The Coalition: our programme for government

The coalition government published its plans for government in The Coalition: our programme for government. In this, the government set out agreed priorities across a range of domestic policy areas, including health and social care.

In relation to the NHS, the government said, 'We want to free NHS staff from political micromanagement, increase democratic participation in the NHS and make the NHS more accountable to the patients that it serves. That way we will drive up standards, support professional responsibility, deliver better value for money and create a healthier nation.'

The programme for government did not reflect the Equity and excellence white paper which followed just weeks later, and which did indeed outline plans for wide-scale structural reform.

The government made a commitment to:

• increase real-term health spending every year and to cut the cost of NHS administration by a third
• cease top-down reorganisations of the structures of the NHS
• allow GPs to commission services on behalf of their local population
• reform primary care trusts into democratically elected organisations
• establish an autonomous NHS board, responsible for allocating resources and issuing commissioning guidelines
• give every patient the right to choose to register with their preferred GP, without being restricted by their address
• develop a 24/7 urgent care service in every area of England
• develop Monitor's role into an economic regulator (rather than simply the regulator of foundation trusts).

On public health, the coalition government pledged to:

• enable local communities to gain control over public health budgets, with payment incentives to achieve better population health outcomes
• provide GPs with more incentives to tackle public health problems
• explore ways of improving access to preventative healthcare for those in disadvantaged areas.

On social care and disability, the coalition government pledged to:

• establish a commission to consider funding arrangements for long-term care
• ensure greater integration by breaking down barriers between health and social care funding, to focus more on preventative action
• extend the offer and use of social care personal budgets for service users and carers
• improve access to respite care, through the use of social care direct payments to carers and through improving community based provision.

In July 2010, in line with its commitment in Our programme for government, the coalition government set up an independent Commission on Funding of Care and Support, chaired by Andrew Dilnot, to consider the issue of sustainable long-term funding for the social care system. The other two commissioners were former health minister Lord Warner and the former chair of the Care Quality Commission, Dame Jo Williams. The commission reported back in July 2011.