Liberal Democrat manifesto Below is a summary of the policy pledges that relate to health, care and wellbeing, broadly defined, from the Liberal Democrats’ manifesto. They are presented as the pledges alone, without the party’s surrounding narrative. Policies have been grouped under headings by the Patients Association, based on the layout of the manifesto. Other parties’ manifestos will be summarised in the same way when they are published. The full manifesto can be read on the Liberal Democrats’ website: PDF Interactive webpage Easy read version PDF. The health and care system Raise £7 billion a year additional revenue which will be ring-fenced to be spent only on NHS and social care services. This revenue will be generated from a 1p rise on the basic, higher and additional rates of Income Tax (this revenue will be neither levied nor spent in Scotland.) Use this cash to relieve the crisis in social care, tackle urgent workforce shortages, and to invest in mental health and prevention services. Also use £10 billion of the new capital fund to make necessary investments in equipment, hospitals, community, ambulance and mental health services buildings, to bring them into the 21st century. Commission the development of a dedicated, progressive Health and Care Tax, offset by other tax reductions, on the basis of wide consultation and extensive engagement with the public. The aim will be to bring together spending on both services into a collective budget and set out transparently, on people’s payslips, what the Government is spending on health and social care. Establish a cross-party health and social care convention that builds on the existing body of work from previous conventions, select committees and the 2018 citizens’ assembly to reach agreement on the long-term sustainable funding of a joined-up system of health and social care. Introducing a cap on the cost of care, as provided for in the Care Act but not so far delivered, would be a key starting point for Liberal Democrat participants. Introduce a statutory independent budget monitoring body for health and care, similar to the Office for Budget Responsibility. This would report every three years on how much money the system needs to deliver safe and sustainable treatment and care, and how much is needed to meet the costs of projected increases in demand and any new initiatives – to ensure any changes in services are properly costed and affordable. Mental health services Ring-fence funding from the 1p Income Tax rise to provide additional investment in mental health. Introduce further mental health maximum waiting time standards, starting with children’s services, services for people with eating disorders, and severe and enduring conditions. Aim to ensure that all children and young people with a diagnosable condition receive NHS treatment (currently only 35 per cent do). Increase access to a broader range and number of clinically effective talking therapies so that hundreds of thousands more people can receive this support, with equal access for older people, BAME and LGBT+ patients, and people with autism or learning disabilities. Make prescriptions for people with chronic mental health conditions available for free on the NHS, as part of our commitment to review the entire schedule of exemptions for prescription charges, which has not been fully updated since 1968 and contains many anomalies. Transform perinatal mental health support for those who are pregnant, new mothers and those who have experienced miscarriage or stillbirth, and help them get early care when needed. Ensure every new mother gets a dedicated maternal postnatal appointment as well as introducing other measures to tackle under-diagnosis of maternal physical and mental health problems. Implement all the recommendations of the Wessely review of the Mental Health Act, including bringing forward the necessary investment to modernise and improve inpatient settings and ambulances. The principle of ‘care not containment’ will be applied to mental health, while ensuring an emergency bed is always available if needed. Ensure that no one in crisis is turned away, improving integration between mental health trusts, local authorities and hospitals, to promote a holistic approach to improving mental health services. Work to make mental health crisis services 24-hour, including mental health liaison teams in all hospitals, and ending the use of police cells for people facing a mental health crisis. Ensure those admitted to hospital for mental ill-health are able to be treated close to home for all but the most specialist mental health services, minimising the use of hospital admissions through high-quality community and housing support for people who don’t need an admission. Ensure that all frontline public service professionals, including in schools and universities, receive better training in mental health, and add a requirement for mental health first aiders in the Health and Safety First Aid Regulations. Fully introduce Sir Stephen Bubb’s ‘Time For Change’ report recommendations and ensure that Assessment and Treatment Units are closed urgently. Stop the cliff edge of young people transitioning to adult services and ensure uninterrupted care.Establish a Student Mental Health Charter which will require all universities and colleges to ensure a good level of mental health provisions and services for students. Tackle stigma against mental ill-health through investment in public education including Time to Talk. Require that a fair proportion of all public funding for health research should be focused on research into mental ill-health, including research into the different mental health needs of different communities within the UK such as BAME and LGBT+ people. Improve