Cancer – a rare area of political convergence?

24^th April 2015

So manifestos are out and for those working on charities’ general election campaigns, the anxious wait is over.

Of course we know that, even in a typical election, manifestos are only really of interest to policy wonks and the likelihood of a further coalition in May makes them less significant still. Any policies may be tinkered with, watered down or dropped entirely in the tumult of coalition horse-trading.

However, they do provide the clearest mandate and sense of direction for the next government, whatever the complexity of its makeup. For example, the Conservatives’ 2010 manifesto set out their commitment to introduce a cancer drugs fund, something that they of course followed through in coalition.

So, how did cancer do? Pretty well, all things considered. Cancer was mentioned in all three of the main parties’ manifestos, and by the Greens. This was far from certain a few months ago, with parties suggesting this was going to be the ‘mental health election’ and that, anyway, the economy rather than health would be the focus of manifestos.

Macmillan Cancer Support has been campaigning for a year for parties to include three commitments that people affected by cancer told us mattered most to them. These are: cancer outcomes matching the best in Europe, dignity and respect for all patients, and free social care support to enable more people to die in a place of their choosing. So we were delighted to see each of these in the main parties’ manifestos, in some form or another.

Labour committed to best cancer outcomes in Europe, the Conservatives to world class cancer care, and Liberal Democrats to setting ambitious outcomes for cancer. All parties pledged they would do more to address the factors underpinning our poor outcomes in this country, such as late diagnosis (Labour and Conservatives), access to treatments (same), and after care (Lib Dems).

On dignity and respect, the Conservatives said they would ensure hospital and GP surgeries are places where you are treated with dignity and respect, Labour said they would support NHS staff to deliver the ambition that all patients are treated with the highest levels of dignity and respect, and the Lib Dems said they would set the highest standards in care.

Finally, on end of life care, the Lib Dems pledged to increase choice at the end of life and provide free social care support for those on end of life registers, if it proves affordable, the Conservatives said they would support commissioners to combine health and social care services for the terminally ill, so that more people are able to die in a place of their choice, and Labour said they would support those who are terminally ill to remain at home with home care provided by the NHS.

There were many further commitments that would impact on the lives people affected by cancer, for example, Labour’s one week wait for cancer tests, the Conservatives’ commitment to deliver the cancer strategy, and Lib Dems’ improved support for carers and legal duty on the NHS to identify them (something Macmillan has been told by cancer carers would make a particular difference to them). All parties made commitments on health system and welfare reform.

All in all there was much to be welcomed, and perhaps an indication of the cross-consensus on health that organisations like the British Medical Association have been calling for, and that could make Simon Stevens, CEO, NHS England’s life a whole lot easier.

Perhaps.

In addition to the impact of a minority or coalition arrangement, there may be other factors that mean that people affected by cancer do not see the rapid implementation of the changes they need, come 8th May.

It is a question of priorities. The Conservatives under David Cameron have been committed to the NHS. But unless they win an outright majority, his leadership could be threatened and a new leader could have very different priorities. Added to this, there is the distraction of an in/out referendum on the EU. Labour is said to be drafting a bill to repeal parts of the Health and Social Care Act 2012, which would be introduced in their first 100 days. Could this detract political energy and capital away from frontline improvements? Finally, the Lib Dems will be keen to make their presence felt in any further coalition government, and reforms to mental health are likely to be a red line for them. Indeed they have repeatedly cited cancer care as benchmark for improvements in mental health, suggesting that they believe it is already ‘fixed’.

But cancer is not fixed. By the end of the Parliament in 2020, 3 million people will be living with cancer. Sadly, already too many people are dying too soon, not being treated with dignity, and being denied a good death. If the system is not coping now, how will it support this growing population?

So despite welcome commitments in manifestos, Macmillan and every single person who cares about cancer will continue to call for urgent action to improve cancer care and services. We will be demanding that whoever forms the next government makes an early announcement of a timetable for implementation of their commitments.

For the one in two of us who will soon face cancer in our lifetime, it is now time to deliver.