2016 Devolved Administration Elections: Scotland, Northern Ireland and Wales Health and Higher Education Policies Introduction On 5 May 2016, elections will be held in the devolved administrations in the UK to determine who is elected to the Scottish Parliament, Northern Ireland Assembly and the National Assembly for Wales. As health and education is a devolved matter in the UK, the devolved administrations have responsibility for setting policies in these areas. This briefing provides a summary analysis of the key election policy announcements on health and higher education from the party manifestos in Scotland., Northern Ireland and Wales. Scotland pages 2-4 Northern Ireland pages 5-8 Wales pages 9-14 2016 Election Manifestos: Devolved Nations Purpose To inform members of the political parties policy positions on key health and higher education issues for the 2016 UK Assembly elections in Scotland, Northern Ireland and Wales which will be held on 5 May 2016. Publication Date April 2016 CoDH Contact Rachel Craine, Senior Policy Officer Neil Freshwater, Senior Policy Officer, Scotland 1
2 Scotland Page Number Health Policies Page Number Education Policies Scottish Conservative & Unionist Party (Manifesto 50 pages) 27 Phased re-introduction of 25 Higher Education prescription charges (with Introduction of 1,500 annual exemptions as before) to raise contribution for university 65m over the next parliament to graduates. Payable when earning invest nurses, HVs or GPs and > 20K PA. Exemption for p/t, access to new medicines. post-grad and disabled. Support for health and social care Protect part-time fee grant for OU integration. Work with housing students. associations to house patients post-hospital if unable to return home immediately. Analysis Commitment to invest in nurses and health visitors. In contrast to other parties they do not support free tuition fees. NHS Funding Protect NHS funding with a health guarantee and increase investment in mental health. Scottish Labour Party Not published 2
Scottish Liberal Democrats (Manifesto 36 pages) Increased number of nurses and AHPs. Increased funding and focus on primary care funding. Keep funding in line with elsewhere in UK and ahead of inflation. 7-8 Higher Education Protect the nursing and midwifery bursary (page 7) No university tuition fees 30m of new FE/HE bursary funding Increase student loan repayment threshold to 21K. Commitment to increase nurses and AHPs but lacks details on numbers. They would protect the nursing and midwifery bursary. SNP (Manifesto 76 pages) 8 Health workforce Extra 1,000 training places for nurses and midwives (page 13) Extra 500 health visitors by 2018 (page 15). NHS Funding NHS revenue budget will be increased by 500 million more than inflation by the end of this parliament. 1.3 billion extra will be invested to meet the challenges of an ageing population; plans include increasing the numbers of nurses working in the community. Apprenticeships Support for the current Scottish Government s plan for 30,000 new apprenticeships. 8 Higher Education Reaffirm commitment to free education Target that by 2030, students from 20% most deprived areas of Scotland will make up 20% of university entrants Guaranteed university place for all care leavers who meet basic entry requirements and full bursary support Reform student support funding, making it fair and equitable for students between 16 and 24 (page 17). More specific on the number of nurses, midwives, and health visitors they would train. Intention to increase the number of community based nurses. 3
Scottish Green Party Online Review all contracts with private sector service providers. Push for debt arbitration commission to look at PFI contracts Fight for Living Wage Plus for all health workers. Push for healthcare jobs to be more attractive with less paperwork and more time for learning and development. UKIP (Manifesto 32 pages) 10-12 Health workforce Would bring back the State Enrolled Nurse (SEN) and fund return to practice training for people who take a career break. Long term planning and training projects for doctors and nurses by 2018. 19 Apprenticeships 30,000 modern apprenticeships by 2020 Online Hardship for HE students at risk of dropping out over the summer break Support findings of Commission on Widening Access. 12 Higher Education Does not support degree level education for nurses. The manifesto says many vocations such as nursing have been forced down the Degree route to the detriment of the nurses and to the patients Believes university fee structure is inequitable Limited details specifically related to nursing, midwifery and AHP Negative perception of degree-level nursing education. 4
Northern Ireland Page Number Health Policies Page Number Education Policies Alliance Party of Northern Ireland (Manifesto 86 pages) 51 Health workforce 44 Higher Education Should be appropriate numbers Support further development of of nurses and healthcare support Higher Education being workers to allow for safe, provided through FE Colleges, individulised care. Student including, in particular, workrelated support should be orientated to Foundation Degrees. encourage more people into the Need to create a sustainable professions funding strategy consider AHP should be central to diversification of traditional HE integrated workforce plans. model. Welcome the decision to allow Ensure TEF model in England direct self-referral to had flexibility to allow needs of physiotherapists. education in NI to be met. Analysis No details on the numbers of nurses and healthcare support workers required Focus on midwifery and AHP welcome. Midwifery Services Commitment to NI Midwifery Strategy. Midwives should have an integral role at strategic level. Recognition of the ageing workforce and the need for workforce planning (page 57). NHS Greater focus on prevention, public health, mental health and early interventions Support reintroduction of 44 Apprenticeships Committed to the implementation of the Apprenticeship Strategy. 5