mental health support and treatment within the criminal justice system and ensure continuity of mental health care and addiction treatment in prison and the community. Regard every suicide as preventable. Take an evidence led approach to prevention, making it easier for people at risk to get the help they need, and equipping more members of the public with the skills and confidence to talk about suicide. Ensure that LGBT+ inclusive mental health services receive funding and support. Develop a scheme to reward employers who invest in the mental wellbeing of their employees, piloting reduced business rates for employers who support employees’ mental wellbeing and provide mental health first aid training to staff. Problem gambling Introduce a compulsory levy on gambling companies to fund research, education and treatment of problem gambling. Ban the use of credit cards for gambling. Restrict gambling advertising. Establish a Gambling Ombudsman. Access to Care End the GP shortfall by 2025 by both training more GPs and making greater appropriate use of nurses, physiotherapists and pharmacists, and also phone or video appointments, where clinically suitable. Make sure they are based in premises that are fit-for-purpose and equipped with modern technology and well-connected to other parts of the healthcare system. Support GPs, nurses, physiotherapists, mental health and other professionals to work together across their local areas to provide multi-disciplinary health and care services, to improve appointments outside of normal working hours, including mobile services. Review the NHS’s future needs for all staff, and produce a national workforce strategy, taking the long view and matching training places to future needs. Do more to retain staff as well as to train them. Take a ‘what works’ approach to improving retention including continuing professional development, better support, and more flexible working and careers. This will help to retain staff through more flexible working. Act on the pensions crisis that is driving away experienced clinicians and worsening waiting times and the workforce crisis. Target extra help for nursing students, starting with bursaries for specialties where shortages are most acute such as mental health and learning disability nursing, linked to clinical placements in areas that are particularly under-staffed. Attract and support talented professionals from countries with developed health systems, with an ethical recruitment policy in line with World Health Organization guidance, and make the current registration process more flexible and accessible without lowering standards. Attract staff back from EU member states, encouraging them to once again come and work in our public services. Encourage healthcare professionals to work in areas where there are shortages, especially inner city and remote rural areas, through the Patient Premium – which would give incentive payments to clinicians. Implement the recommendations of Roger Kline’s report into the lack of diversity in senior management in the NHS and commission a strategic analysis of racial discrimination in the NHS. Address continuing inequalities in health services access faced by same-sex couples, and continue to improve LGBT+ healthcare overall. Health and care structures and finance Support the changes to the Health and Social Care Act recommended by the NHS, with the objective of making the NHS work in a more efficient and joined-up way, and to end the automatic tendering of services. Move towards single place-based budgets for health and social care – encouraging greater collaboration between the local NHS and Local Authorities in commissioning. Encourage Clinical Commissioning Groups and Local Councils to collaborate on commissioning, including further use of pooled budgets, joint appointments and joint arrangements, and encourage emerging governance structures for Integrated Care Systems to include local government, and be accountable to them. Support the creation of a new Professional Body for Care Workers, to promote clear career pathways with ongoing training and development, and improved pay structures. Introduce a new requirement for professional regulation of all care home managers, who would also be required to have a relevant qualification. For care staff, set a target that 70 per cent of care staff should have an NVQ level 2 or equivalent (currently levels are around 50 per cent). Provide support for ongoing training of care workers to improve retention and raise the status of caring. Provide more choice at the end of life, and move towards free end-of-life social care, whether people spend their last days at home or in a hospice. Carers Introduce a statutory guarantee of regular respite breaks for unpaid carers, and require councils to make regular contact with carers to offer support and signpost services. Provide a package of carer benefits such as free leisure centre access, free bus travel for young carers, and self-referral to socially prescribed activities and courses. Raise the amount people can earn before losing their Carer’s Allowance from £123 to £150 a week, and reduce the number of hours’ care per week required to qualify for it. Help to stay healthy Publish a National Wellbeing Strategy, which puts better health and wellbeing for all at the heart of government. Ministers from all departments will be responsible for implementing the strategy. Pursue a Health in All Policies approach, as recommended by the World Health Organization. This means that national and local decision making, policies and interventions will only take place after the full impact on people’s mental and physical health has been fully assessed. Keep public health within local government, where it is effectively