--- election_year: 2017 party_id: nha party_name: National Health Action Party party_leader: Alex Ashman political_spectrum: centre-left victory: false government_outcome: opposition sections: - economy - taxation - health - education - housing - immigration - foreign-policy - environment - transport - welfare - democracy-and-constitution - agriculture - energy - science-and-technology - local-government --- # National Health Action Party Manifesto 2017 The National Health Action Party Election Manifesto 2017 A new politics. A healthy NHS. A better Britain. ## Contents * Introduction …p3 * Our NHS action plan …p6 * Public health …p14 * Social care …p17 * Creating a fairer economy …p20 * Our vision for political reform …p24 * Better access to housing …p26 * Equal access to education…p29 * Women’s equality…p31 * Common sense on Brexit …p33 * Transport …p36 * Sustainable development …p37 ## Foreword **Introduction to the National Health Action Party 2017 Election Manifesto by Dr Alex Ashman, junior doctor and NHA co-leader.** The National Health Action Party was founded on the principles of public service and accountable democracy. We believe our public services should reflect our sense of national identity and social cohesion. They should be publicly owned, publicly delivered, and publicly accountable. This election comes at a key moment in the history of our nation. Over the last 7 years we have seen public services cut across the board. Policing, education, transport, health, and social care have suffered. This has affected us all, either personally or through friends and family. The NHS now faces a shortfall in funding of tens of billions, leading to a genuine humanitarian crisis in A&Es this past winter. Now plans are being brought in to permanently reshape our NHS, in the form of Sustainability and Transformation Partnerships. These plans are based upon the rationing of care and closure of local services in order to make the NHS ‘financially sustainable’. On the back of this comes ‘accountable care’, a US model of healthcare being promoted by the government and NHS England CEO Simon Stevens. Plans for ‘accountable care’ are already being made by STP leaders, and the first £6bn contract has already gone out to international tender. The organisations tasked with outsourcing the NHS are now themselves being handed over to private firms. And yet there is little, if any, mainstream debate of these plans – the very opposite of accountability. These changes are being brought in by stealth, with no explanation as to their purpose. We want an honest and open debate on how our NHS and public services are run. We want the public to be given the facts so they can make an informed choice as to who runs their country. Our manifesto lays out what we believe are the key themes necessary to restore our public services, our democracy, and our country. We want to see excellent education, health and support services providing the foundation for a strong economy. Above all, we want an NHS that puts people before profits. This is the General Election that will decide the future of the NHS. Please make your vote count. I want a system that works for all. I hope you do too. ### Dr Alex Ashman ### May 2017 ## Our NHS action plan We must restore the NHS as a safe, comprehensive, publicly funded, publicly delivered, and publicly accountable integrated healthcare system. We support the NHS Reinstatement Bill, and wish to take the following actions: 1. **Restore** the duty of the Secretary of State for Health to provide universal and comprehensive healthcare in England. Halt privatisation and scrap the costly, bureaucratic market within the NHS. Reinstate the NHS as the national provider of healthcare and remove the requirement to tender out contracts to the private sector. 2. **Ensure** funding, resources and staffing levels are consistent with maintaining patient safety and high quality care and that the value of staff pay is maintained. Publicly fund the NHS spending gap while multi-billion pound savings from policies removing the market kick in. 3. **Listen** to patients and staff to improve the NHS. Establish a Health Ombudsman at the head of local independent health commissioners acting on concerns expressed by patients and staff to speed up complaint resolution, introduce improvements more swiftly and reduce the growing litigation bill. 4. **End** financially driven A&E and hospital closures. Stop the Sustainability & Transformation Partnerships which are re-designing the NHS on a US ‘Medicare’ model. Changes and closures do happen to services over time, but they must be based on clinical evidence, with the support of the local population and the affected professional staff. Accessible replacement services must always be in place before any closures. 5. **Oppose** international free trade agreements which contain deregulatory elements affecting public service, public health and human rights as they threaten not only the NHS but the health and well-being of the public. Trade is a key element of our society but must be balanced by government responsibility for public well-being. 