How to run a country: health and social careRead the full report
Reform is this week publishing recommendations for the 2015 Spending Review. Each day we will publish analysis for each of the main areas of public spending.
Reforming the NHS and social care is one of the defining challenges for the new Government. An ageing population and the rising cost of care is stretching budgets to their limits. In the long term it is the most significant threat to the sustainability of the public finances.
The temptation remains for governments to pledge more ‘inputs’, whether more doctors or more money. What really matters to the wellbeing of current and future patients, however, is changing the service to deliver better outcomes and doing so at the lowest possible cost.
This should mean a health and care service coordinated around empowered patients, focused on preventing illness as well as treating it. It should mean a radical new push on productivity and an honest conversation about the sustainability and equity of the financial foundations of the service. Flexibility as to who delivers these better value services should be encouraged.
In his first speech on NHS reform this Parliament, the Prime Minister recognised this need for high value care. Future success, he argued, cannot just depend on additional investment: “in return the NHS must step up. There is no choice between efficiency savings and quality of care.” This will mean difficult changes, most of all for the NHS employees whose actions, terms and conditions determine what the service can achieve.
In the last Parliament, departments such as the Home Office demonstrated that better services could be delivered for less. The NHS and social care must now follow suit.
Please also read the supporting blog by Lord (Norman) Warner, the former Health Minister