash terms by 2023/24, with total NHS England spending rising to £148.5 billion in 2024 (this represents a £20.5 billion increase in real terms).¹⁶ 
• A double lock commitment – This constitutes a legally binding requirement on the Secretary of State for Health and Social Care and HM Treasury to honor certain specified levels NHS revenue funding over a four-year period.¹⁷ 
• This must be included in revenue spend and cannot be reallocated to capital spend.   
• No restrictions on how the money is spent – This does not specify how the funding must be spent, these decisions will be made locally by clinicians on the ground. 

What’s the verdict? 

• Legal guarantees aren’t always what they seem – Previous governments have made the decision to enshrine their policy goals in legislation, such as reducing the deficit and leaving the European Union by a certain date. In practice, these dates and commitments were revised in line with changing political circumstances.  
• There’s no reason why this commitment couldn’t be altered at a future date should the economic outlook or the government’s spending priorities change. Moreover, the explanatory notes for the bill confirm that the funding settlement has already been agreed by the Treasury and does not constitute additional expenditure. 
• Staffing shortages could hold things back -The National Audit Office expressed concerns that the funding may not be used to maximum effect due to staffing shortages in the NHS, which will hamper its implementation.¹⁸ 

4) More legislation in the pipeline  

The Queens speech also included new legislative announcements for the coming parliamentary session. 

What’s the policy?  

• Health Service Safety Investigations Bill – This will establish an independent body to investigate serious healthcare incidents in England and wales.¹⁹ 
• This aims to avoid the cost of the Francis Report which examined the Mid–Staffordshire scandal. Health Service Ombudsman found that 40% of NHS investigations, were not adequate at finding out what had happened.²⁰ 
• Medicines and Medical Devices Bill – This aims to ensure that the UK remains at the forefront of the global life sciences industry after Brexit.²¹ This will apply UK wide. Its aims are to: 
• Make it easier for the NHS to trial the most innovative medicines and diagnostic devices; and 
• Establish the UK to be a world leader in the licensing and regulation of innovative medicines and devices.²² 

What’s the verdict? 

• Avoiding Francis Report mark two will potentially save the government time, money and embarrassment – This could be a useful way to introduce greater accountability and scrutiny into the system in the wake of the Mid Staffordshire scandal.  
• The global competitiveness of the UK medicines and devices industry will be a big post Brexit issue – This could have potential benefits for drug and medical device manufacturing and its details should be closely monitor when then bill is putting before parliament later in the year.