The leading preventative healthcare testing organisation London Medical Laboratory has scrutinised the details of the two main national parties’ policies on preventative health measures and community healthcare plans.
The Labour and Conservative parties have now both released their general election manifestos. Both contain plans for healthcare reforms. A leading expert says there is something to commend in both, but there are also questions that need answering.
Dr Avinash Hari Narayanan (MBChB), Clinical Lead at London Medical Laboratory, says: ‘While both parties do address many of the issues facing healthcare in England, the fact is that for the last two years, Government healthcare spending has gone down in real terms when adjusted for inflation. Reform is needed urgently, and when we look at both manifestos, the devil really is in the detail.
Labour Manifesto
‘Labour’s manifesto, released today, pledges to cut the NHS waiting list with 40,000 more appointments each week, during evenings and weekends, paid for by cracking down on tax avoidance and non-dom loopholes. It also promises the ‘Return of the family doctor’.
‘We agree entirely with its policy to “shift our NHS away from a model geared towards late diagnosis and treatment, to a model where more services are delivered in local communities”. It’s important that the manifesto says Labour will “embed a greater focus on prevention throughout the entire healthcare system and supporting services”.
‘How Labour undertakes these measures remains to be seen, however. It says the 40,000 additional appointments a week will be achieved by “incentivising staff to carry out additional appointments out of hours.” The fact is, NHS workers, just like staff at local clinics and pharmacies, already work long hours and that includes significant amounts of overtime. Healthcare is not a 9-5 job. Those incentives need to include appropriate compensation, maintaining healthy staffing levels or expanding staffing numbers without overstretching and burning out the current workforce.
‘Its manifesto also says: “Labour will use spare capacity in the independent sector to ensure patients are diagnosed and treated more quickly.” There is an important role that private sector healthcare providers, including private clinics and laboratories, can play in contributing to local health reforms. However, this will not be an overnight fix and needs to be carefully planned. Private health is a controversial topic for both Rishi Sunak and Keir Starmer. However, true leadership requires an ability to leverage private health to break the deadlock in NHS service provision.
‘Crucially, its manifesto says: “Labour will also take the pressure off GP surgeries, by improving access to services and treatment through new routes. We will create a Community Pharmacist Prescribing Service, granting more pharmacists independent prescribing rights where clinically appropriate.”
‘That is an excellent policy. Pharmacies should be empowered to offer many more services, including menopause support and treatment for certain infections. They should also be able to increase specialist services such as finger-prick blood tests to identify a range of conditions.
‘However, many community pharmacies say that they are receiving insufficient renumeration for new services at a time when they are increasingly stretched. According to analysis from the National Pharmacy Association, 177 pharmacies closed between January and April 2024, compared to 116 in the same period in 2023, making this the equivalent of 10 local pharmacies closing their doors every week on average so far this year. Adding to their workload without sufficient renumeration will increase the number of “pharmacy deserts”.
‘Furthermore, it is important to note that medical services cannot be substituted with non-medical services, despite achieving similar or comparable outcomes for patients. People still do want to see doctors. Changing mindsets would be a long-term game not only through educating the public, but levelling up other services while improving the medical workforce.
Conservative Manifesto
‘On the face of it, the Conservative’s manifesto commitments on health also look promising. They pledge to increase NHS spending above inflation every year, recruit 92,000 more nurses and 28,000 more doctors, drive up productivity in the NHS and move care closer to people’s homes through Pharmacy First, new and modernised GP surgeries and more Community Diagnostic Centres.
‘However, once again, it’s all about the fine print. The promise to increase NHS spending above inflation every year does not square with our recent research that shows that, in real terms, Government-financed healthcare expenditure was around £239bn in 2023, a decrease of 2.1% after adjusting for inflation. Government healthcare expenditure also decreased by 0.7% in nominal terms and by 5.5% in real terms between 2021 and 2022.
‘The Conservatives also say their NHS Long-Term Workforce Plan will help shift care away from hospitals and into local communities. To support this, they too will expand pharmacy services, including for menopause support, contraception and treatment for chest infections, freeing up 20 million GP appointments a year.
‘Once again, this is a sensible approach. However, there is no real indication that, on their watch, the Conservatives appreciate the funding issues facing local pharmacies or how many vital community pharmacies have closed recently.
‘With real-term cuts in Government funding over the past two years, private health spending – particularly on preventative health products – is likely to grow, whichever party wins. Increasingly, consumers are wisely spending money on preventative healthcare items such as vitamins, supplements and off-the-shelf blood tests.
‘Based on consumer trends and current healthcare pressures, the expansion of private healthcare is inevitable in the UK. However, as already mentioned, true leadership is needed to strengthen this sector in the wake of current economic pressures. Although regarded as friendly towards privatisation, Conservatives have not demonstrated a tangible commitment to this agenda.
‘For those concerned about easy access to healthcare, it’s useful to know that revolutionary new blood tests introduced in the last few years mean people have swift access to a vast array of information about their own health through a simple finger-prick test, which can even be taken in their own home.
‘For example, London Medical Laboratory’s General Health Profile blood test monitors seven key areas of health. It includes muscle and bone profile, liver & kidney function, risk of diabetes (by checking levels of HbA1c), cholesterol levels, iron levels and even the risk of gout.
‘London Medical Laboratory’s General Health Profile blood test can be taken at home through the post, or at one of the many drop-in clinics that offer these tests across London and nationwide in over 120 selected pharmacies and health stores. For full details, see: https://www.londonmedicallaboratory.com/product/general-health