6. **Stop** further Private Finance Initiative (PFI) deals and remove the PFI repayment burden from individual hospital trusts. The Government should renegotiate on the basis of “fair value”. End the fire sale of public assets and restore the property from NHS Property Services Ltd and other government owned private companies to public ownership. End the imposition by government of commercial rents on public services. 7. **Urgently** repair the damage to our mental health services, strengthen maternity services and address the crisis in General Practice. 8. **Introduce** free personal social care for the elderly and disabled, and create co-operative working arrangements for NHS health provision and local authority social care. 9. **Prioritise** and focus on public health and preventative medicine, including measures to reduce alcohol consumption, smoking and obesity. 10. **Make** the social determinants of health an absolute priority in the design and development of all government policies. Health is affected by our income levels and work, our education, our housing, the environment and more and in turn our health affects our ability to engage in and enjoy life. That is why inter-departmental collaboration is essential to provide excellent public services to underpin our civil society and provide the life blood of a healthy economy. ### Restoring the NHS Health care is a basic human right, not a marketable commodity. The NHS is the world’s best example of the principle of social solidarity, remarkable for having had the support of people from all political persuasions, since its creation. When the country invests in healthcare it not only reduces poor health and extends lives, but also creates a healthier workforce and contributes to economic growth. The NHS principles have been undermined by a toxic mix of increasing marketisation and chronic underfunding, with an estimated funding gap of £30bn by 2021. The Coalition government’s £20bn ‘efficiency savings’ programme resulted in falling NHS productivity. The additional £50-60bn programme of savings now envisaged by this Conservative government is unachievable without vast cuts to services. And now we are seeing the Sustainability & Transformation Plans (STP), 44 local plans that use this artificially-created funding gap as a reason to close services and ration healthcare. We believe that STPs will lead to a fragmented, privatised service incapable of delivering universal healthcare. This would lead to a two tier system as NHS hospitals are forced to take more private work in order to stay open. We say: *  **Halt** the service closures contained in the 44 STPs. Make funding available where it is needed, and ensure local bodies follow national clinical guidelines. *  **Restore** the NHS to public ownership: publicly funded, publicly provided and publicly accountable. *  **Restore** the duties and responsibilities of the Secretary of State for Health to provide universal and comprehensive healthcare in England. But with less political interference in the day-to-day running of the NHS. *  **Halt** and reverse privatization by **abolishing** competition and the market in health provision with its associated huge and unnecessary costs and bureaucracy. *  **Reinstate** the NHS as the national provider of healthcare and remove the requirement to tender out contracts to the private sector. *  **Replace** the market with a system based on resource allocation, not commissioning. This system would enable effective planning of healthcare according to the needs of the population at local, regional and national level. *  **Implement** the ‘NHS Reinstatement Bill’ as the best way to achieve this (www.nhsbill2015.org). The Bill not only repeals the 2012 Health & Social Care Act, but also corrects the previous legislation which created a market within the NHS. **Defending local hospitals and the District General Hospital (DGH) model of care** *  We would defend the DGH as a good model of care for the majority of people who need admission to hospital. They provide care close to home, with easier visiting for relatives. *  While it is appropriate to have a Major Trauma Network and similar services when there is evidence that this improves patient outcomes, this should not be allowed to result in the downgrading and closure of DGHs. *  Reconfigurations of services should not proceed without local community and clinician support. A full consultation process must occur and an equality impact assessment should be published before any hospital or service closures. ### Funding the NHS The average annual increase in funding for the NHS since its inception was historically 3-4% a year. This matched the average rate of increase in other developed countries with similar economies. The causes are a combination of the rising costs of medical advances and technology, the rising population, demographic change and changes in the nature of ill health with many people living with long term conditions. Investing in the NHS to meet these ongoing challenges has been shown to stimulate our economy and generate jobs locally. *  We call for investment in the NHS to close the funding gap created by the Conservative government and bring the UK closer to the G7 average spend on healthcare. *  We call for real terms increases in funding for the NHS of 4% per year. *  In the medium term, the savings from ending the market and halting privatisation will pay for a substantial part of the increased funding required