Political pledge digest

Ahead of the general election on 12 December, we’ve read the manifestos of the main political parties. Here’s an outline of what they say, in their words, on nursing and health

The RCN does not support one political party over another. We work with all political parties to champion the cause of nursing and enact positive change. 

The information published here is not exhaustive, but rather maps the pledges made by the main political parties in their manifestos to the RCN’s priorities. Please see their full manifestos to make an informed choice. 

Parties appear in alphabetical order. 

Invest in health and care services

• Provide continued investment in the NHS with better management and an increase in the number of medical staff. 
• Keep the NHS as a publicly-owned, comprehensive service that is free at the point of use. 
• Reject privatisation of the NHS. Return existing private initiatives to public ownership where they have failed to deliver. 
• Have a national debate on the NHS, involving the public alongside MPs, doctors and experts. Discuss ring-fencing the NHS budget and the tax revenues that pay for it.

Invest in nursing education and professional development

• Abolish interest on student loans.
• Re-open the nursing and midwifery professions to recruitment without the degree requirement, alongside a new nursing qualification in social care. 

Build an immigration system that supports nursing

• Reduce annual immigration and address wage stagnation and the skills gap by introducing a fair points system that is blind to ethnic origin. 

Improve working conditions and pay

• Review the position of women unexpectedly short-changed by recent rises in the state pension age.

Address the nursing workforce shortage

• Deliver 50,000 more nurses.

Invest in health and care services

• Increase NHS funding by 29% between 2018 and 2023. 
• Build and fund 40 new hospitals over the next 10 years. 
• Provide £1bn extra funding every year for more social care staff and better infrastructure, technology and facilities.
• Provide £74m over three years for additional capacity in community care settings for those with learning disabilities and autism.
• Guarantee that no-one needing social care has to sell their home to pay for it.
  

Invest in nursing education and professional development

• Give nursing students a £5,000-£8,000 annual maintenance grant, which they don’t have to pay back, and provide help with child care costs. 
• Provide further funding for nursing students in regions or disciplines that are struggling to recruit, such as mental health. 
• Provide more funding for professional training.

Build an immigration system that supports nursing

• Introduce an NHS visa, providing fast-track entry, reduced visa fees and dedicated support to qualified nurses who have been trained to a recognised standard, and who have good working English.
• New NHS visa applicants to pay back the cost of the Immigration Health Surcharge (IHS) via their salary. The IHS will rise to £625 per year, per person, to use the health service. 

Improve working conditions and pay

• Free hospital car parking for staff working night shifts

Address the nursing workforce shortage

• Reinstate the health secretary’s duty to provide health care services.
• Create a duty to ensure there are enough nursing staff to meet the needs of the population.

Invest in health and care services

• Increase NHS funding by £6bn a year until 2030.
• Roll back privatisation of the NHS, through repealing the Health and Social Care Act 2012. 
• Focus funding to enable the construction of new community health centres.
• Focus funding to enable major improvements to mental health care, ensuring everyone who needs it can access evidence-based therapies within 28 days.

Invest in nursing education and professional development

• Invest an extra £1bn a year in nursing higher education, allowing nursing bursaries to be reinstated.

Address the nursing workforce shortage

• Recruit 24,000 extra nurses by investing £1bn in restoring a training bursary for nurses and providing continuing professional development.
• Put safe staffing limits into law. 
• Repeal the Health and Social Care Act.
• Reinstate the responsibilities of the secretary of state to provide a comprehensive and universal health care system.
• Recruit 4,500 more health visitors and school nurses.

Invest in health and care services

• Increase expenditure across the health sector by an average 4.3% a year.
• Invest an extra £1.6bn a year in mental health care to ensure access to treatments is on a par with that for physical health conditions.
• Invest £2bn to modernise hospital facilities for mental health patients and end the use of inappropriate, out-of-area placements.
• Double annual spending on children and adolescent mental health services.
• Invest more than £1bn in public health. 
• Build a national care service for England, providing community-based, person-centred support. 
• Provide free personal care to older people. 
• Develop eligibility criteria for the provision of social care with a lifetime cap on personal contributions to care costs.
• Provide free annual NHS dental check-ups.

Invest in nursing education and professional development

• Introduce a training bursary for nurses, midwives and allied health professionals.
• Invest, train and develop NHS staff throughout their careers.
• Abolish tuition fees and bring back maintenance grants for university students. 

Build an immigration system that supports nursing

• Remove obstacles to ethical international recruitment.

Improve working conditions and pay

• Deliver year-on-year above-inflation pay rises, starting with a 5% pay increase.
• Provide free hospital parking for staff.
• Put Agenda for Change terms and conditions into law. 
• Review tax and pension changes to ensure the workforce is fairly rewarded.
• Provide mental health support for staff and tackle harassment, bullying and violence. 
• Provide care workers with paid travel time, access to training and an option to choose regular hours. 

Address the nursing workforce shortage

• Produce a national workforce strategy for the NHS, matching training places to future needs. 
• Take a “what works” approach to improving retention including continuing professional development, better support, and more flexible working and careers. 
• Reform the Health and Social Care Act to improve efficiency and integration. 

Invest in health and care services

• Raise £7bn a year, ring-fenced for the NHS and social care, from a 1p rise on Income Tax. 
• Use this cash to relieve the crisis in social care, tackle urgent workforce shortages, and invest in mental health and prevention services. 
• Re-instate the funding that was cut from public health budgets and join up services across public health and the NHS.
• £10bn capital fund to upgrade equipment, ambulances, hospitals and other NHS buildings.
• Introduce a statutory independent budget monitoring body for health and care, reporting every three years on how much money the system needs to deliver safe and sustainable treatment and care. 

