A Restored Contract Between The Generations is part of the Conservative Parties 2017 General Election Manifesto.
Conservative Manifesto 2017 – A Restored Contract Between The Generations
Theresa May’s Conservatives will deliver
- Sound public finances, built on fiscal credibility and a balanced budget by the middle of the next decade.
- Guaranteed annual increases in the state pension through a new Double Lock to be introduced in 2020.
- Dignity and protection in old age through the right long-term solution for elderly care.
- Exceptional healthcare, whenever, wherever, delivered by an NHS with the money, buildings and people it needs.
- Homes for all, including a new generation of fixed-term council housing linked to a new Right to Buy.
- High-quality childcare for working families, supported by thousands of new nursery places a year.
No grandparent wants to see their grandchildren worse off than they were, yet that is precisely the fear many older people now have. No son or daughter wants to see their parents poorly cared for or their hard-earned assets whittled away, yet that is the reality for too many old people in care. We must admit that the solidarity that binds generations is under strain in our country.
We will restore the contract between the generations, providing older people with security against ill health while ensuring we maintain the promise of opportunity and prosperity for younger generations. That contract includes our National Health Service, which is founded on the principle that those who have should help those who do not. It is a system of solidarity to which we all contribute, not just to help us and our families when we are in need but to protect others in our community when they need help too. This not just expediency: we do it because the support we give each other ties us together.
This solidarity is a Conservative principle, growing out of family, community and nation – all things that Conservatives believe in and work to conserve. At times, solidarity will require great generosity from one group to another – of younger working people to pay for the dignified old age of retired people, and of older people balancing what they receive with the needs of the younger generation.
Our United Kingdom can seize enormous opportunities but only if we make decisions for the long term. We trust the people of this country, who know that we face difficult choices – and demand the respect of politicians who should be honest about how those choices can be resolved.
DEALING WITH THE DEFICIT
The greatest impact a government can have on future generations is the amount it chooses to borrow to pay for current spending. Borrowing always means spending money you do not have; but government borrowing differs because the repayment falls to others – those who come later, including people not yet born. Conservatives believe in balancing the books and paying down debts – because it is wrong to pass to future generations a bill you cannot or will not pay yourself.
The next Conservative government will continue the difficult but necessary work of restoring our public finances while still ensuring that we are investing for the future. As we set out in chapter one, we will continue to aim for a balanced budget by the middle of the next decade, in line with the fiscal rules announced by the chancellor in his autumn statement last year.
AN AGEING SOCIETY
People are living longer. This is a good thing, but we should not ignore the consequences. As our society ages, the costs of caring for older generations – pensions, pensioner benefits, health and social care – rise; and these are borne by working people through their taxes. As the relative number of younger people is falling, those costs increase, not just in total, but also for individuals. So if we are to give older people the dignity we owe them and younger people the opportunities they deserve, we face difficult decisions.
Guaranteed annual increases in the state pension
A decade ago, pensions were in crisis and poverty blighted the retirement of many older people. It was wrong and it has been a Conservative government that has helped to put it right. By introducing the Pensions Triple Lock and the new State Pension, we have lifted the incomes of millions of older people, reducing pensioner poverty to historically low levels. The Triple Lock has worked: it is now time to set pensions on an even course. So we will keep our promise to maintain the Triple Lock until 2020, and when it expires we will introduce a new Double Lock, meaning that pensions will rise in line with the earnings that pay for them, or in line with inflation – whichever is highest. We will also ensure that the state pension age reflects increases in life expectancy, while protecting each generation fairly.
The state pension is the basic building block for income in retirement. In addition to safeguarding the rising state pension, we will continue to support the successful expansion of auto-enrolled pensions, enabling more people to increase their retirement income with help from their employers and government; we will continue to extend auto-enrolment to small employers and make it available to the self-employed. We will promote long-term savings and pensions products, including the Lifetime ISA, to encourage and incentivise more people to make provision for long-term needs, including a house purchase and retirement.
A long-term plan for elderly care
Our system of care for the elderly is not working for the hundreds of thousands currently not getting the dignified and careful attention they deserve, nor for the people and organisations providing that care, nor is it sustainable for today’s younger people who will potentially one day face care costs themselves. It is not fair that the quality of care you receive and how much you pay for it depends in large part on where you live and whether you own your own home.
