Renew aims to enhance the life expectancy and health of UK citizens in the most fair, efficient and optimised way. We love the inspirational principles on which the NHS operates but wish to stabilise it. Over the coming years, research suggests that the NHS’s budget will need to rise just to maintain the current level of service. The majority of financial pressures arise from changes to population health, technology, pay and policy decisions. The number of people receiving treatment for chronic illness is increasing, attributable in part to the UK’s ageing population. However, the prevalence of other conditions such as COPD, lung cancer, and various cardiovascular illnesses is most heavily influenced by lifestyle factors such as smoking, alcohol misuse, obesity and lack of physical activity.
Our solutions are aimed at dealing with demand and the need for explicit choices about what is provided by the NHS, in mental health provisions and how we balance the needs of an ageing population and prioritise disease prevention. We must focus on reorganisation and better practices, making NHS bureaucracy more efficient and accountable. We must also accelerate work being done to deliver a genuinely integrated health and social care systems.
These problems are compounded by failures of the state elsewhere. A hospital is frequently the only state organ that cannot turn you away. When our community institutions fail, the NHS is often left to pick up the pieces. This is not just tragic for the people who suffer as a result, but is also far and away the most expensive way of dealing with these issues. For example, today one of the biggest challenges facing the NHS is access to social care, with frail patients stuck in hospital for want of a place elsewhere.
Though the Better Care Fund was an initial attempt to move towards integration, we now need nothing less than a fundamental reform of the funding of health and social care services and citizens’ entitlements to publicly funded support to address these problems. Successive governments have pretended there are easy answers to these challenges, whether through funding or massive reorganisations. They were wrong. Solving this problem to deliver a sustainable NHS free at the point of delivery will require a number of often painful choices, coupled with clear resolve.