The 5th July marked the 65th anniversary of the NHS. To mark the occasion, the Nuffield Trust has published a new report ‘Wisdom of the Crowd: 65 views of the NHS at 65’ which invites 65 health and political leaders to give their opinion on the current state of the NHS and social care system. They have been asked specifically to reflect on what they think needs to happen now and over the coming years to ensure the NHS and social care system is viable and fit for purpose in ten years’ time.
Contributors consisted of current and former health secretaries and ministers, senior civil servants, clinicians, managers, academics, patient representatives, journalists and other key individuals. Amongst the contributors is Lord Ara Darzi, the Director of the Institute of Global Health Innovation at Imperial College London and former Parliamentary Under-Secretary of State at the Department of Health from 2007 to 2009. Over the past 10 years, NHS funding had more than doubled and there were a series of reforms in England aimed at improving the quality and timeliness of care. Darzi states that the injection of money did a lot of good; there was a huge amount of progress, fantastic outputs and outcomes, but he feels we could have pushed the reforms even further.
He goes on to offer four suggestions of what the NHS needs to do now to remain viable and to divert the tsunami that is about to hit. They are:
- Aligned political and clinical leadership
- Ensuring that there is no further national restructuring during the next ten years
- To infuse more transparency into the system at all levels
- To engage and get clinicians and the public on board
So can the NHS remain free at the point of use?
Darzi’s view is that co-payment will creep in, probably around something to do with the patient experience. His fear is that only once it is in place will the real difficulties become apparent with such a system, including its effective policing: “If we end up in a scenario where things are falling apart and the money is tight, co-payment may well happen. I don’t know whether it will, or whether it is the right thing. But I have always feared it. How do you manage it? How do you police it? How do you have it without eroding some of the fundamental values of the NHS?”
There seemed to be a consensus across the board, at least among contributors to this publication, that the NHS should continue as a comprehensive service, free at the point of use. But what are your views and what can we do to avoid the tsunami about to hit? What kind of life jackets are needed to enable us to weather the storm? Comments are welcomed and encouraged.
The full publication which includes Lord Darzi’s contribution (page 35) can be downloaded here