prescription charges for those that can afford it (page 58) Recognition of the importance of research and would support better funding for health related research p (page 59). Democratic Unionist Party (Manifesto 17 pages) 10-12 Health workforce Employ at least 1,500 more nurses and midwives and 200 more consultants by the end of the Assembly term Support the Northern Ireland wide roll out of the physiotherapy direct access scheme and will develop similar projects in other specialisms. Nursing Support nursing by implementing the recommendations of the newly created Nursing Task Group, retain Nursing Bursaries in Northern Ireland and continue to increase the number of nurses and midwives in training and in practice. NHS Increase spending by at least 1 billion Encourage active and healthy ageing. 15 Higher Education Commitment to maintaining university fees at a level that will keep it affordable and accessible to everyone. Recognition is given to the contribution made by nurses and midwives. Commitment to increase numbers of nurses and midwives and retain nursing bursaries. Support direct patient access to physiotherapy and would extend access to other specialisms. 6
Green Sinn Fein Not published. Not published. Social Democratic and Labour Party (Manifesto 27 pages) 26-30 Clinical priorities Mental health, older people. Cancer, autism. 11 Higher Education Refocus support for third level education toward the STEM subjects Will reverse cuts to university placements an commitment to increased funding Reduce the portion of the tuition fee paid by students to minimise their debt burden. Commitment to increase GP training places to 111 and number of GPs. No mention of training for other healthcare professions. Traditional Unionist Party (Manifesto 45 pages) 27-32 Cancer patients should have access to a Clinical Nurse Specialist (CNS) p28. Clinical priorities Autism, mental health. Apprenticeships Support for apprenticeships, increased investment for apprenticeships. 25 No specific details on the healthcare workforce. 7
UKIP (Manifesto 29 pages) 8 Duty on all health staff to report low standards of care. Ulster Unionist Party (Manifesto 44 pages) 10-13 Clinical priorities Mental health, end of life care, cancer. 9 Scrap 50% target of all school leavers going to university. 17 Higher Education Protect student maintenance grants Fair and sustainable funding model. Limited details are set out in the manifesto specific to the healthcare workforce. The UUP published separate paper on health matters prior to the general manifesto for the NI Assembly elections. The party supports an appropriately trained workforce. 8
Wales Page Health Policies Number Welsh Conservatives (manifesto - 30 pages) 15-19 Health Workforce Increase number of doctors and nurses, including numbers of nurse specialists, nurse prescribers and nurse consultants Additional 10 million annual investment in the Welsh Ambulance Service and recruit an extra 100 staff Appoint a nurse in every secondary school, college and university in Wales. Healthcare Support Workforce Introduce a system of registration for all support workers in Wales. NHS Funding Protect investment in the NHS, increasing NHS expenditure in real terms each year for the next five years. Introduce prescription charges, with exemptions for those who can t afford it. Page Number Education Policies 23-25 Higher Education Reform to tuition fee support, introduce a Student Rent Rebate to help students with living costs Explore the feasibility of compressing degrees into two years, to help reduce student debt Encourage flexibility, increase part-time and distant learners Reform Educational Maintenance Allowance, reinvesting the money in childcare, school/college transport Develop links between local employers, FE and HEIs. Apprenticeships Introduce thousands of flexible apprenticeships. Analysis Commitment to ensuring enough health professionals to meet patients needs but there is no detail on the workforce numbers that might be required. There is a general commitment to roll out the number of apprenticeships but it is not clear whether there is an aspiration to apply this to health professional education. The NMC sets the length of nursing and midwifery programmes. It would not be feasible to deliver preregistration programmes within two years. 5 key policy plans with the NHS right at the top of this list. The extra funding for the NHS would come from cuts to the budget for university 9
Clinical priorities Integrating health and social care systems, cancer, stroke, dementia, heart disease, stroke, and improving mental health and wellbeing. Welsh Labour / Llafur Cymru (Manifesto 24 pages) 9-12 Health Workforce Increase investment in education and training by 85m. This will be used to increase nurse training places by 10%. Clinical priorities Mental health, cancer, helping people to take responsibility for their own health. 17 Higher Education Offer a package of student support that is better than that offered in England, based on the recommendations of the Diamond Review Develop closer links between Universities and schools to strengthen our widening access work and support more of our looked after children to get into university Create a new funding body for Higher and Further Education in Wales Encourage FE Colleges and Universities to develop stronger links with industry and business to support the regional economies of Wales. Apprenticeships (page 15) 100,000 high quality, all age, apprenticeships students. The party intends to publish a health manifesto for Wales A Healthier Nation (page 15). Little information on how the policies will be afforded. The Welsh Labour Party has six key pledges for the 2016 AM election. None of them focus specifically on nursing, midwifery or AHP education or workforce. Commitment to educating more nurses, but this does not extend to midwifery or AHPs. There is a general commitment to roll out the number of apprenticeships but again it is not clear whether there is an aspiration to apply this to health professional education. There is little information on how the policies will be afforded and there is a lot of information about past delivery. 10