to maintain acceptable standards in the NHS. *  The cuts to public health budgets must be reversed and there must be significant investment in public health and prevention. ### Abolish prescription charges *  We call for the abolition of prescription charges, which are effectively a tax on people of working age with chronic health problems. This would bring England in line with the policy of the NHS in Wales, Scotland and Northern Ireland. ### Abolish PFI *  No more PFI or PF2 deals should be signed. *  The Treasury should force a full investigation of PFI contracts and renegotiate onerous contracts on the basis of fair value. ### Eligibility checks *  We feel it is reasonable to use eligibility checks prior to scheduled care, but not prior to emergency care. We reject up front checking of passports and utility bills for eligibility at the front door of hospitals, as this could discourage sick people from attending and deprive those who are not able to provide such documents of access to care. *  We should continue to provide emergency health care to anyone who becomes ill while in the UK. *  We should ensure that refugees and asylum seekers have access to essential provision such as emergency and maternity care. ### General Practice *  Support the traditional model of General Practice with primary care teams working in defined areas, distributed fairly, and based on long-term relationships with patients and underpinned by the vital concept of continuity of care. *  Improve access and continuity of care by increasing GP numbers by 10,000, in line with recommendations from the Royal College of GPs. *  Allow GPs to remain free from pressures, particularly financial incentives, which could detrimentally affect clinical decision-making. Their patients’ best interests must be their priority. *  Reverse the cuts to general practice funding of the last 7 years, with greater investment in premises and local GP-led out-of-hours services. ### Nursing *  We endorse the Royal College of Nursing’s 2015 manifesto. *  Improve patient care – safe staffing levels, access to training and environments where staff concerns are listened to. *  Value nursing – provide fair pay for nursing staff, an end to down-banding and for a focus on the future of nursing. *  Invest in health and care – no more cuts to nursing; increased community resources; workforce planning around patient need. ### Maternity Services *  Ensure a safe and effective service for women and their babies at one of the most vulnerable times in their lives. *  Address midwife shortages and training numbers *  Statutory maternity pay and allowances must at least be the equivalent of a Living Wage. *  Increase support for working parents *  Focus on maternal mental health issues ### NHS Staffing *  Restore the bursary for nursing and health care students *  Invest in safe staff-patient staffing levels and reduce dependency on costly agency staff. *  Increase training places for nurses, medical students and other health professionals. *  Implement a pay structure to reward NHS staff fairly for their skills and their work. Salaries should rise in line with inflation. Terms and conditions of service should be protected. *  The living wage, not the minimum wage, as the lowest rate payable in the NHS. ### Supporting Mental Health Services with “parity of esteem” *  Mental health funding to be addressed as a matter of urgency. *  Increase staffing levels and training places for mental healthcare professionals. *  End the privatisation of mental health service provision. ### Listening to patients and staff to improve the NHS *  Make the NHS Complaints Process patient-friendly and be used as a means to improve the NHS. Provide an independent ombudsman to review cases. *  Reduce the NHS and Department of Health dependence on management consultants, and increase the influence of healthcare professional bodies, health staff and patient groups. *  Restore responsibility for health planning to public health and clinical leaders. *  Strengthen the whistle blowing system to allow staff to identify and report their concerns about quality of care and patient safety without fear of recrimination. ## Public health We believe prevention is a key pillar of maintaining a healthy society. As well as tackling the social determinants of health, we would encourage investment specifically in public health measures. This would save the NHS money in the long term by keeping people healthy. *  Reverse cuts to public health budgets and ensure that money given to local government is ringfenced for public health spending. *  We should continue to treat all individuals with infectious diseases, regardless of citizenship, as a public health protection measure. *  Take urgent measures to deal with air pollution to minimize harm to human health. *  Introduce minimum unit pricing for alcohol, and a sugar tax. Force the fast food industry to cut the use of additives such as sugar and salt. *  Universalise detailed food and drink labelling, including calorie labeling on alcohol. Place tougher controls on alcohol advertising. *  Stricter rules and greater transparency surrounding links between the food & drinks and pharmaceutical industries, and public health research & policy *  Provide greater access to exercise and sport in