Now it has a long-term funding settlement, the NHS must take the chance to transform
3 min read
The funding boost is welcome – but investment must be accompanied by reform, says Alan Milburn
The penny has dropped. The prime minister has come to realise that the NHS needs more money. Whether it is enough, only time will tell but a long-term funding settlement gives the NHS the chance to transform itself.
The NHS has remarkable strengths but faces some formidable challenges. The population is ageing. Chronic diseases such as diabetes, which already absorb most of the NHS budget, are growing. Changes in demography and disease are compounded by a profound misalignment between how the care system is organised – in silos split between health and social care, primary and acute medicine – and what is needed – integrated services focused on prevention not just treatment.
As the US proves, simply throwing more resources at healthcare won’t by itself bring about sustainable improvements. In America, they spend twice as much as we do on healthcare but outcomes are no better than in the UK. That is why reforms are as important as resources.
The challenges facing healthcare today are different from yesterday. Perhaps more importantly, the opportunities for healthcare to do more will make them different still tomorrow. The injection of more cash is the moment to instil a new sense of possibility into the public debate about healthcare.
The world is on the verge of a huge leap forward. We know more about how the brain works and the impact the broader environment has on our mental health. Similarly, about how gut health works and the impact of food and diet.
The advent of big data and predictive analytics mean we can better plan care for a population. Advances in pharmacogenetics are changing our thinking from diagnosing and treating illness to instead predicting and preventing ill-health. The development of precision medicine allows a patient to be treated as an individual not just another number. An influx of new mobile devices and bio-devices means we can check – and take greater control over – our own health in a way that was never previously possible.
All of these big changes are under way. They will accelerate in the years to come. The question that policymakers should be focusing on is how to harness them to improve the health of the nation. That will mean redesigning the care system away from its 20th-century focus on episodic treatment – largely in hospitals – towards earlier preventative action and continuity in treatment in the community.
New financial incentives will be needed to drive these changes. New structures will be needed to integrate health and social care. New types of skills will be needed in the workforce. New partnerships will be needed with technology and pharmaceutical companies to harness their expertise. New individual budgets should give patients the power to decide the care that is right for them.
The promise of more government investment is welcome, but it must be accompanied by reforms. There is a huge opportunity to better optimise resources, better empower patients and better improve health outcomes. Change is always hard in the NHS, but there is a big prize on offer – not just to sustain the system, but to transform it.
Alan Milburn was Labour health secretary from 1999-2003
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