NHS at 75

Think tank: Social Market Foundation

Author(s): Lord Norman Warner

July 17, 2023

This report from UK think tank the Social Market Foundation provides a reality check and new priorities for the NHS on its anniversary.

The NHS’ long anticipated workforce plan is finally here, but it won’t be enough to reverse the health spiral of decline. This pamphlet, authored by Lord Norman Warner, outlines ways of trying to fix some of the NHS’ problems, by proposing much more devolution of decision-making on services, both regionally and locally, and with a bigger focus on population health and prevention of ill health. A combination of circumstances – Brexit, COVID-19, austerity, and two reorganisations thrown in – created an existential threat to the NHS. Public satisfaction with the NHS and social care is at an all-time low, 29% and 14% respectively. The long-awaited Workforce Plan faces formidable challenges: currently there are 112,000 staff vacancies and is on a trajectory for this to grow to 360,000 by 2037. To survive another 75 years, and beyond, policymakers must radically reform the NHS to meet changed expectations and demographics, and reckon with the damage done over the past decade or so that has landed the health service in its current mess. Lord Warner, former health minister under Tony Blair, calls for reform starting with the Department of Health and Social Care, which needs greater devolution of powers and a “more businesslike approach” to health policy. Further radical changes required to save the NHS include: devolution of expanded community services; concentrating specialist services on fewer sites; more standalone surgical hubs and more diagnostic capacity in the community, and a robust plans for improving population health and prevention of ill health, with a new independent Office of Public Health.