Where others have failed to lead, we will act. We have already taken immediate action, putting £2 billion into the social care system and allowing councils to raise more money for care themselves from Council Tax. We are now proposing medium and long-term solutions to put elderly care in our country on a strong and stable footing.
Under the current system, care costs deplete an individual’s assets, including in some cases the family home, down to £23,250 or even less. These costs can be catastrophic for those with modest or medium wealth. One purpose of long-term saving is to cover needs in old age; those who can should rightly contribute to their care from savings and accumulated wealth, rather than expecting current and future taxpayers to carry the cost on their behalf. Moreover, many older people have built considerable property assets due to rising property prices. Reconciling these competing pressures fairly and in a sustainable way has challenged many governments of the past. We intend to tackle this with three connected measures.
First, we will align the future basis for means-testing for domiciliary care with that for residential care, so that people are looked after in the place that is best for them. This will mean that the value of the family home will be taken into account along with other assets and income, whether care is provided at home, or in a residential or nursing care home.
Second, to ensure this is fair, we will introduce a single capital floor, set at £100,000, more than four times the current means test threshold. This will ensure that, no matter how large the cost of care turns out to be, people will always retain at least £100,000 of their savings and assets, including value in the family home.
Third, we will extend the current freedom to defer payments for residential care to those receiving care at home, so no-one will have to sell their home in their lifetime to pay for care.
We believe this powerful combination maximises protection for pensioner households with modest assets, often invested in the family home, while remaining affordable for taxpayers. We consider it more equitable, within and across the generations, than the proposals following the Dilnot Report, which mostly benefited a small number of wealthier people.
An efficient elderly care system which provides dignity is not merely a function of money. So our forthcoming green paper will also address system-wide issues to improve the quality of care and reduce variation in practice. This will ensure the care system works better with the NHS to reduce unnecessary and unhealthy hospital stays and delayed transfers of care, and provide better quality assurance within the care sector. We will reduce loneliness and promote technological solutions to prolong independent living, and invest in dementia research. As the majority of care is informally provided, mainly by families, we will give workers a new statutory entitlement to carer’s leave, as enjoyed in other countries.
Creating a sustainable elderly care system means making decisions about how the rising budget devoted to pensioners is spent, so we will target help where it is needed most. So we will look at Winter Fuel Payments, the largest benefit paid to pensioners, in this context. The benefit is paid regardless of need, giving money to wealthier pensioners when working people on lower incomes do not get similar support. So we will means-test Winter Fuel Payments, focusing assistance on the least well-off pensioners, who are most at risk of fuel poverty. The money released will be transferred directly to health and social care, helping to provide dignity and care to the most vulnerable pensioners and reassurance to their families. We will maintain all other pensioner benefits, including free bus passes, eye tests, prescriptions and TV licences, for the duration of this parliament.
OUR NATIONAL HEALTH SERVICE
Our National Health Service is the essence of solidarity in our United Kingdom – our commitment to each other, between young and old, those who have and those who do not, and the healthy and the sick.
The Conservative Party believes in the founding principles of the NHS. First, that the service should meet the needs of everyone, no matter who they are or where they live. Second, that care should be based on clinical need, not the ability to pay. Third, that care should be free at the point of use. As the NHS enters its eighth decade, the next Conservative government will hold fast to these principles by providing the NHS with the resources it needs and holding it accountable for delivering exceptional care to patients wherever and whenever they need it.
The money and people the NHS needs
In five ways, the next Conservative government will give the NHS the resources it needs.
First, we will increase NHS spending by a minimum of £8 billion in real terms over the next five years, delivering an increase in real funding per head of the population for every year of the parliament.
Second, we will ensure that the NHS and social care system have the nurses, midwives, doctors, carers and other health professionals that it needs. We will make it a priority in our negotiations with the European Union that the 140,000 staff from EU countries can carry on making their vital contribution to our health and care system. However, we cannot continue to rely on bringing in clinical staff instead of training sufficient numbers ourselves. Last year we announced an increase in the number of students in medical training of 1,500 a year; we will continue this investment, doing something the NHS has never done before, and train the doctors our hospitals and surgeries need.
Third, we will ensure that the NHS has the buildings and technology it needs to deliver care properly and efficiently. Since its inception, the NHS has been forced to use too many inadequate and antiquated facilities, which are even more unsuitable today. We will put this right and enable more care to be delivered closer to home, by building and upgrading primary care facilities, mental health clinics and hospitals in every part of England. Over the course of the next parliament, this will amount to the most ambitious programme of investment in buildings and technology the NHS has ever seen.
