Uncertain times

It is traditional that we only publish one issue to cover both July and August so it’s been a while since we went to press here at HealthInvestor UK. In the meantime, the political landscape has undergone something of a transformation. The emergence of a second consecutive unelected prime minister and an outspoken, energetic government seemingly intent on leaving the EU on 31 October “do or die” will have major implications for the UK investment community.

The well-worn subject of Brexit is back on the table in boardrooms across the country as businesses struggle to understand how to protect themselves from what now seems like the much more likely outcome of a no-deal departure from the EU. The health and social care market is subject to a host of Brexit-sensitive variables, from recruitment and retention, to the supply of pharmaceuticals, to the removal of competition and procurement laws, and there’s widespread concern that a crash-out will cause massive problems for providers and their investors.

With Mr Johnson, his ultra-Brexit cabinet, and his even more committed band of special advisors preparing the country for some sort of no-deal/people-versus-parliament election combo, there can be little doubt we face a stormy and uncertain autumn. 

The shadow of Corbyn

Johnson is relentlessly playing to the gallery with the three focus group favourites of Brexit at all costs, law and order reforms, and reducing GP waiting times. This is seen by many as a clear sign that he will soon go to the country with a populist agenda hoping to win the mandate, and meaningful parliamentary majority, that he so patently lacks.

But if his gamble fails to pay off and voters decide to punish the Conservatives for the unholy mess in which we now find ourselves, it could mean Jeremy Corbyn is handed the keys to Number 10.

Talking to investors and operators this year, it seems the one thing causing more sleepless nights than Brexit is the prospect of a Corbyn government. Labour has, for example, pledged to reduce private sector involvement in public services and many fear that health and social care provision is likely to prove a particularly juicy piece of low-hanging fruit for reformers intent on extracting investors’ fingers from the public purse.

But how would this work in reality? The NHS has, since its inception, relied on independent providers for a wide range of services. Social care, from care homes for older people, to specialist provision for children and adults, is now delivered almost entirely by the private and charity sectors using local authority and health service funding. How easy will it be to reverse this decades-long shift away from state-run care?

Labour says it will establish what it calls a National Care Service to operate alongside the NHS, which to be honest sounds preferable to the current state of affairs that all agree is leading to a deepening crisis. Surely an experienced and competent private sector will be a valuable ally in establishing a sustainable and effective new model of provision?

Of course, to do so, operators and investors need to be above reproach. While the vast majority of provision is exemplary, the growing list of failings in mental health care (see pages 9 and 10) is undermining public confidence in private sector. Quality needs to be put firmly at the top of the agenda by those providing the funding for providers.

Meanwhile, where we’ll all be in two months’ time is anyone’s guess. The best advice available seems to be to tighten our seatbelts. 

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