Phil Hunt on the likely winners and losers from the Conservative’s new legislative proposals
What unites the mixed bag of subjects in today’s Queens Speech debate in the Lords is the contrast between the extravagant claims made by the government for a one nation approach with the reality of a programme where the cost will fall heaviest on the very disadvantaged people the Government claim to want to help.
This is seen in the promised £12bn of welfare cuts where the government have been at a loss to say where and when the axe will fall. Inevitably, working age families who have already seen large reductions in their entitlements may face an even tighter squeeze in the years ahead.
Education is another area where parents need help. The promise of free childcare for 3 and 4 year olds is promising. But the average family are now paying £1,500 more per year for nursery fees than they would have been in 2010. Worryingly, the Day Nurseries Association have warned that fees will rise to subsidise these free places because the government has got its sums wrong.
On culture, the Queen’s Speech is silent, with no mention of the brilliance of our cultural heritage nor the importance of culture to the economy. Indeed, if Ministers were serious about a one nation approach, they would do more to address the massive imbalance in funding between London and the rest of the UK. The 2013 ‘Rebalancing our Cultural Capital’ report showed that the per capita spend in London was 15 times everywhere else.
A one nation approach to the NHS would have seen repeal of the ill-fated 2012 Health Act, described by the King's Fund as producing an unwieldy structure with leadership fractured between several national bodies, a complex regulatory system and a strategy vacuum in leadership. Yet, it is on that rocky ground, that the government promises integration of health and social care, more to be spent on mental health, implementation of the five year Forward Plan, and seven day working.
But how can integration be achieved when social care funding has been remorsefully slashed? Can there be any confidence that Clinical Commissioning Groups will invest more in mental health given their lamentable record so far? Is a true seven day working model deliverable?
Performance is already deteriorating rapidly. The four hour waiting time target for major A and E Departments has been missed every week for nearly two years. Cancer waiting time targets have been missed for five consecutive quarters, and lack of access to GPs is a source of considerable public concern. Nurse training places have been cut and under the government’s watch, employment agencies have taking the NHS to the cleaners.
Seven day working is hardly credible without a recognition of the financial consequences of employing more doctors and nurses. The provider deficit of nearly £1bn in 2014/5 is estimated to double in the current financial year. £8bn is promised, but not until 2020. Yet, the NHS needs resources immediately with a Secretary of State seemingly in denial about the pressures it is under. The Queens Speech does not want for lack of rhetoric. But the government will be judged on its ability to deliver on their promises rather than starve the NHS of funds and penalise working age families.
Labour will be rigorous in our scrutiny of the legislative programme in the Lords; and within the bounds of the conventions, we will be robust in our challenges and if necessary seek to defeat the government where its own behaviour demands it.
Lord Phil Hunt of Kings Health is a Shadow Health Minister and Shadow Deputy Leader in the House of Lords. He tweets at @LordPhilofBrum
Published 3rd June 2015