With the NHS now being 70 years old, there has been much recent publicity as to the excellent healthcare it provides and how it has changed since its formation in 1948.
The NHS is clearly held in high regard by the public at large, as well as being a key topic for politicians. With healthcare being one of the largest elements of public expenditure, second only to pensions, it is inevitable that there will always be political interest and involvement in the NHS.
Recent years have seen the publication of the NHS Forward View and GP Forward View documents, each of which was intended for reference for a period of five years. NHS England are currently drafting a ten year NHS Forward View, which is a significant step in the right direction in that it transcends two parliamentary terms. To give this greater impact, it would be ideal if the Forward View were supported by the main political parties. To provide the NHS with a period of consistency of approach, without the disruption of constant reorganisation, would be a great step forward.
Likewise, it would be greatly beneficial if the budget for the NHS could also be firmly established. My suggestion is that this is done as a fixed percentage of GDP. If the main parties can agree that the healthcare budget is to be X% of GDP for the next ten years, this would give the NHS some stability. Of course, there is the risk of recessions occurring, but the NHS would have to take the rough with the smooth, as a trade-off for having more certainty in general funding terms.
This leads onto the issue of the organisations that make up the NHS. Whilst there is never any doubt as to the commitment and diligence of the clinical staff providing care within the NHS, we often feel guilty about talking passionately about the NHS as if it were a single entity. The unfortunate reality is that the NHS is made up of many hundreds of organisations, each entitled to use the NHS’ name. Whilst there may be good reasons for this with the care providers, this does mean that there are an awful lot of management and administration functions within each of these organisations, as well as a myriad of organisations that do not directly provide clinical care. It could and should be considered as to what level of efficacy and added value these non-clinical organisations provide to the NHS, with the ultimate question being “Do these organisations improve health outcomes?”.
The potential to reorganise the NHS and direct much of the budget towards the delivery of healthcare, is too great an opportunity to miss. With the current thinking being towards how to improve efficiency, and the transformation of the NHS, to reconsider the overall structure and organisation to allow integration and simplification of its structure, would allow the NHS to become much more effective.