schools and local communities. *  Adequately fund local authority public health education and public health policies. *  Stop the outsourcing of public health services and reintegrate them with other NHS services. ### Reducing health inequity There is incontrovertible evidence (e.g. Centre for Welfare Policy Reform) that health inequity arises from social inequalities. To reduce such inequalities requires action across all determinants. Targeting the most disadvantaged alone will not improve health sufficiently. To reduce the social gradient in health, actions must be universal and with a scale and intensity that is proportionate to the level of disadvantage. We therefore strongly support evidence based programmes to achieve the following 6 policy objectives: *  Give every child the best start in life. *  Enable young people to achieve the maximum of their potential for healthy lives. *  Create fair employment and meaningful work for all. *  Ensure a healthy standard of living for all. *  Create and develop healthy and sustainable communities. *  Take every opportunity to promote well-being and prevent ill-health. ## Social Care Social care is a safety net for us all. It contributes to our economy by generating employment and supporting individuals whose families require care. And yet it has been eroded continually by the government. Spending less on social care when the need is growing shows a lack of regard for those whose families need care, and for those who work within the care sector. Cutting social care is also bad for the health service. Delayed discharges put pressure on hospitals that are already short of beds, and a lack of community care leads to unnecessary admissions. And cutting social care is immoral. Forcing those with long term ill health or disability to bear the cost of care personally is a regressive step. Nobody should live in fear of losing their home to pay for care costs. Making individuals pay for certain forms of frailty or illness but not others is not only unfair, but is the direct opposite of the shared pooling of risk that is meant to be provided by a universal healthcare system. ### Funding for social services *  Provide better central funding for social care. Local councils are already permitted to raise extra funds by charging care precepts on council tax, but these are insufficient to meet care costs and will worsen the postcode lottery of care. *  Reverse the cuts to local authority budgets and increase funding for social care to a level that fully meets the needs of vulnerable, elderly and disabled people. *  Reverse the cuts to social services budgets for children and families. ### Free personal social care and integration with health *  Introduce free personal social care and increase funding to meet the needs of vulnerable elderly and disabled people *  Implement the Dilnot Commission recommendations, even if the level of the cap needs to be reconsidered in the light of fiscal policy. The Dilnot Commission recommended that social care costs be shared by the whole community. We say that this would be fairer to all, and would not result in a new industry for lawyers and accountants in seeking to avoid the large and draconian costs that are in the Conservative manifesto. *  Prioritise streamlined planning for housing-with-care schemes and clarify as a matter of urgency proposed changes to how supported housing is funded through the benefits system to put an end to uncertainty about the future of existing schemes and new developments. ### Care homes *  Support the provision of new local authority owned and managed care homes to provide high quality local care for those who need them. *  Oppose the closure, for merely ideological reasons, of existing local authority owned and managed care homes where they are providing good standards of care. *  Set out in regulations what any care home owing human rights to publicly funded clients must do if considering closure and the eviction of all of its residents for business failure reasons. *  Ensure that care homes and agencies threatened with closure due to business failure can be taken over temporarily by local authorities. Regulate what care homes must provide for publicly-funded clients in the event of closure and eviction. *  Restore full inspectorate powers with regard to councils’ discharge of Care Act commissioning duties to the CQC. ### Care staff *  Improve the quality and provision of care through a transformation in the pay and conditions of care and support workers *  Prevent social care commissioners purchasing from agencies which use zero hours contracts. *  Enforce minimum personnel levels for people with particular profiles of need. End the notion that 15-minute care slots for personal care staff, without payment for their journey time between clients is a legitimate way for the State to purchase services or to provide them. ## Creating a fairer economy We understand the need for careful financial stewardship, but this must not be at the expense of our public services. There is good evidence that austerity policies have actually slowed economic growth. Meanwhile, increased spending on public services and infrastructure has been shown to give a positive economic return (e.g. health, education, transport, and energy infrastructure). We want to see