The NHS has always aroused strong feelings for politicians and voters alike and emotions will continue to run high as the election approaches. No surprise then that the future of the NHS dominated the recent Party conferences. Labour’s pledge to find an additional £2.5 billion to employ more doctors and nurses as part of a “Better Care Fund” triggered both the starting gun for an election campaign but also a bidding war on NHS spending. A week later the Prime Minister vowed to protect the health budget throughout the next Parliament, while his Coalition partners went one better with plans to spend an extra £1 billion a year. Alongside extra cash, each Party unveiled their latest doorstop friendly pledge to guarantee GP access or cut waiting times for cancer and mental health services. But while government and opposition struggle to find the odd extra billion down the back of the Treasury sofa, this alone will not safeguard what Danny Alexander described as “the jewel in our country’s crown”.
In recent months people have started to wake up to the scale of the challenge facing the health service. While health spending was “ring fenced” in 2010, the health service has come under growing pressure in the face of rising demand driven by demographic change, rising expectations and the rising costs of healthcare delivery. To keep up with this “perfect storm” of funding pressures NHS England had called for spending to increase by 1.5 per cent in real terms, or £8 billion extra by 2020. Now a week seldom goes by without the national papers warning of “NHS in crisis”. With over a third of hospitals now in deficit and waiting times on the rise, experts claim the NHS will hit the financial buffers sooner rather than later.
But alongside this well versed chorus of impending doom a transformation of healthcare is now on the horizon. In recent years all health systems have begun to embrace the digital technologies that have revolutionised other sectors of society. The internet and smart phones have opened the door to dramatically different ways for patients to access healthcare. Breakthroughs in modern medicine continue to deliver innovative new treatments that can radically improve the experience of patients. NHS hospitals are now following in the footsteps of their global peers in adopting sophisticated methods to use data to measure and manage quality on the front line. Some health economies are starting to work together, often in partnership with other public services, in more “integrated” ways to coordinate the care that patients receive. As the demand for healthcare continues to rise policymakers will need to identify options to accelerate these trends that have only just begun to transform the NHS.
The case for NHS reform is overwhelming. The Coalition’s attempted restructuring of the health system, by putting NHS budgets in the hands of family doctors, did not lead to all the improvements that were hoped for. But reforms will be needed if political parties want to achieve their ambitions to integrate health and social care or put mental healthcare in equal footing with physical health. How then can policy makers square the circle of transforming services without simply restructuring the architecture? Equally pressing will be the need to resolve the future of the Cancer Drugs Fund, re-launch care.data and tackle obesity, to name a few of the challenges that lay ahead. Given the scale of the challenge and the size of the opportunity the NHS is too important an issue to be pushed to the side-lines.