Welsh Liberal Democrat (Manifesto 104 pages) 29-39 Health workforce Increase the number of nurses (p29) Develop national workforce and training strategy, prioritise high quality education. NHS Legislate for parity between mental and physical health (p34) Abolish Public Health Wales and transfer funding to local govt (p37) Introduce whistleblowing hotline and set up a new independent health watchdog with a chief inspector for hospitals and health care (p39). Equal esteem between academic and vocational learning. 27 Higher Education Increase access to university. Will introduce a Student Living Support Grant for all undergraduate students resident in Wales, regardless of where they choose to study. Require universities to adopt fair access agreements to help widen access and participation Pay full tuition fees of care leavers Protect hardship funds for vulnerable students Employability enhancement bursary for students on postgraduate courses in Wales Protect funding for Higher education in Wales and HEFCW. Top election pledge in the party s three point plan for a better health service: More Nurses, better access to your GP, and improved mental health services. No figures on the number of nurses needed to fulfil policy of safe staffing. Safe Staffing Extend the Staffing Levels Bill to include mental health wards, maternity wards and community nurses (page 29). Apprenticeships (page 15) Commitment to increasing apprenticeships by tens of thousands (p7). 11
Plaid Cymru Health workforce An additional 5000 nurses to be trained and recruited into the NHS, with at least half working in community based care. An additional 1000 doctors. Nursing CPD and training Ensure nurses are able to access continuous professional development, with protected training time, and ensure that more nurses are funded to specialist level. Healthcare Workforce Explore pathways for healthcare support workers to become nurses, occupational therapists or counselors. Safe Staffing: Extend the Staffing Levels Bill to include other healthcare settings such as community health services, mental health and children s wards. Higher Education Learning Bond: will replace the tuition fee grant system. Every student will be given a loan, wherever they choose to study. Savings made from moving to a Learning Bond system will be invested in Welsh universities and colleges, specifically for research, expensive subjects such as medicine, part-time courses, postgraduate courses and Welshmedium courses. Students will have 6,000 written off for every year of completed study if they return to work in Wales within five years of graduating. Apprenticeships 50,000 new apprenticeships More specific on the number of nurses they will train, including where they will be employed. Commitment to opening up pathways into preregistration nursing education. Incentives for students to remain in Wales after graduating. 12
Green (Manifesto 25 pages) 20 Health Workforce Address staffing shortages including nurses through improved retention, increased opportunity for in-profession training and progression, and attracting staff to work in Wales. Ensure staffing levels on wards are in line with RCN guidelines. NHS Clinical Priorities Greater emphasis on public health; greater attention on mental health support services and developing new approaches to social care services. Integrated person centred care (p19). UKIP (Manifesto 48 pages) 9-12 Healthcare Workforce Support long-term investment in staff and resources Develop an integrated and longterm plan for training and developing the health and social care workforce Assign a specialist cancer nurse to everyone who is given a cancer diagnosis. 17 Higher Education Prioritise no tuition fees for Welsh students studying in Wales Create single independent funding body for colleges and universities Reinstate maintenance grants for all students Support fee and maintenance loans for postgraduate study Apprenticeships Develop apprenticeships and other work based learning. 20-21 Higher Education Abolish fees for Welsh domiciled undergraduates taking degrees in STEM subjects Replace tuition fee grant with loans for Welsh domiciled students choosing to study in England Establish a bursary fund to help students from poorer backgrounds attend the most prestigious universities Commitment to addressing staffing shortages in the NHS Proposals to create a single funding body. Little information on how the policies will be afforded Limited understanding of nurse education and requirements set by the NMC. UKIP believes that it does not make sense to cut our own training programmes in the NHS to save money, then recruit staff overseas Estimate that based on 13
14 Recruitment of nurses Recognition that recruitment difficulties are causing strains on the system Increase investment in the nurse training programme, e.g. retain nurse bursaries Introduce the equivalent of State Enrolled Nurses to allow health care assistants and others to train as nurses without requiring a degree. Paramedics UKIP will pilot the integration of fire and ambulance service response in an area where there is local support Train fire personnel so that they can also operate as paramedics. Remove the 5,190 tuition fee grant from EU students studying in Wales following a Leave vote in the referendum Retain the quality-related research (QR) budget that underpins world leading research in Wales Support part-time provision to widen access to higher education and to help up-skill the Welsh workforce Encourage institutions to keep part-time fees low and to incentivise part-time provision. Retain the widening access premia paid to institutions to support recruitment and Students from widening access backgrounds Introduce loan restriction exemptions for Equivalent or Lower Qualification (ELQ) students in priority subject area Support disabled students to counter any adverse effects from the proposed changes to Disabled Students Allowances (DSA). figures from the Diamond Review interim report, the saving to the Welsh government of replacing loans for Welsh domiciled students studying in England as 62.1 million. 14