Invest in nursing education and professional development

• Target extra help for nursing students, starting with bursaries for specialties where shortages are most acute such as mental health and learning disability nursing, linked to clinical placements in areas that are particularly under-staffed.
• Support the creation of a new professional body for care workers, to promote clear career pathways with ongoing training and development, and improved pay structures.
• Introduce a new requirement for professional regulation of all care home managers. 
• Set a target that 70% of care staff should have an NVQ level 2 or equivalent. 
• Provide support for ongoing training of care workers to improve retention and raise the status of caring.

Build an immigration system that supports nursing

• Attract and support talented professionals from countries with developed health systems, with an ethical recruitment policy in line with World Health Organization guidance.
• Make the registration process for overseas nurses more flexible and accessible without lowering standards.
• Attract staff back from EU member states, encouraging them to work in our public services.

Improve working conditions and pay

• Give incentive payments to health care professionals to work in areas where there are shortages. 
• Commission a strategic analysis of racial discrimination in the NHS.
• Listen and act on the pensions crisis that is driving away our most experienced clinicians.

Address the nursing workforce shortage

• Train and recruit an additional 5,000 nurses for the Welsh NHS. 
• Reduce spending on agency staff, freeing up an extra £90m to contribute to recruitment.  

Invest in health and care services

• Provide free social care for older people and other vulnerable people through a new national health and social care service.
• Provide a 5% increase in mental health expenditure every year for the next decade.
• Invest in early intervention and preventative health and care services.
• Create a community NHS rehabilitation service, bringing together a range of health professionals, including nurses. 
• Reject the marketisation and privatisation of the NHS.

Invest in nursing education and professional development

• Increase the number of home-grown nurses through investment in training.

Build an immigration system that supports nursing

• Change the settled status application system into a registration system, ensuring all EU citizens resident in the UK before exit day have the right of permanent residence. 
• Create a Welsh migration advisory service that enables skills gaps in social care to be plugged and protects the health service from staff shortages.
• Actively recruit across the EU where there are identified skills shortages. 
• Legally protect the rights of all EU citizens in the UK. 
• Press for free movement of health professionals throughout the EU.

Improve working conditions and pay

• Establish parity of pay and terms and conditions between social care and health care workers.
• Support the Women Against State Pension Injustice (WASPI) campaign and provide compensation to those women who have lost out.
• Establish a new regulatory body for approved NHS managers, responsible for setting and improving professional standards for managers within the NHS. This body will have the power to strike managers off the register in the event of serious errors or misconduct. 
• Establish a new national whistleblowing procedure and enhanced protection for whistleblowers in the NHS.

Invest in health and care services

• Call on the UK government to match Scottish per capita NHS spending, delivering an increase to frontline investment in NHS Scotland to more than £17bn by 2024/25. 
• Propose a new National Health Service Protection Act to guarantee that trade deals will not undermine the founding principles of the NHS, nor open it to profit-driven exploitation. 
• Support moves to re-instate a publicly owned, publicly operated, and publicly commissioned NHS in England through the replacement or significant amendment of the Health and Social Care Act 2012.

Build an immigration system that supports nursing

• Oppose plans to introduce a minimum salary threshold preventing anyone earning less than £30,000 from being admitted to the UK. 
• Press for the Immigration Skills Charge – a charge for employers of up to £5,000 per non-EEA worker – to be scrapped.
• Seek the devolution of immigration powers so that Scotland can have a tailored migration system that works for its economy and society.
• Support a review of the citizenship application process, with a view to bringing down its cost and reducing its complexity.

Improve working conditions and pay

• Oppose any increase to the state pension age.
• Continue to support the Women Against State Pension Inequality (WASPI) campaign in their efforts to secure fairness for the women short-changed due to the accelerated timetable for increases in the state pension age.

As a devolved issue, health would not normally feature in the general election manifesto of a Northern Ireland political party. In the current political vacuum, however, the parties have, this time, chosen to set out their health commitments, often in some detail.
 
On the staffing and pay issues underpinning the current RCN industrial action in Northern Ireland, the Social Democratic and Labour Party manifesto states: “It is vital that proper workforce planning is put in place now to mitigate future demand for services, ensuring better health outcomes for patients and improving working conditions for staff”. It also states: "The move by the Royal College of Nursing to take industrial action for the first time in their over 100-year history is a clear indication that nurses have been taken for granted for too long and action is needed to address the immense pressure on our public servants. SDLP MPs will use our influence and votes to deliver a consolidated pay increase for public sector workers."

The Sinn Féin manifesto states: “A new Assembly and a new kind of politics is what we are working towards. To be credible, then it must adequately deliver on issues like…public sector pay, safe staffing levels for health care workers…”

The Democratic Unionist Party commits to “enthusing and motivating staff including fair pay and conditions for all”. The Alliance Party advocates “implementing reforms to transform our health service, freeing up resources to pay health sector staff fairly”. 

The Ulster Unionist Party manifesto states the need for “a health care emergency to be declared in Northern Ireland”, with “health functions to be formally transferred back to Westminster and a Westminster MP appointed as a NI Health Minister”. It also advocates that: “The £1.02bn Barnett consequential funding from the £34bn extra spending previously announced in the NHS five-year settlement for the period between 2018-2019 and 2023-2024 be ring-fenced for health” and that “consequentials for pay awards must also be ring-fenced to fund similar awards for staff in Northern Ireland”.