The Conservatives have presented their manifesto today confirming an extra £8 billion a year for the National Health Service by 2020, in a strong show of support for the NHS’ own five-year action plan.

Where this extra cash will come from has not been specified, but writing in the Guardian recently chancellor George Osborne said the party is able to make the commitment “because we’ve got the track record and a plan to grow our economy”. 

The pledge is “a welcome recognition that the health service needs significant extra money simply to stand still,” said Nigel Edwards, chief executive of think-tank the Nuffield Trust. But he also stressed that even with the additional money “the NHS will have to find unprecedented levels of efficiency savings within five years just to break even”. 

Other plans laid out in the manifesto include a truly seven-day NHS for all in England by 2020, a guarantee that everyone over 75 will get a same-day appointment if they need one, faster access to novel medicines, and closer health and social care integration via the Better Care Fund.

But Edwards, among others, questions the affordability of these planned improvements, particularly given the NHS’ dire financial straits. While it is “absolutely right” to aim for seven-day access to GP and NHS hospital services, “this will either mean big changes to the way services are run across the country or significantly more money,” he warns.

Centralisation and local closures

“Without further funding, seven-day hospital services will probably require centralisation, involving the downgrade and closures of local services such as emergency surgery or maternity units,” and it will also mean further stretching primary care resources. “It is hard to see how these changes could happen without extra funds that go beyond £8 billion minimum set out in the manifesto,” Edward argues.

There was also no mention in the manifesto of the Conservatives previous pledge to increase the number of GPs; last year, Health Secretary Jeremy Hunt promised to train and retain an extra 5,000 GPs should they remain in power after the general election.

Elsewhere, another commitment enshrined in the manifesto - which has been applauded by Alzheimer’s Research UK and which was noticeably absent in Labour’s plans - is to deliver the Prime Minister’s Challenge on Dementia 2020, including an aim to invest more than £300 million in research over the next five years.