a society where taxation is progressive and money is invested wisely to benefit everyone. ### Progressive taxation *  Taxation policies should be based on maintaining a decent standard of living for all. We support the re-instatement of – and efficient collection of – the 50p higher rate of tax. We support higher taxes on luxury goods and services. ### A determined clampdown on tax avoidance and evasion The Tax Justice Network estimates up to £70 billion in tax is avoided and evaded each year – just under half the amount of income tax that was actually collected in 2013-14. Beyond being a simple matter of principle, the collection of this money could have huge benefits if invested in public services and infrastructure. *  We feel that all due taxes should be collected. Greater efforts must be made to close the tax loopholes which enable tax avoidance. Short-sighted cuts to HMRC staffing levels must be reversed and inspectors increased to focus on tax evasion by the richest corporations and individuals. ### A financial transaction tax *  A small levy of 0.1-0.5% on all financial transactions could raise billions of pounds that could be used to stimulate private sector growth and generate more revenue for public services. To be effective, the tax would need to be adopted by all the major economies. Eleven European nations have signed up for it, but the UK, as yet, has not. We fully support these proposals and the UK should sign up to these Financial Transaction Tax proposals ### Better banking *  Small businesses and entrepreneurs need access to loans to grow their businesses. We support the idea of stronger local community banking, and a national state-run bank to support business lending and encourage growth of UK manufacturing industry and small businesses. *  Small businesses face particular challenges, including late payments by contractors, difficulty getting mortgages or insurance, and business rates taking no account of ability to pay. These are issues that Government should tackle to support small businesses. *  Better regulation of the financial sector at G20 level, as our politicians of every hue have shown themselves unwilling to control sharp operators at national level. The retail and investment arms of major banks must be separated. ### Investment in transport and energy infrastructure *  It is crucial to improve cities' transport links outside London, to stimulate their local economies. We support the idea of investing in renewable and sustainable energy policies. ### Welfare benefits *  Replace the benefits capability assessment system with a humane system based on a genuine assessment of people’s abilities and support needs, plus the resources to support them back to work where possible. *  We support the abolition of the cruel and target driven ‘sanction’ system which is driving many people to poverty. *  The ‘bedroom tax’ (spare room surcharge) should be scrapped. ### Your working life *  We oppose enforced zero hours contracts. In the case of home care workers, they must be paid at least the Minimum Wage for the time they spend travelling between clients as well as the time spent with them. *  The reported fall in unemployment masks the rise in underemployment and insecure self-employed and zero hours contract job. We support policies to promote full employment with jobs that are secure and well paid. *  We support the introduction of a statutory Living Wage. This would transform the quality of life and health of low-paid workers; slash billions from the benefits bill (actually a state subsidy for low-paying employers); and stimulate economic growth. A Living Wage creates jobs by pumping more money into the economy at the level where it will be spent locally. *  We support provision of a comprehensive and universal childcare support system. This would pay for itself by freeing parents to contribute to the economy through their taxes for paid work. We would increase investment in the evidence- based early years programmes. *  We support gender equality in pay and oppose all forms of discrimination in the workplace. Workers’ rights, their health, and their safety, must be protected. ## Our vision for political reform There are profound faults in the UK political system. Public confidence in both individuals (MPs, peers and civil servants) and the wider political system has been undermined. This has resulted in increasing numbers of people failing to engage with politics at all, thus destabilising our democracy. We therefore believe that reform is essential. ### A parliament that works for people, not politicians. *  Stricter control of MPs’ and Peers’ ability to support legislation where they or their family have a personal or financial interest. *  A monthly People’s Question Time. *  An end to the ‘revolving door’ through which civil servants, politicians and corporate employees put profit before professionalism as they move between the private and public sectors. *  Much greater control and transparency of corporate lobbying of civil servants and elected officials. ### Better access to democracy *  Appoint an independent Commission to investigate a move towards a system of proportional representation. *  Lower the voting age to 16. *  Liberalise the rules governing access to the media both before and during election