Health, Care and Wellbeing (2024 Manifesto)

Invest in health and social care

• Deliver sufficient and sustainable funding for health and social care, including capital investment.
• Deliver parity of esteem between health and social care.

Although health and social care are devolved to the Scottish Parliament, Senedd Cymru and the Northern Ireland Assembly, the quality and funding of public services across the UK is fundamentally dependent on the approach the UK Government takes in England. The next UK Government must therefore ensure that there is sufficient and sustainable funding for health and social care services, including the capital investment necessary to ensure the NHS estate is safe and fit for purpose.

In Scotland, there is a long term aspiration to deliver “parity of esteem” for social care relative to healthcare. Currently, social care does not receive the level of investment necessary to ensure everyone who should be able to access care can do so, with strict eligibility criteria instead being used to ration care. At the same time, the social care workforce continues to experience poorer pay and conditions than workers doing equivalent jobs in the NHS.

The UK Government should work towards delivering this parity of esteem in England, ensuring more people can access care and improving pay and conditions for the workforce, creating consequentials that could be used for the same purpose in the devolved nations.

Reduce health inequalities

• Improve the availability and affordability of healthy, nutritious food.
• Increase investment in housing, public transport and active travel infrastructure.

Entrenched health inequalities continue to blight lives across the UK, especially for people living in the least affluent parts of the country and groups like disabled people, people living with long term conditions, unpaid carers, ethnic minorities, and LGBT people. In many cases, these inequalities are driven by factors beyond simply direct spend on health and social care services.

Government action to support health and wellbeing must therefore extend beyond investment in health and social care, and into tackling the wider social and commercial determinants that impact on the health of the population. This should include further advancing policies that support the availability of affordable, healthy, nutritious food, shifting the balance of affordability away from less healthy foods and making it easier for people to make healthier choices that reduce their chances of developing long term health conditions.

Health and wellbeing should also be supported through increased investment in housing and infrastructure for active travel and public transport, and the links between them. Improved active travel infrastructure enables more people to take regular exercise whilst going about their day, helping to improve their health. Significant work is also required to improve the accessibility of public transport infrastructure for wheelchair users, others with reduced or limited mobility, and people with sensory impairments. This will help ensure that people are able to access leisure, public services and employment opportunities that are essential for their mental health and wellbeing.

Address gambling harms

• Recognise gambling harms as a public health issue.
• Regulate industry practices in new and emerging sectors.
• Make all gambling marketing and advertising opt-in.

The ALLIANCE’s Scotland Reducing Gambling Harm programme champions the lived experience of people impacted by gambling, including through hosting the Scottish Gambling Harm Lived Experience Forum. We advocate for a public health approach to gambling harm rooted in improved treatment and support. The Gambling Act Review is an opportunity to explicitly recognise gambling harms as a public health issue, as well as to engage with people with lived and living experience of gambling harms to ensure the review delivers a blueprint for meaningful change.

Steps must also be taken to further regulate the gambling industry. Recent years have seen increasing “gamble-ification” through existing sectors like gaming and emerging ones such as cryptocurrencies. Current regulation is not equipped to deal with these new approaches, requiring a dynamic legislative process that is future proofed and can keep up with industry developments.

Gambling advertising and marketing must be further regulated. All forms of advertising and marketing should be opt-in, with a view to reducing the number of people induced into gambling. This should be backed up with effective accountability measures which ensure industry compliance, and restrictions on data selling and sharing that may be used to further target people at risk of gambling harms.