Manifesto report: Health

In this section

• Independent expert commentary from the Nuffield Trust
• Manifesto clash: staffing
• Manifesto clash: TTIP
• Manifesto clash: waiting times
• Manifesto clash: cancer fund
• Manifesto clash: mental health

Introduction

The health service in England faces major challenges. That, at least, is something the Conservatives, Labour, and Liberal Democrats can all agree on.

The UK's population is growing, and it's ageing too. That means more and more has been demanded of the NHS during this parliament, at a time when it's been called upon to make significant efficiency savings.

How well the service is coping under the pressure is hotly debated. The size and complexity of the health service means there's no single measure of how well it's performing. Taking just two examples, Labour have pointed to worsening performance on A&E waiting times, while the Coalition parties can in turn speak about rising public satisfaction with how the service is run.

Then again, in some areas it can be difficult to find any information at all. For instance in the case of mental health treatment, especially specialist services like those for young people or those that deal with rarer or more serious conditions, there are no national-level statistics. What evidence there is suggests services can vary across geographical areas and are not always sufficient to meet demand.

If the service's performance has been under scrutiny, so has the amount of money that's been put into it. NHS funding rose by almost £5.5 billion on top of inflation during the last Parliament, from £108 billion in 2010/11 (in today's prices) to a planned £113 billion in 2014/15.

But for part of that period growth in funding was outpaced by growth in the population, meaning from 2010/11 to 2012/13 spending per person fell by 0.4% once inflation is factored in.

Costs are also rising. The number of over-65s is estimated to be up by 10.7% over this parliament, and average spending on retired households is nearly double that on non-retired households.

This is perhaps why integration of the health and social care systems has come to the forefront of the debate in recent years. More people will require both health and social care in coming years. The NHS budget has been protected, but the social care budget has not. Funding for over-65s social care has fallen by 16% from 2009/10 to 2013/14, after accounting for inflation.

Looking ahead, the NHS itself will have a funding gap of £8 billion at the very least by 2020/21, according to the health service's own plan for the next five years.