campaigns. *  Repeal the Transparency of Lobbying, Non-Party Campaigning and Trade Union Administration Bill. ### House of Lords reform We support a completely new second chamber to review proposed legislation. At least 80% of the members of a reformed Upper House should be by direct election using a single transferrable vote system. The remaining members to be appointed for fixed terms on the basis of expertise in specialist fields such as science, technology, health, education, business, charities, the voluntary sector, local government and trade unions. ## Better access to housing We reject the free market “solution” to the housing crisis, which is to remove planning controls to let developers build wherever they see a profit, regardless of local objections. The rights of local people to determine the way development happens in their area through the Neighbourhood Planning process should be strengthened. Development should be for the benefit of local people by creating affordable homes, with due regard for infrastructure to sustain local health and wellbeing – including health, education and recreational facilities, sustainable green transport facilities and protection of natural habitats. ### Sensible, sustainable investment *  Ban the sale of local authority homes and housing association property, unless sale can finance more and better social public housing in the area on the same terms. *  Reinstate government house-building programmes for truly affordable homes, including new social housing, improving and upgrading current housing stock and tackling the number of empty homes. *  We would restore the presumption in favour of brownfield sites for development before greenfield sites. *  House building and modification should be as efficient as possible, using as little energy and water, and producing as little waste as can be reasonably achieved. Investing in a national infrastructure with these objectives would generate jobs and increase energy security. We would examine the evidence on using carbon taxes/rebates to drive this effort. *  Re-examine the evidence around large infrastructure projects such as HS2, to assess whether the billions of public investment required would yield better returns for the 26 community, economy and social development if redirected into our house-building project. ### Fair taxation of land and housing *  Introduce further council tax bands to reflect the reality of soaring top property values, with extra monies gathered going to building up the local public housing property portfolio. *  We believe there is a strong case for a progressive tax on property. We would examine the evidence around the ability of a national Land Value Tax to suppress the speculation and land-hoarding that currently drives up house prices, and deter the massive rise in speculative property purchase for profit by overseas investors who may never set foot in the country and have no interest in its well-being. Any such tax would have to protect designated public spaces such as parks and the Green Belt, while encouraging the development of well-designed communities. *  We oppose privatisation of the Land Registry and call for this vital national monitor to be returned to public ownership, resourced appropriately, to record all property ownership accurately and help prevent tax avoidance and evasion. *  We believe that the use of tax havens to purchase and own UK property in order to avoid taxation must be made illegal. All property in the UK should be purchased only through a UK bank account, with strict money laundering controls. We would look at the evidence around possible regulations on house purchase by foreign speculators. ### Greater protection for tenants *  Tenants should be protected by regulation of rented property to ensure it is safe, hygienic, and energy-efficient. *  We support extended tenancy agreements, with the sitting tenants offered first refusal, to protect tenants and prevent rent inflation (which generally transfers to an increased burden on the public purse). *  We support the introduction of a national register of landlords to improve private rental standards across the country. Local Authorities must have a statutory duty and sufficient funding from local and central government to identify poor quality housing and enforce improvements. *  Every property must be certified as fit for purpose before being put on the rental market. ## Equal access to education We believe there is compelling evidence that, as with healthcare, access to high quality education is beneficial to society and to the economy. It should be viewed as an investment, not a cost. Education is a basic right and public good and should be free to all. Schools are suffering severe funding cuts and difficulty recruiting and retaining teachers, especially in core subjects like Mathematics, English and Science. Budget cuts have led schools to cut wider curriculum areas such as the arts and music and this is impoverishing children and young people’s educational experience. School buildings are being left unrepaired through lack of funding and this causes health and safety risks. Parents are regularly being asked to make financial contributions to their children’s schooling - not just for extras but for basics. *  The marketisation of further