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Where the Long-Term Plan comes up short

There is nothing governments like more than a long-term plan for the NHS, there have been 13 in the last 18 years alone. The changing health landscape, funding pressures and the political class’s failure to build cross-party consensus around health, make the NHS catnip for tinkerers.

There is nothing governments like more than a long-term plan for the NHS, there have been 13 in the last 18 years alone. The changing health landscape, funding pressures and the political class’s failure to build cross-party consensus around health, make the NHS catnip for tinkerers.

Nevertheless, this week we finally saw the Long-Term Plan and for those of us whose interest lies in primary and commmunity care, there was a lot to like. There is a £4.5bn funding boost, a fresh emphasis on integrated care and preventative measures, and a stated aim to tackle health inequalities. Since this is techy Matt Hancock’s plan, there is also an interesting, if starry-eyed suggestion that digital consultations can free up GPs. But broadly this is a welcome shift away from the market excesses, towards place-based care, and away from a National Sickness Service to a genuine Health Service.

But a disingenuous air hangs over matters. It doesn’t help that the Prime Minister introduced the plan boasting about a Brexit dividend boosting NHS funding (even the most fervent leavers dropped that claim on 24 June 2016). But the focus on prevention comes just after another cut of £100m for public health budgets; the fine words about increasing nursing numbers come after financial support to student nurses has been completely removed; and the goal of integrated health is unachievable, while we still wait for the long-delayed Green Paper on social care.

Mr Hancock’s diagnosis is sound, his clinical priorities focussed, but he needs to add ‘cognitive dissonance’ to his list of morbidities to be eradicated. Good intentions alone will not deliver the change he wants.