After a turbulent night, predictions are difficult. However, with the Conservative Party as the most likely to form a government, it is probable that the direction of travel will continue largely as before: towards increased year on year funding for the NHS, but not enough to meet the shortfall identified in the service, and leaving the UK well below the European average for health expenditure. The move to integrated health and social care will continue, but at a slow pace and dogged by problems – not on the basis of a new combined health and care system as Labour had proposed.
Social care, usually the neglected sidekick of the NHS, has been the defining issue of this election campaign. The Conservatives’ surprise manifesto policy on care spending proposed that people would pay for care themselves until their assets were reduced to £100,000. This was quickly called a ‘dementia tax’ because people with long-term conditions such as dementia would pay a lot more than people who don’t need care. Theresa May’s re-interpretation of the policy some days later to say that there would be a cap on care expenses to limit people’s costs was doubly damaging. It left the Conservatives with an apparently incoherent care policy, after Jeremy Hunt had explictly rejected a cap on the Today programme, and damaged her claims of strong and stable leadership.
In recent years, there had been a sense of an increased consensus around the need for change in the care sector – a cap on costs similar to that proposed by Andrew Dilnot had drawn broad support – and prior to the election there was hope that the proposed Green Paper might pull together some consensus around a new, more sustainable approach to care funding. With bitter rows about the ‘dementia tax’ during the campaign, and May weakened by a policy shift which exemplified her uncertain leadership, it’s hard to feel confident that the parties will be able to work together on a way forward.