Edmund Stubbs: Three big ideas for a healthier, happier society

These could be new ways to improve efficiency, patient experience and service quality, or, as society and technology changes, adjustments to medical services to fit future styles of care.

Innovative ideas will always be valued, but they alone cannot ensure the NHS’s survival.

Every democratic nation in the world strives towards providing a universal healthcare system for its people. Universal healthcare is achieved when a country can provide free (or easily-affordable), high quality healthcare to every citizen.

The risk of enormous medical costs are spread out over the entire population, with each working individual required to contribute to a pooled fund, whether this be as a government tax levy or social insurance. All are then safe from medical bankruptcy.

However, despite championing this ideal by establishing the NHS 68 years ago, Britain’s universal healthcare is now under threat.

It is plain to most that the NHS is asked to work far above capacity and is approaching a meltdown situation. Staff are demoralised; asked to do too much with too little on each shift; NHS trusts are accumulating ever increasing budget deficits and key targets, such as waiting times, are being missed.

We also know the causes: an ageing population, with chronic, expensive to treat, diseases (ones which would have previously killed them) and a population that eats unhealthily, adopts a sedentary lifestyle, drives most places and often drinks and smokes with relatively little thought of the consequences.

This takes place in a fragmented society with large socio-economic divides which promote mental health disorders.

When we asked 11 high-profile health professionals and commentators (including a former Health Secretary) what they would do if they suddenly had the power to change anything and everything they wanted in British healthcare we expected to receive 11 blueprints of a new, idealised, health system.

What we got back instead was something different and far more useful. The resultant collection of thought-provoking essays is published by Civitas in The Health of the Nation: Averting the demise of universal healthcare.

Collectively, the book suggests that any reorganisation or token weight-shedding we do inside of the NHS will be about as effective as chucking a deckchair off a sinking ship. We need to work on the bigger picture. For years, professional advice of this nature has been ignored while health leaders focus on the ‘urgent rather than the important’ to paraphrase Professor David J. Hunter (one of the book’s authors).

The authors’ chapters show us how little relevance continuing debates which focus on the NHS per se have for ensuring the continued existence of universal healthcare in the UK.

Instead, with remarkable 
unity, they highlighted three issues, each associated with wider, pre-clinical, determinants of health. These are investment in preventative medicine, an enhanced role for civil society in healthcare planning and provision and an increased responsibility from each individual for their own behaviour.

Encouraging an increased responsibility in each of us for our own health is not a blame game. The circumstances we work within to maintain our health vary hugely from person to person. However each of us must be encouraged to work to the limit of our own capabilities to reduce our present and future reliance on health services as much as possible; reducing avoidable utilisation of our stretched system.

Civil society can also play a larger role in the future of British healthcare. We have many organisations, especially charities, in the UK which support patients both inside and outside the periods of their lives when they are using health services. Such organisations often have an extensive knowledge of the needs of their patient group as well as the group’s trust and respect.

Professor John Ashton, another of the book’s authors, believes that instead of institutions like the NHS bending the agenda of these organisations to their will, a far more equal relationship is needed.

We all too often hear of a lack of hope inside the NHS. The organisation is seemingly left forever muddling through, while services become ever more unsteady and patients and staff ever more dissatisfied. This collection of opinions shows us a way health services can be secured for the future.

Hope for the British healthcare comes from developing a society which is healthier both mentally and physically. Such a society will still need health services, but at a far reduced rate, easily managed by the NHS. Moreover, not only will we have stable, good quality, health services but we will have a population who can enjoy a better standard of life without the burden of ill health weighing upon its members.

Edmund Stubbs is Healthcare Researcher at the think-tank Civitas.