Fourth, whilst the NHS will always treat people in an emergency, no matter where they are from, we will recover the cost of medical treatment from people not resident in the UK. We will ensure that new NHS numbers are not issued to patients until their eligibility has been verified. And we will increase the Immigration Health Surcharge, to £600 for migrant workers and £450 for international students, to cover their use of the NHS. This remains competitive compared to the costs of health insurance paid by UK nationals working or studying overseas.
Fifth, we will implement the recommendations of the Accelerated Access Review to make sure that patients get new drugs and treatments faster while the NHS gets best value for money and remains at the forefront of innovation.
Holding NHS leaders to account
It is NHS England that determines how best to organise and deliver care in England, set out in its own plan to create a modern NHS – the Five Year Forward View. We support it. We will also back the implementation of the plan at a local level, through the Sustainability and Transformation Plans, providing they are clinically led and locally supported.
We will hold NHS England’s leaders to account for delivering their plan to improve patient care. If the current legislative landscape is either slowing implementation or preventing clear national or local accountability, we will consult and make the necessary legislative changes. This includes the NHS’s own internal market, which can fail to act in the interests of patients and creates costly bureaucracy. So we will review the operation of the internal market and, in time for the start of the 2018 financial year, we will make non-legislative changes to remove barriers to the integration of care.
We expect GPs to come together to provide greater access, more innovative services, share data and offer better facilities, while ensuring care remains personal – particularly for older and more vulnerable people – with named GPs accountable for individual patients. We will support GPs to deliver innovative services that better meet patients’ needs, including phone and on-line consultations and the use of technology to triage people better so they see the right clinician more quickly. We will ensure appropriate funding for GPs to meet rising costs of indemnity in the short term while working with the profession to introduce a sustainable long-term solution.
We will introduce a new GP contract to help develop wider primary care services. We will reform the contract for hospital consultants to reflect the changed nature of hospital care over the past twenty years. We shall support more integrated working, including ensuring community pharmacies can play a stronger role to keep people healthy outside hospital within the wider health system. We will support NHS dentistry to improve coverage and reform contracts so that we pay for better outcomes, particularly for deprived children. And we will legislate to reform and rationalise the current outdated system of professional regulation of healthcare professions, based on the advice of professional regulators, and ensure there is effective registration and regulation of those performing cosmetic interventions.
We will also help the million and more NHS clinicians and support staff develop the skills they need and the NHS requires in the decades ahead. We will encourage the development of new roles and create a diverse set of potential career paths for the NHS workforce. And we will reform medical education, including helping universities and local health systems work closer together to develop the roles and skills needed to serve patients.
We want the NHS to become a better employer. We will strengthen the entitlement to flexible working to help those with caring responsibilities for young children or older relatives. We will introduce new services for employees to give them the support they need, including quicker access to mental health and musculoskeletal services. We will act to reduce bullying rates in the NHS, which are far too high. We will take vigorous and immediate action against those who abuse or attack the people who work for and make our NHS.
Exceptional standards of care, wherever, whenever
Outcomes in the NHS for most major conditions are considerably better than three, five or ten years ago. However, the founding intention for the NHS was to provide good levels of care to everyone, wherever they live. This has not yet been achieved: there remain significant variations in outcomes and quality across services and across the country. We will act to put this right.
To help the NHS provide exceptional care in all parts of England, we will make clinical outcomes more transparent so that clinicians and frontline staff can learn more easily from the best units and practices, and where there is clear evidence of poor patient outcomes, we will take rapid corrective action. We will ensure patients have the information they need to understand local services and hold them to account.
We will empower patients, giving them a greater role in their own treatment and use technology to put care at their convenience. In addition to the digital tools patients already have, we will give patients, via digital means or over the phone, the ability to book appointments, contact the 111 service, order repeat prescriptions, and access and update aspects of their care records, as well as control how their personal data is used. We will continue to expand the number of NHS approved apps that can help monitor care and provide support for physical and mental health conditions. We will pilot the live publication of waiting times data for A&Es and other urgent care services. We will further expand the use of personal budgets. We will also continue to take action to reduce obesity and support our National Diabetes Prevention Programme.
