Healthcare needs a radical rethink

Lord Nigel Crisp is an independent crossbench member of the House of Lords, where he co-chairs the All Party Parliamentary Group on Global Health. He works and writes extensively on global health. A former chief executive of the National Health Service (NHS) and Permanent Secretary of the United Kingdom’s Department of Health, he is a Senior Fellow at the Institute for Healthcare Improvement and an Honorary Professor at the London School of Hygiene and Tropical Medicine.

Against a backdrop of Brexit and the ‘troubled’ state of the NHS, the powerful group has taken the bold step of setting out a manifesto for a ‘health creating society’ across Britain with a fundamental shift of provision of care from hospitals to the community at its heart.

Writing in The Lancet, they presented their vision of how the UK can promote and improve health and at the same time strengthen the country’s economy.

Lord Nigel Crisp, crossbench peer and former NHS Chief Executive said: ‘The NHS faces severe financial constraints, and leaving the EU is likely to exacerbate many problems, including staffing.

‘With a new government comes the opportunity for a clear, bold new strategy. We need a new approach to health that recognises on the one hand the enormous contribution health and biomedical sciences make to the economy and, on the other, that every part of society has a role to play in improving health.’

In the report, entitled ‘Manifesto for a healthy and health-creating society’, the authors propose action in four closely linked aims:

1. The UK should strengthen its role as a global centre for health and the biomedical and life sciences; that should be at the centre of the UK’s industrial strategy and vision for the future as an outward facing country and help to shape the future health, prosperity, and security of the UK and the world.
   
   
2. The transformation of the health and care system from a hospital-centred and illness-based system to a person-centred and health-based system needs to be accelerated and funded. This will require a massive increase in services in homes and communities and new ways to empower front-line staff, enabled by technology, to manage the complex needs of patients across different services and organisations.
   
   
3. The UK needs to develop and implement a plan for building a health-creating society, supported by all sectors of the economy and the wider population, in a way that addresses health inequalities. Current plans for health promotion and disease prevention are too small scale and fragmented and need to be replaced by a larger scale, society-wide effort.
   
   
4. Health, care, and scientific institutions should help develop and restore a healthy society in the UK, but a health-creating society can only be built in a society that itself is healthy.

However, the authors warn the success of the aims will crucially depend on having an effective and sustainable health system which can provide a platform for the development of science, expertise and products.

Professor David Stuckler is Research Director and Professor of Political Economy and Sociology at the University of Oxford. His research integrates political economy and public health and he currently focuses on macro-social and economic determinants of health, political economy of global health and development, and comparative social welfare.

David Stuckler, Professor of Political Economy and Sociology at Oxford University, said: For too long, the NHS has been fire fighting. The system is struggling to maintain old services whilst creating new ones – and as a result is facing double running costs and failing to invest in the future. We need to fund modern services and take some of the strain off the NHS by creating a society where everyone has a role in promoting health.’

Dr Richard Horton, Editor-in-chief of The Lancet, said: It’s time to write a new contract between the UK’s NHS and society. The relationship between Government and the medical profession is broken. It’s therefore urgent to set out a new, positive vision for health and the health service - a modern NHS that delivers the best care for patients wherever they live, supports world-class scientific research, is supported by all sectors of society working to create a healthier nation.’

Professor Robert Lechler is Vice-Principal (Health) and Executive Director of King’s Health Partners Academic Health Sciences Centre and President of the Academy of Medical Sciences. Formerly Dean of King’s College School of Medicine, his research interests revolve around transplantation tolerance.

Professor Sir Robert Lechler, President of the Academy of  Medical Sciences, said the significant health challenges facing society  as a result of an ageing and growing population, rising obesity levels  and environmental and economic change cannot be ignored.

‘Finding ways to keep the population healthy matters - a healthy society is also a wealthy and happy one.’

Other  authors included Professor Dame Sue Bailey, Chair of the Academy of  Medical Royal Colleges; Professor Maureen Baker, Chair of the Royal  College of General Practitioners; Martin McKee, Professor of European  Public Health, London School of Hygiene and Tropical Medicine; Heather  Henry, co-Chair of the New NHS Alliance, a grassroots organisation of  10,000 individuals and organisations working to improve community  health; and Professor Cathy Warwick, Chief Executive of the Royal  College of Midwives.

30.03.2017

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