education and higher education should end. This includes an end to student fees and student loans. *  The cuts to school budgets must be reversed and schools provided with sufficient funding to meet the needs of all their pupils, including those with special educational needs. *  Funding for Sure Start should be restored. The 1% cap on teachers’ pay should be removed. The Education Maintenance Allowance for 16 year olds should be restored. *  There should be free school meals, of good nutritional standard, for all school children. *  The shortage of primary school places must be urgently addressed and we support the need for smaller class sizes. *  The policy of encouraging Free Schools and Academies should be abolished, and the money be spent more fairly and equitably across the system. *  The policy of creating new Grammar Schools should be halted, and funds used to improve the quality of all secondary schools. *  The teaching profession should have a greater role in the policy-making process and the structure and functioning of the education system, as well as the national curriculum. *  Exercise including sport should play a major role in schools, with education about healthy lifestyles a key part of the curriculum. *  We call for support and development for genuine apprenticeships, especially in advanced technology areas, manufacturing and infrastructure industries such as building. *  We call for a substantive programme for adult further education and learning. *  We call for a serious review of whether the educational provision for medical and care staff at all levels is sufficient for the future needs of the nation and its NHS, and call for any shortcomings to be addressed. ## Women’s equality Our policies on healthcare, the economy, housing, and education indicate our ambition to drive down social inequalities by tackling the root causes. The continued existence of gender inequality in Britain today is also of great cause for concern, with symptoms such as the 18% gender pay gap and the male domination of executive level boards. ### Recognising parental roles *  The two-child policy and the outrageous ‘rape clause’ for child benefits must be ended. *  Shared parental leave, including 9 months statutory pay, should be available to all, including the self-employed and regardless of gender. *  Statutory maternity pay and allowances must at least be the equivalent of a Living Wage. *  Free universal childcare should be provided and children’s centres should be re-established throughout the country. ### Equality in the workplace *  Employers who support flexible working and job sharing should be encouraged via tax benefits. *  Carers should be provided with a paid leave allowance from their workplace, with protections against redundancy. *  Reporting on gender pay gaps should be extended to all organisations with 50 employees or more. ### Sanitary protection *  The ‘tampon tax’, which treats sanitary items as luxury goods, must end. *  Free basic sanitary protection should be available to minors who cannot otherwise afford it. ## Common sense on Brexit Under a Conservative government it is clear that the economic costs of Brexit will be borne by the least-well-off in our society, and our public services will see their funding squeezed even further. Instead of £350 million extra per week for the NHS there is likely to be less funding as the economic impact of Brexit hits our economy. It is important that the Brexit negotiations safeguard the positive aspects of our relationship with the EU. We must be realistic in our negotiations and not expect to be able to cherry-pick only the aspects of the Common Market that we want. The final Brexit deal must, at a minimum, be put to a vote of the UK Parliament. ### Recognising the role of EU migrants The majority of EU citizens who live in the UK are young, healthy, tax-paying workers. Those who stay for a few years pay far more in to the NHS than they could ever take out. Those who settle become part of the fabric of our society. The NHS relies on overseas staff to fill 1 in 8 posts. This includes over 60,000 EU citizens who, following the Brexit vote, have suffered a great deal of uncertainty over their future in the UK. NHS figures show a record 17,197 EU nationals, including doctors and nurses left the service in 2016. The NHS is experiencing a serious and long term staffing crisis. The loss of thousands of EU nationals who currently work in the NHS will exacerbate that crisis significantly. *  EU citizens and their families resident and working in the UK must be given proper assurances without delay that they will not face deportation and that British citizens abroad will also be able to continue with the lives they have created for themselves without hindrance. The damage that will be done to individuals, to communities and to our international relations may otherwise be irreparable. ### Safeguarding collaboration with the EU on health issues *  Medical and scientific research collaboration between the UK and the EU must be safeguarded. *  We must ensure that on leaving the EU, the UK maintains reasonable standards of regulation on air, food and water quality, environmental hazards, and health and safety at work. *  We should continue to collaborate with the EU on regulation and approval