Going with the Flow

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Healthcare and the economy series (2) Briefing Paper

Julia Manning & Gail Beer

The public hear the future of the NHS frequently debated by politicians, commentators, economists. This paper identifies some of the themes of the current debate and looks beyond ‘the NHS must change’ mantra to actually consider how to change, what needs to be communicated to people about these themes, how potential solutions can ‘go with the flow’ of public behaviour and what are the consequent trade-offs that need to be understood. Above all, we need managed public debate to de-politicise the NHS and involve us all in decision making that will determine how best to ensure we have an NHS for the future.

Recommendations include:

  1. Produce a National Financial Plan and work towards a National Service Guarantee
  2. Promote stewardship and accountability
  3. Be honest about what’s available and enable people to spend on themselves
  4. Promote clarity on choice
  5. Use technology to deliver choice
  6. ‘Payment by Result’ benefit for those who make positive behavioural choices
  7. Strategic review and development of National ‘Blue’ Specialised Hospitals
  8. Strategic review and development of Local ‘Red’ General Hospitals
  9. Promotion of public involvement

If adapting the NHS to be fit for the 21st century was easy, it would have been done by now. Debate has been stifled by party political point scoring and vested interests polarising the debate, not least between private and public provision. The financial pressures require that a mature, managed public debate is planned, with clarity on the financial pressures and the call for us all to be involved – both to promote understanding and appropriate use of our precious, national health service.

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