By Hugo Greenhalgh on 16 Apr 2015
The language of the manifesto is key to political PR
With three weeks to go till the 2015 General Election, the launch of manifestos allows for some reflection on how far the parties will prioritise the NHS.
It has been portrayed as one of the major issues in this election for some time now, with the key players keen to stress their commitment to the NHS and present themselves as the most capable of handling the UK’s healthcare system.
The Labour Party gave their health manifesto a special launch on Saturday, a clear statement of how highly it ranks in Labour’s priorities and an opportunity to air some of their flagship health policies.
The full manifesto launch took place on Monday in Manchester. The location alone was not insignificant; as well as being a traditional Labour heartland, Manchester has also been thrust into the limelight in a game of political football, following the Coalition’s February announcement of healthcare devolution and a combined health and social care budget of £6 billion. Shadow Health Secretary Andy Burnham has already been quick to criticise these plans as one that “could cause a two-tier service and challenge the notion of a National Health Service”.
As for the Labour manifesto itself, it takes just the second paragraph of Ed Miliband’s foreword for him to reference the “dedicated staff of the NHS” as an integral part of what makes Britain a great country. He also talks up the importance of “rebuilding the NHS”, a barbed dig at the Coalition’s handling of the organisation over the past five years.
After the economy, the NHS is the second chapter in the document, another indicator of its high status. As readers, we are reminded that the NHS was born out of a Labour Government and they are positioning themselves as the only ones who can save it. They will “put patients first” by driving recruitment and increasing investment into the NHS.
However, there continues to be some discord between Labour’s ideas and the ‘Five Year Forward View’, launched in October by NHS English chief executive Simon Stevens. While the manifesto claims they will “create a 21st-century health & care service”, there is no reference to Stevens’ vision. Indeed, just this week Burnham told HSJ that Forward View “leaves many big questions unanswered” and Labour would not be adopting it without considering other “fundamental changes”.
While Labour’s ambitions are at odds with the status quo, the Conservative’s health policies have not been without controversy either. Even the very first line of their manifesto has caused confusion. Their pledge to “provide seven-day a week access to your GP and deliver a truly 7-day NHS”, which was met with much disdain from the healthcare community, appears to either be poorly worded or an overly ambitious measure. Upon questioning, the Party has said that this actually means ‘a GP’ and not that practitioners would have to cancel their weekends. This offers a healthy reminder of the importance of proof-reading and the correct use of the pronoun.
David Cameron’s intro reflects on the achievements of the Coalition but also looks to towards a “better future”. Interestingly, he refers to the “cherished” NHS – a passive word that perhaps says more about how the health service is perceived by the public, rather than his own party’s view of it. While the Hinchingbrooke Hosptial debacle was a lesson learnt the hard way and quells any immediate plans for further privatisation, it seems probable it will be on the Conservative’s long-term agenda in its drive to make the NHS “more efficient”.
The manifesto also includes a pledge to back the Five Year Forward View, with an explicit commitment to spend an additional £8 billion on the NHS by 2020. This figure has already been the source of much discussion. Stevens has stated that the £8bn is essential for the NHS to plug a funding gap by the end of the decade (together with an eye-watering £22bn in ‘efficiency savings’), while Miliband has been more cautious about promising such a high amount and described the Tories’ pledge as funding the service on an “IOU”.
It is important to remember that the promise a manifesto brings and the reality of its implementation are two different things. For instance, the Conservatives pledged to stop closures of A&E and maternity wards in their 2010 manifesto but have seen 14 hospitals have their casualty and maternity units closed, downgraded or still at risk under their watch.
However, the language of the manifesto gives an important insight into the two parties’ plans for the NHS and this will no doubt play a significant factor in the minds of voters who value a healthcare system available to all.