joined-up with preventive community services. Re-instate the funding that was cut from public health budgets and join up services across public health and the NHS. Introduce a new statutory requirement for public health interventions evaluated as cost effective by NICE to be available to qualifying people, within three months of publication of guidance. Develop a strategy to tackle childhood obesity including restricting the marketing of junk food to children, and closing loopholes in the Soft Drinks Industry Levy. Extend it to include juice- and milk-based drinks that are high in added sugar. Guarantee that every child who is eligible for free school meals has access to at least an hour a day of free activities to improve their health and wellbeing. Local authorities will be funded through the public health grant to deliver the ‘Wellbeing Hour’ according to local needs, for example through voluntary organisations or after-school clubs. Require labelling for food products, in a readable font size, and publication of information on calorie, fat, sugar and salt content in restaurants and takeaways. Restrict how products high in fat, salt and sugar are marketed and advertised by multiple retailers. Reduce smoking rates by introducing a new levy on tobacco companies to contribute to the costs of health care and smoking cessation services. Legislate for the right to unpolluted air, and take urgent action to reduce pollution especially from traffic. Introduce minimum unit pricing for alcohol, taking note of the impact of the policy in Scotland. Ensure universal access to addiction treatment. Fund public information campaigns to tackle stigmas within specific communities. Address the scandal of women with learning disabilities dying an average 20 years younger, setting a national target for reducing this gap. Ensure people with learning disabilities can access screening, prevention, health and care services fairly. Review on the basis of evidence any unscientific and discriminatory practices aimed solely at LGBT+ people, such as around blood donations. Ensure Pre-Exposure Prophylaxis (PrEP) for HIV prevention is fully available to all who need it on the NHS. Wellbeing Introduce a wellbeing budget, following the example of New Zealand – basing decisions on what will improve wellbeing as well as on economic and fiscal indicators. Appoint a Minister for Wellbeing, who will make an annual statement to Parliament on the main measures of wellbeing and the effects of government policies on them. Introduce wellbeing impact assessments for all government policies. Prioritise government spending on the things that matter most to people’s wellbeing – both now and in the future – including: Access to high-quality mental health and other health services. Schools that build emotional resilience and properly prepare our children for both work and relationships. Jobs for the future, through further education and Skills Wallets. Community services that tackle loneliness and prevent isolation. Targeted support for those most at risk of poor wellbeing: vulnerable children, people who are homeless, victims of trafficking and exploitation. Providing welfare support to those who need it. Reducing Adverse Childhood Experiences by investing further in services during pregnancy and the first two years of a child’s life. Ensure that the environment is protected for future generations with clean air to breathe and urgent action to tackle the climate emergency. Introduce ‘baby boxes’ in England, as advocated by the Royal College of Midwives, to provide babies and parents with essential items to help with health and development. Act on the recommendations of the Public Inquiry into Infected Blood, ensuring a just settlement for victims and their families. Establish a legal right to food to enshrine in law the government’s responsibility to ensure that existing and new public policy is audited for its impact on food security. Education End the crisis in Special Educational Needs and Disabilities funding by allocating additional cash to local authorities to halve the amount that schools pay towards the cost of a child’s Education Health and Care Plan. Introduce a ‘curriculum for life’, in all state-funded schools. This will include Personal, Social and Health Education, financial literacy, environmental awareness, first aid and emergency lifesaving skills, mental health education, citizenship and age-appropriate Relationships and Sex Education (RSE). Teaching about sexual consent, LGBT+ relationships, and issues surrounding explicit images and content will be included in RSE. Extend free school meals to all children in primary education and to all secondary school children whose families receive Universal Credit, as well as promoting school breakfast clubs. Ensure that all teaching staff have the training to identify mental health issues and that schools provide immediate access for pupil support and counselling. Ensure there is a specific individual responsible for mental health in schools, who would provide a link to expertise and support for children experiencing problems. They would also take a lead on developing whole-school approaches to mental well-being. Give schools a statutory duty to promote the wellbeing of their pupils as part of the inspection framework. Include teaching about how to use social media responsibly in our ’curriculum for life‘ and provide advice and support for parents on how to help their children protect themselves online. Require universities to make mental health services accessible to their students, and introduce a Student Mental Health Charter through legislation. Drugs Move the departmental lead on drugs policy to the Department of Health and Social Care, and, crucially, invest in more