As the clocks struck 10:00 on the 12th December, student union bars across the country fell silent.

The shouts of “ooohh Jeremy Corbyn!” dissipated as the exit poll was released and Huw Edwards uttered those three dreaded words: Conservative majority likely. As each hour passed the extent of the Labour parties utter capitulation became more apparent. The ethical coffee shops and wine bars of London were especially quiet the next day as the reality that the Tories had won an 80- seat majority began to sink in. Not only had the Conservatives won the election, but they had won it decisively. Managing to secure their best election result since 1987, when Margaret Thatcher was their leader. Although this will be the Tories’ tenth year in power, small majorities, coalition governments and Brexit have limited their attempts to enact even wider-reaching conservative policy.

However, 2020 will undoubtedly stand in striking contrast to their previous nine years in government. No more knife-edge votes in the commons; opposition members will no longer be able to take control of the order paper and Lindsay Hoyle’s interpretation of standing order 24 means MP’s will no longer be able to stifle the Tories ability to enact policy by holding emergency debates and introducing legislation like the Benn Act. With a weakened opposition and such a large majority, the government now have five years to enact their vision for the future of the UK. This will likely include sweeping and potentially unpopular reform of public services including the NHS.

We have already seen the difference such a decisive victory makes; earlier this month, the EU withdrawal agreement passed its third reading in the commons by 99 votes and the UK is now set to leave the European Union on the 31st January 2020 at 11:00pm. Prominent Brexiteer and ERG member, Mark Francois, has even proposed a motion for Big Ben to strike to celebrate our departure at an estimated cost of half a million pounds. This emboldened Conservative government is certainly in stark contrast to Theresa May’s government, who for months attempted the Sisyphean task of introducing their Brexit legislation, to no avail. They are determined to “get Brexit done” and enact their domestic agenda and to hell with the naysayers.

Ever since the 2016 Brexit referendum, the NHS has taken centre stage of political discussion. I seem to remember our now prime minister bumbling around the country in a big red bus which had a less than truthful slogan emblazoned on its side. However, we cannot just blame Brexiteers for weaponising the NHS for their own political gain. Remainers and so called “Project Fear” claimed that in the event of an out vote, there would be immediate medicine shortages and all European NHS workers would spontaneously disappear in a puff of smoke.

Nigel Lawson, former Chancellor of the Exchequer, observed that, “the NHS is the closest thing the English have to a religion”. This is borne out by the doublespeak operated by most British politicians. Most now dutifully refer to the healthcare system as “our NHS” and “privatisation and reform” have been entirely expunged from briefing papers and speeches. The NHS also took centre stage in the final week of the December General Election when the Daily Mirror released a photo of four-year-old Jack Williment. Jack was brought to hospital with suspected pneumonia and due to a lack of beds was forced to wait on a pile of coats, highlighting what many saw as a funding and capacity crisis within the health service. These events are just snapshots of the many occasions on which the NHS has been a central issue in British politics over the recent year. Politicians on all sides of the political spectrum have made it clear--in public at least--that they are supportive of the NHS and increased funding. Now the Tories have their majority, it remains to be seen whether such enthusiasm will continue.

When I began to write this piece, I felt it was important to understand the commitments the Tories made on the NHS during this most recent election campaign. When I read a transcript of the Queen’s Speech and the Tory manifesto I was pleasantly surprised. At first glance the documents were filled with promising commitments; £1 billion for social care, 50,000 new nurses, 40 new hospitals. I was filled with optimism that Boris Johnson would help reinvigorate the health service. However, on closer inspection, to say these promises stretch the truth would be an understatement. In reality 18,500 of these “new” nurses already work in the NHS, the government will only upgrade 6 hospitals by 2025 and the government has not yet decided what this £1 billion will be spent on, stating “[we hope] to seek cross-party consensus on proposals”. Many also are worried that Boris, desperate to agree a trade deal with the US in a post-Brexit Britain would be willing to provide lucrative contracts to American firms and allow further privatisation of the NHS. Although the government has since stated the NHS is not for sale, leaked documents of preliminary talks do not explicitly take the NHS off the table.

It is very easy to blame all the woes facing the NHS on the Tory tightening of the purse strings and a lack of funding. How then do you explain the similar problems facing the NHS in Scotland. The SNP government, who spend 6.3% more per patient than England, still fail to meet their A&E waiting times since 2017 and the opening of a new hospital in Edinburgh, which has been delayed for 8 years. Unquestionably, there are significant structural problems facing the NHS which none of the major political parties are willing to address for fear of negative press. How is it that the NHS is still the world’s biggest purchaser of fax machines and uses one out of ten of the world’s pagers? Moreover, since there is a determination that healthcare is paid for exclusively through tax receipts and is free at the point of delivery, it’s inevitable that a country with an ageing population will find it increasingly difficult to fund this system if its ambition is to spend within its economic means. Surely a sensible approach to liberate further funding for the NHS would be to introduce some form of limited patient responsibility. Perhaps introducing a small fee for GP appointments for those who can pay—a proposal favoured by up to eight in ten GP’s (according to the Telegraph)–could be such a reform. Furthermore, until the government centralises PFI debt and explicitly states extra funding is for front line services, this money will be used to offset growing costs and pay off a Trust’s debt.

This new government finds itself at a profound moment in the NHS’ history. We can all agree that the NHS requires increased funding, which is why the government is set to enshrine its new NHS funding settlement into law; however, the government must also identify and eliminate the root causes of the health service’s pressures. In order to have effective healthcare system, we must also improve our prison system, education system, police service and social care system. To improve the NHS, an overhaul and improvement of all public services is required. This is no easy task. The question is whether Boris Johnson is up to the challenge.