The Waiting Room with Atticus Partners

Welcome to the third edition of the Atticus Partners Health Newsletter: The Waiting Room. The third in our regular series, January’s edition, looks at the latest stories surrounding health, including Labour and the Conservative’s policy priorities and the issues expected to dominate the UK health space in 2024.

Also included is our upcoming event with Jess Phillips MP, taking place on the 20th of February at 09:30, at our offices. More information, including how to register, is included below.

For more information about Atticus’ work in the health sector, or if you have any questions about how we can support you and your organisation, please get in touch via [email protected].

2024 – The year of prioritising women’s health?

Campaigners have been calling for an update to The Women’s Health Strategy, citing rising health inequalities as the primary reason for change.

Last week, Secretary of State for Health and Social Care, Victoria Atkins MP, spoke at the Women’s Health Summit, where she outlined the Government’s priorities surrounding women’s health for the new year. Atkins noted that menstrual problems, trauma following birth, birth loss and menopause were among the issues she hoped to tackle as Secretary of State in 2024. The priorities were developed as a result from responses to the Government’s call for evidence on the Women’s Health Strategy which was open until December 2021. The consultation received responses from over 100,000 healthcare professionals, women’s health champions, and other stakeholders across the health sector.

To address these priorities, Atkins announced that the Government’s one-stop-shop women’s health hubs pilot scheme will be under expansion after receiving ￡25 million of investment. The aim is to establish one women’s health hub in every local area this year, enabling better access and quality of care in services for menstrual problems, contraception, and menopause care.

Atkins went on to further announce that the Office for National Statistics will be asked to begin an investigation into the impact of period problems and endometriosis on women’s participation and progress at work – with the aim to address women’s health issues that have been “overlooked and under-researched” for too long. Spain’s ground-breaking move to grant paid menstrual leave to workers who suffer from severe period pain last year, could have influenced the Government’s drive to confront the impact of “problem periods” in the workplace.

Various voices from across the health sector welcomed the announcement. Emma Cox, CEO of Endometriosis UK said: “implementing the aspirations in the Women’s Health Strategy will provide a much-needed boost to turning this around, improving treatment and the lives of those suffering from endometriosis and menstrual health conditions.” Dr Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists, added: “the focus on improving care and treatment for women with gynaecological conditions, such as endometriosis and fibroids, which are often progressive, and have a huge impact on a woman’s quality of life, is hugely welcome.”

There has been little reaction from the Labour Party as of yet, although it is apparent that strengthening the Women’s Health Strategy has been on their radar since October 2022. Feryal Clark MP, the former Shadow Minister for Health and Social Care, claimed that the Government had fallen short on the status of women’s health and “it has no plan to address spiralling waiting lists [in the Women’s Health Strategy], no plan to improve standards in maternity care and nothing to address the chronic shortage of midwives.” With the general election on the horizon, will Labour be the Party that ensures women’s health services have the staff, resources, and technology they need to get women seen on time?

Starmer v Sunak, who will take it furthest on interventionist health policies?

Sir Keir Starmer MP’s announcement two weeks ago, embracing the ‘nanny state’ moniker that the Labour Party has long sought to ditch, speaks to a wider shift in UK politics whereby national governments, incumbent and prospective, feel more comfortable for the state to play a role in previously personal health responsibilities.?

Starmer marked this shift with a slew of manifesto policies. Labour’s “children’s health plan” outlines a commitment to work with parents through the provision of free breakfast clubs in every primary school, supervised tooth brushing, and a ban on junk-food advertising. Alongside this, Labour is proposing to build a smoke-free Britain roadmap which includes banning vapes branded towards women.?

It is possible that Labour feels increasingly comfortable outlining more interventionist health policies as a result of the smoking ban which Prime Minister Sunak announced at his Party Conference in September. Swaying from more traditional liberal Conservative values, this policy seems to have moved the Overton window to allow more room for creativity in interventionist policies.

However, being the Party who, according to Mrs Thatcher, does not believe in a society only “individual men and women”, Sunak’s smoking ban has received criticism from his own MPs due to it infringing on personal liberties. The backlash certainly serves as a warning to the Parties to not sit comfortably in this policy space, with Labour stakeholders warning the same.

Yet with both the main political parties now committing to insert themselves between unhealthy habits and the public, it begs the question of how far interventionist health policies might go? For example, calls for a restriction on the sale of junk food, led by the founder of Leon Restaurants and former government food advisor, Henry Dimbleby, now seem more plausible, especially in light of the ￡100 billion price tag attached to the nation’s obesity.

Whether a Treasury-friendly intervention or a more personally motivated priority, the political headwinds seem to indicate that personal health will become ever more the responsibility of the state as we go into this general election year.

Can Labour’s plan truly rescue NHS dentistry?

As part of a package of measures to rescue NHS dentistry, Labour has pledged to provide an extra 700,000 urgent dentist appointments and reform the NHS dental contract. Over 40,000 children went to hospital to have teeth removed in 2021 and 2022 and tooth decay is the most common reason for children aged 6-10 to be admitted to hospital.

The plan, and third priority of Labour’s Child Health Action Plan, is expected to cost ￡111 million. The key ambitions include recruiting dentists to areas that need them and the introduction of targeted national supervised toothbrushing programmes for 3–5-year-olds in Labour’s ‘fully funded breakfast clubs’. Labour have said this will be funded by the abolition of the non-domicile tax status.

