Making the NHS and social care system sustainable

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1826 (Published 18 April 2017) Cite this as: BMJ 2017;357:j1826
  1. Jennifer Dixon, chief executive
  1. Health Foundation, London WC2E 9RA, UK
  1. jennifer.dixon{at}health.org.uk

The House of Lords has made a start on a longer term strategy

The UK is currently facing numerous complex challenges. A cross party House of Lords select committee has examined one—how the NHS and adult social care could best be sustained in the next 10-20 years. Drawing on evidence from hearings and written contributions over a year, the committee reported its recommendations earlier this month.1

Short term thinking

The healthcare budget constitutes a sizeable and growing share of government spending—about one fifth in England, one third in Scotland, and one half in Wales—and the NHS consistently remains among the public’s top priorities.2 Governments will therefore have to be active in shaping the agenda. But the Lords’ report notes the endemic problem: governments have a tendency to short termism. The Department of Health is “unable or unwilling” to think beyond the next few years, and the NHS is often absorbed in everyday struggles, leaving the future to “take care of itself.” Traditional approaches—such as reactive and tactical …

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