addiction services and support for drug users. Divert people arrested for possession of drugs for personal use into treatment, and imposing civil penalties rather than imprisonment. Help to break the grip of the criminal gangs by introducing a legal, regulated market for cannabis. Introduce limits on the potency levels and permit cannabis to be sold through licensed outlets to adults over the age of 18. Reproductive health and parenthood Decriminalise abortion across the UK while retaining the existing 24-week limit and legislate for access to abortion facilities within Northern Ireland. Enforce safe zones around abortion clinics, make intimidation or harassment of abortion service users and staff outside clinics, or on common transport routes to these services, illegal. Fund abortion clinics to provide their services free of charge to service users regardless of nationality or residency. Increase statutory paternity leave from the current two weeks up to six weeks and ensure that parental leave is a day-one right, and address continuing inequalities faced by same-sex couples. Require organisations to publish parental leave and pay policies. Welfare benefits Introduce an incentive-based scheme to replace the current sanctions system, which does not encourage people into work, penalises people with mental health issues and deters people from claiming support. Reverse the cuts to Employment Support Allowance for those in the work-related activity group. End Work Capability Assessments and replace them with a new system that is run by local authorities and based on real-world tests. Reinstate the Independent Living Fund. Radically overhaul the Bereavement Allowance, slashed by the Conservatives, so that widows and widowers receive far more support and extend the payments to unmarried couples when a parent dies. Housing Build at least 100,000 homes for social rent each year and ensure that total housebuilding increases to 300,000 each year.Set clearer standards for homes that are socially rented. Urgently publish a cross-Whitehall plan to end all forms of homelessness. Cut energy bills, end fuel poverty by 2025 and reduce emissions from buildings, including by providing free retrofits for low-income homes, piloting a new subsidised Energy-Saving Homes scheme, graduating Stamp Duty Land Tax by the energy rating of the property and reducing VAT on home insulation. Justice system Embed Trauma-informed Youth Intervention Specialists in all Major Trauma Centres. Introduce a target of one hour for handover of people suffering from mental health crisis from police to mental health services and support the police to achieve adequate levels of training in mental health response. Ensure that all prison-leavers have a suitably timed release and are supported with suitable accommodation, a bank account and employment or training, and are registered with a local GP. Improve mental health support and treatment within the criminal justice system and ensure continuity of mental health care and addiction treatment in prison and the community. Establish a firewall to prevent public agencies from sharing personal information with the Home Office for the purposes of immigration enforcement and repeal the immigration exemption in the Data Protection Act. Human rights Complete reform of the Gender Recognition Act to remove the requirement for medical reports, scrap the fee and recognise non-binary gender identities. Increase accessibility to public places and transport by making more stations wheelchair accessible, improving the legislative framework governing blue badges, setting up a benchmarking standard for accessible cities, and banning discrimination by private hire vehicles and taxis. End period poverty by removing VAT on sanitary products and providing them for free in schools, hospitals, hostels, shelters, libraries, leisure centres, stadiums, GP surgeries, food banks, colleges and universities. Introduce a general duty of care for the environment and human rights – requiring companies, financial institutions and public sector agencies to exercise due diligence in avoiding specified activities such as child labour or modern slavery, or specified products such as commodities produced with deforestation, in their operations and supply chains, and to report on their actions. Democracy and government Decentralise decision-making from Whitehall and Westminster, by inviting local areas to take control of the services that matter to them most. Give democratic local government enhanced powers to call on new income sources appropriate to their area to support local services and investment. Devolve more decision-making power over key levers of economic development including transport, energy, housing and skills. Specifically include health and education departments of the Scottish and Welsh governments in UK policymaking on drug policy and student visas. Environment and Transport Introduce a National Food Strategy, including the use of public procurement policy, to promote the production and consumption of healthy, sustainable and affordable food and cut down on food waste. Pass a Clean Air Act, based on World Health Organisation guidelines, enforced by a new Air Quality Agency. The Act will enshrine the legal right to unpolluted air wherever you live. Introduce a nationwide strategy to promote walking and cycling, including the creation of dedicated safe cycling lanes, increasing spending per head five-fold to reach 10 per cent of the transport budget. Animals Improve standards of animal health and welfare in agriculture, including a ban on caged hens, and promote the responsible use of antimicrobials. Minimise the use of animals in scientific experimentation, including by funding research into alternatives.