of medicines and devices, and mutual recognition of medical qualifications. ### Avoid opening up the NHS to ‘free trade’ deals We remain clear about our opposition to transatlantic deals such as TTIP, CETA and TiSA. Such deals would allow unprecedented access to our public services, opening the NHS ‘market’ to foreign interests and allowing them to sue the government if they lose out on contracts. US healthcare firms in particular would like to siphon taxpayers’ money overseas whilst reducing the quality and accountability of care. We are a trading nation and our trading relations with the world play an important role in our economy. However, we must ensure that harmonisation of standards does not remove or reduce environmental, employment or human rights protections in pursuit of 'free' or deregulated trade. ## Transport We believe that an integrated, environmentally sustainable transport system, with access for all, promotes economic development. This requires an integrated transport policy, which decades of de-regulation and increasing privatisation have thwarted. ### A return to truly public transport *  Privatisation of the railways has not served the nation well, and we support re-nationalisation. The recovery of a franchise into public ownership proved popular for several years on the East Coast Mainline, and this mechanism should be used again to take expiring franchises back under public ownership. *  Rail fares must come down to increase rail use and reduce the burden on our roads. *  We support re-regulation of buses services nationwide and the expansion of bus routes to provide better services to rural and isolated populations who depend on them. ### Sensible investment for the future *  We support transport initiatives to improve the connectivity and economic fortunes of our major northern cities and towns. However, we believe HS2 has run into too many problems and we believe there should be better ways to invest £55bn with a much wider range of policies, to improve the connectivity and economic fortunes of our major northern cities and towns. *  We would promote walking and cycling in our cities and towns with more cycle lanes and greater urban pedestrianisation. *  Public safety must be a priority in design, planning and building. ## Sustainable development The long-term health of people depends on a healthy environment, supportive social structures and adequate natural resources. We believe in development that fulfils the needs of the present generation without endangering future generations. Almost any human activity consumes resources and has both social and environmental effects but we now have the technology to outstrip the planet's natural capacity to regenerate itself. Human induced climate change (HICC) is real and we must act to halt and reverse its effects to the extent that we are able. Motivating people to take a long-term perspective on everyday decision-making is difficult in a society increasingly consumerist and short-term in outlook. However, most adults desire a better quality of life not only for themselves, but for their children and grandchildren. The 2006 Stern Review on the Economics of Climate Change put a price on HICC. It concluded that, without action, the overall costs and risks of climate change will be equivalent to losing at least 5% of global GDP each year, now and forever. The poorest, most vulnerable countries and populations will suffer most, although they will have contributed least to the causes of climate change. ### Taking steps to protect the environment *  The UK must redouble its efforts to meet or surpass the most ambitious goals of the Paris Climate conference, and to encourage others to do the same. *  The global temperature should be kept below 1.5 degrees Celsius above pre-industrial level (agreed in Paris); it is already at around 0.94 degrees Celsius (NASA). *  Investment in renewable energy must be promoted. Use of fossil fuels must be phased out relatively quickly, including a ban on fracking. *  The UK should aim to move to circa 100% renewable energy generation as soon as possible. It is possible: on April 30th this year, Germany generated 85% of its energy from renewables. *  A clean environment is essential to our health and wellbeing. Both the environment and nature need to be protected from misuse, pollution and unnecessary interference. Government must take urgent steps to tackle the growing crisis in air quality and consequent health problems. ### Farming and wildlife A healthy society needs a healthy environment. We call for a sustainable, life and health enhancing approach to food production, including the production of meat, poultry and dairy produce. Sustainable farming and humane animal rearing is good for animal wellbeing and the environment and, because it also leads to better quality food, is good for human health. *  We will promote sustainable farming methods and high animal welfare standards. *  We would support improved labelling of meat, poultry and dairy products to indicate the use of sustainable and humane practices. *  We would push for an increase in ‘farm gate’ prices for farmers whose livelihoods depend on fair prices for their produce. *  We would keep existing legislation that limits the pursuit of certain blood sports such as fox hunting.