With over 4.4 million children in England not having seen an NHS dentist in at least a year, and a further 22 million adults not having been seen by an NHS dentist in the past two years, the plans have been met with a largely positive response from healthcare professionals. Supporters include NHS Confederation, who said Labour is ‘right to have highlighted’ the issue. The British Society of Paediatric Dentistry called the policy a ‘serious plan’ that would both ‘grip the immediate crisis of the NHS, and set dentistry on the path to recovery in the long term’.

The news comes, however, as a ￡400m underspend in the NHS budget was reported between 2022/23. Moreover, with a shortage of dentists willing to take on NHS work, and the privatisation of many practices, some have questioned whether Labour’s plan will work. Nuffield Health highlighted this in a recent report, concluding that NHS dentistry has likely gone for good.

There has been strong pushback to the plan from teachers. The General Secretary of the National Association of Head Teachers, Paul Whiteman, has expressed reservations about how such a policy ‘could even work’. Stating that the policy is not the immediate response needed to solve the ‘mounting crises in school’, the union leader argued that the policy lacked ambition in the short, medium, and long term. Supported in his stance by teachers, who have said the policy will ‘take away from learning time’, it is clear that the proposed approach is leaving much to be desired by members from across the education industry.

Yet the Shadow Health Secretary, Wes Streeting MP, has insisted the plans are capable of solving the ‘NHS dentistry disaster’, but added that Labour must act promptly in their first term to ensure it is effective.

The State of our Nations

Overview

As in England, the health services across the other home nations have experienced significant difficulties in recent times. Governments of all stripes have been grappling with similar issues, from widespread staff shortages, strikes and record-high waiting lists.

Scotland

In contrast to other devolved nations, the Government in Holyrood has been more successful in averting strikes in the health service. Junior doctors, who recently staged a six-day walkout in England after rejecting an 8.8% pay offer, accepted a pay offer of 12.4% in Scotland last summer. Despite this, waiting lists in Scotland hit another record high in late 2023, reflecting the complex nature of addressing health challenges across the UK.??

The Scottish Government’s budget released at the end of last year included a rise in funding for NHS boards of ￡550 million which is "above real terms", yet analysis by the Institute for Fiscal Studies (IFS) shows this is set to grow more slowly than the average for all public services (although funding for frontline services will be slightly higher). There will be many questions about the implications of this for Scotland’s health service and health outcomes going forward.

Wales

The Welsh NHS, often the target of Conservative attacks, is also facing severe pressures. The health service was the predominant focus of the 2024-25 Draft Budget released at the end of last year. It delivered an extra ￡450 million for the NHS in 2024-25, with media coverage focusing on its prioritisation of the NHS above all else.

The IFS contrasted the decisions made in Scotland and Wales, highlighting that Wales had prioritised the NHS “to the exclusion of almost every other area of spending”. However, even within the rising health budget, some areas will face funding cuts so that money can be diverted to frontline health services. As in Scotland, the prioritisation of frontline health services in Wales suggests an instinct across devolved nations to shift resources to struggling acute settings in this challenging fiscal environment.

Despite this, there was some bright news recently as it was revealed that Wales' hospital waiting times have dropped after rising to record levels over the previous eight months, while A&E units and ambulances also performed better compared to the record winter pressures in 2022. However, the recent junior doctor's strike and the revelation that Wales ranks among the world's worst for survival rates from deadliest cancers will temper any optimism. Therefore, while improvements have been made in recent months - albeit when judged against recent record baselines - the challenges facing the Welsh health service remain immense.

Northern Ireland

Meanwhile, the state of the health service in Northern Ireland, where there has been no executive at Stormont for almost two years, is intrinsically linked to this long-lasting political deadlock which is expected to soon come to an end.

The health service is currently facing a plethora of issues, from pay disputes to NHS backlogs. The political deadlock, and the failure to resolve public sector pay disputes, led an estimated 150,000 workers, including nurses, to join the recent 24-hour strike action. However, on Monday, the Democratic Unionist Party (DUP) supported a deal to restore power-sharing at Stormont, and Northern Ireland Secretary, the Rt Hon Chris Heaton-Harris MP, confirmed that details of this deal will be published in the next few days.

The Westminster government’s offer of ￡3.3 billion to Northern Ireland’s budget, widely seen as a key factor in securing the restoration of the devolved power-sharing executive, remains on the table. This offer includes up to ￡584 million for public sector pay claims and an extra ￡34 million to tackle hospital waiting lists.

Things are expected to move quickly in the coming days, and the Assembly could even be recalled as early as Friday. The restoration of Stormont will have profound implications for the state of Northern Ireland’s health service and is a welcome move given the range of difficulties it is grappling with.

Events

There is less than a month to go until our next #AskAtticus event, which will be a Q&A event with Jess Phillips MP, Labour’s Member of Parliament for Birmingham Yardley and the former Shadow Minister for Domestic Violence and Safeguarding. The event will be hosted in-person at our office in Millbank and online via Zoom and YouTube. We are inviting guests who attend in person to arrive at 09:00 GMT on 20th of February for a brief networking session with Ms Phillips before the live stream begins at 09:30.

The conversation, hosted by Atticus’ Senior Counsel and Talk TV presenter Peter Cardwell, will be a broad discussion focused on Labour policies regarding women’s safety across a range of sectors, including housing, health, welfare, and the criminal justice system.

To register your attendance in person please email [email protected] or register to watch online here.

Blog Section

• Dry January: an example of individual preventive healthcare, or does the UK still need to regulate unhealthy habits?

To find out more about how Atticus helps health organisations navigate the changing regulatory and legislative landscape, get in touch with our team at [email protected] to learn more about what we can do for you.?