Our ambition is also to provide exceptional care to patients whenever they need it. That is why we want England to be the first nation in the world to provide a truly seven-day healthcare service. That ambition starts with primary care. Already 17 million people can get routine weekend or evening appointments at either their own GP surgery or one nearby, and this will expand to the whole population by 2019.
In hospitals, we will make sure patients receive proper consultant supervision every day of the week with weekend access to the key diagnostic tests needed to support urgent care. We will also ensure hospitals can discharge emergency admissions at a similar rate at weekends as on weekdays, so that when someone is medically fit to leave hospital they can, whichever day of the week it is.
We will retain the 95 per cent A&E target and the 18-week elective care standard so that those needing care receive it in a timely fashion.
We will continue to help the NHS on its journey to being the safest healthcare system in the world. We will extend the scope of the CQC to cover the health-related services commissioned by local authorities. We will legislate for an independent healthcare safety investigations body in the NHS. We will require the NHS to continue to reduce infant and maternal deaths, which remain too high.
Our commitment to consistent high quality care for everyone applies to all conditions. We will set new standards in some priority areas and also improve our response to historically underfunded and poorly understood disease groups.
In cancer services, we will deliver the new promise to give patients a definitive diagnosis within 28 days by 2020, while expanded screening and a major radiotherapy equipment upgrade will help ensure many more people survive cancer.
We will continue to rectify the injustice suffered by those with mental health problems, by ensuring that they get the care and support they deserve. So we will make sure there is more support in every part of the country by recruiting up to 10,000 more mental health professionals. We shall require all our medical staff to have a deeper understanding of mental health and all trainees will get a chance to experience working in mental health disciplines; we shall ensure medical exams better reflect the importance of this area. And we will improve the co-ordination of mental health services with other local services, including police forces and drug and alcohol rehabilitation services.
We have a specific task to improve standards of care for those with learning disabilities and autism. We will work to reduce stigma and discrimination and implement in full the Transforming Care Programme.
We will improve the care we give people at the end of life. We will fulfil the commitment we made that every person should receive attentive, high quality, compassionate care, so that their pain is eased, their spiritual needs met and their wishes for their closing weeks, days and hours respected. We will ensure all families who lose a baby are given the bereavement support they need, including a new entitlement to child bereavement leave.
HOMES FOR ALL
We have not built enough homes in this country for generations, and buying or renting a home has become increasingly unaffordable. If we do not put this right, we will be unable to extend the promise of a decent home, let alone home ownership, to the millions who deserve it.
We will fix the dysfunctional housing market so that housing is more affordable and people have the security they need to plan for the future. The key to this is to build enough homes to meet demand. That will slow the rise in housing costs so more ordinary, working families can afford to buy a home and bring the cost of renting down. And it will ensure that more private capital is invested in more productive investment, helping the economy to grow faster and more securely in future years.
We will meet our 2015 commitment to deliver a million homes by the end of 2020 and we will deliver half a million more by the end of 2022. We will deliver the reforms proposed in our Housing White Paper to free up more land for new homes in the right places, speed up build-out by encouraging modern methods of construction and give councils powers to intervene where developers do not act on their planning permissions; and we will diversify who builds homes in this country.
More homes will not mean poor quality homes. For too long, careless developers, high land costs and poor planning have conspired to produce housing developments that do not enhance the lives of those living there. We have not provided the infrastructure, parks, quality of space and design that turns housing into community and makes communities prosperous and sustainable. The result is felt by many ordinary, working families. Too often, those renting or buying a home on a modest income have to tolerate substandard developments -some only a few years old -and are denied a decent place in which to live, where they can put down roots and raise children. For a country boasting the finest architects and planners in the world, this is unacceptable.
We will build better houses, to match the quality of those we have inherited from previous generations. That means supporting high-quality, high-density housing like mansion blocks, mews houses and terraced streets. It means maintaining the existing strong protections on designated land like the Green Belt, National Parks and Areas of Outstanding Natural Beauty. It means not just concentrating development in the south-east but rebalancing housing growth across the country, in line with our modern industrial strategy. It means government building 160,000 houses on its own land. It means supporting specialist housing where it is needed, like multigenerational homes and housing for older people, including by helping housing associations increase their specialist housing stock.
