Social Market Foundation - The NHS: Decline and fall, or resurrection? (July 2022)

Summary

In this briefing paper for the Social Market Foundation, Lord Norman Warner sets out a radical change programme that could reverse the decline in NHS services. It examines long-term issues that have been exacerbated by the impact of Brexit and the Covid-19 pandemic—the care backlog, workforce issues and loss of public confidence.

Content

Key points

• The National Health Service (NHS) is in serious decline – struggling to recover from the devastating impact of the pandemic and Brexit.
• The issues are deep-seated and more extensive than the pandemic’s treatment backlog. The future sustainability of a tax-funded comprehensive NHS is now open to doubt.
• Throughout its history, the NHS has focused on treating ill-health, even as the disease profile of the UK has vastly changed.
• Rising demand will mean the NHS is unable to provide services to all, ushering in a two-tier health system that no longer provides free universal care.
• Politicians must be much braver in making major changes to the way the country structures and delivers health and care services.

Recommendations

1. Reform public health and prevention – by creating an independent public body, the Office of Public Health, which will make decisions on policy and resource distribution.
2. Expand community health services and social care – rather than expanding hospitals, much more of the NHS capital should be allocated to community health facilities, including GPs.
3. Consolidating specialist health services – create a new system for determining the consolidation of specialist health services on fewer sites.
4. Creating elective surgery and diagnostic hubs – NHS England should be directed to establish either surgical hubs or standalone surgical centres to undertake elective surgery.
5. Reforming workforce planning and delivery – DHSC should be given new powers and a long-term budget to meet future NHS labour demands.