We will never achieve the numbers of new houses we require without the active participation of social and municipal housing providers. This must not be done at the expense of high standards, however: councils have been amongst the worst offenders in failing to build sustainable, integrated communities. In some instances, they have built for political gain rather than for social purpose. So we will help councils to build, but only those councils who will build high-quality, sustainable and integrated communities. We will enter into new Council Housing Deals with ambitious, pro-development, local authorities to help them build more social housing. We will work with them to improve their capability and capacity to develop more good homes, as well as providing them with significant low-cost capital funding. In doing so, we will build new fixed-term social houses, which will be sold privately after ten to fifteen years with an automatic Right to Buy for tenants, the proceeds of which will be recycled into further homes. We will reform Compulsory Purchase Orders to make them easier and less expensive for councils to use and to make it easier to determine the true market value of sites.
We will also give greater flexibility to housing associations to increase their housing stock, building on their considerable track record in recent years. And we will work with private and public sector house builders to capture the increase in land value created when they build to reinvest in local infrastructure, essential services and further housing, making it both easier and more certain that public sector landowners, and communities themselves, benefit from the increase in land value from urban regeneration and development. And we will continue our £2.5 billion flood defence programme that will put in place protection for 300,000 existing homes by 2021.
These ambitious policies will mean more and better homes, welcomed by existing communities because they add, rather than subtract, from what is already there. This is the sustainable development we need to see happen in every village, town and city across our country. These policies will take time, and meanwhile we will continue to support those struggling to buy or rent a home, including those living in a home owned by a housing association.
CHILDREN AND FAMILIES
Britain should be the best country in the world for children. We want to reduce levels of child poverty, and have high ambitions for the quality of childcare, children’s health and support for vulnerable children for whom the state acts as a parent.
We know high-quality childcare is important not just to working parents but even more so to a child’s development and happiness. That is why a Conservative government will introduce, this year, thirty hours of free childcare for three and four-year-olds for working parents who find it difficult to manage the costs of childcare. We will go further. The next Conservative government will assess what more is needed, including looking at the best ways that childcare is provided elsewhere in Europe and the world. As a sign of our commitment, we will immediately institute a capital fund to help primary schools develop nurseries where they currently do not have the facilities to provide one. We will introduce a presumption that all new primary schools should include a nursery. And we will continue to support maintained nurseries and allow them to take on academy freedoms, supporting them to grow independently or as part of a multi-academy trust.
Children’s and young people’s health
We believe government has a role to play in helping young people get the best possible start in life. We are seeing progress: smoking rates are now lower than France or Germany, drinking rates have fallen below the European average and teenage pregnancies are at record lows. We will continue to take action to reduce childhood obesity. We will promote efforts to reduce unhealthy ingredients and provide clearer food information for consumers, as our decision to leave the European Union will give us greater flexibility over the presentation of information on packaged food. We shall continue to support school sport, delivering on our commitment to double support for sports in primary schools.
We understand the massively increased pressures on young people’s mental health. We will take focused action to provide the support needed by children and young people. Half of all mental health conditions become established in people before the age of fourteen. So we will ensure better access to care for children and young people. A Conservative government will publish a green paper on young people’s mental health before the end of this year. We will introduce mental health first aid training for teachers in every primary and secondary school by the end of the parliament and ensure that every school has a single point of contact with mental health services. Every child will learn about mental wellbeing and the mental health risks of internet harms in the curriculum. And we will reform Child and Adolescent Mental Health Services so that children with serious conditions are seen within an appropriate timeframe and no child has to leave their local area and their family to receive normal treatment.
Protecting vulnerable children and families
We have made significant progress in helping vulnerable children and families over the past seven years. Our investments in the social work profession and in successful, innovative programmes have given tens of thousands of vulnerable families the co-ordinated support they need.
Placing a child under the oversight of social services and taking a child into care are amongst the most serious duties the state may discharge. We will demand all local authorities be commissioners of the highest-quality family support and child protection services, removing these responsibilities from the weakest councils and placing them in trust. We will ensure that councils provide consistency of care and cannot relocate vulnerable children far from their home when it is not in their best interests to do so. We will review support for Children in Need to understand why their outcomes are so poor and what more support they might require, in and out of school.
Finally, we shall explore ways to improve the family justice system. The family courts need to do more to support families, valuing the roles of mothers and fathers, while ensuring parents face up to their responsibilities.
Five Giant Challenges
1. A Strong Economy That Works For Everyone
2. A Strong And United Nation In A Changing World
3. The World’s Great Meritocracy
4. A Restored Contract Between The Generations
5. Prosperity And Security In A Digital Age
Conservative Manifesto 2017 Conclusion