A landmark new report for the cross-party IPPR Commission on Health and Prosperity has revealed that UK health and care services are falling further behind international peers – and sets out a 10-point plan to put them right.
IPPR’s proposals to reform health and care services would shift the NHS from a sickness service to a prevention service, focused on effectiveness rather than just efficiency, and so improving both public health and public finances.
In one of the most comprehensive audits of health and care services since Covid-19 emerged, IPPR and CF analysis shows that:
If the UK had an avoidable mortality rate similar to those in comparable European countries, 240,000 fewer people would have died in the decade from 2010
Cancer survival is stubbornly lower in the UK than in almost all other advanced economies, while dementia mortality is far higher in the UK than in western European, Nordic and Anglophone nations
Of those with a preferred GP, fewer than one in six get continuity of care with them – and UK patients are less likely than those in other countries to be involved in decisions about their care, or have enough time with their doctor
Requests for adult social care support have risen 10 per cent since 2016, but the number receiving local authority support has declined 4 per cent
Nearly six in 10 people aged 17 to 24 with a probable mental health disorder are not getting treatment from health services
The report warns that this is costing lives, but also livelihoods. With economic inactivity due to sickness at a record level of 2.6 million people across the UK, it says flourishing health and care services are crucial to deliver a high growth economy with a strong labour market.
Without reform, comprehensive new modelling of NHS expenditure by LCP Health Analytics and IPPR finds taxpayers will pay more for worsening services. On the post-pandemic trajectory, government healthcare spending in England (by DHSC) is on course to rise from 9 per cent of GDP to 11.2 per cent of GDP by 2033/34.
However, IPPR’s reform proposals could save taxpayers up to £205 billion over the next decade in comparison by freeing up growing sums each year – with the annual saving worth the equivalent of the current UK defence budget by 2033/34.
Following extensive consultation with patients and service users, IPPR’s report puts forward a 10-point plan to deliver what it says would be a once in a generation reform.
Its recommendations include:
A new ‘hub-and-spoke’ model to re-invent primary care, creating two Neighbourhood Health Hubs linked to the local GP network in every constituency – to give people easy access to a much wider range of local preventative services, from diabetes care to housing services – while making continuity of care the norm again
A social care guarantee with personal care made free, on a par with the NHS, ending the unfairness of diagnoses like dementia leading to avoidable suffering and patients being forced to bear potentially catastrophic costs
A new deal for health and care workers, who would have their student loan debts cancelled, be offered greater control over their working time and be given a greater voice in planning services, alongside the professionalisation of care work with a new Royal College of Social Care
A new five-year funding deal of 3.6 per cent budget growth per year for NHS England to break the current ‘feast and famine’ model of funding and to fuel an ambitious modernisation project, funded by progressive tax reform
The report argues that failure to invest in reform now will lead to NHS costs rising ever faster, either crowding out investment in other public services or leading to a steady decline in the quality of universal healthcare. It argues that the universal tax-funded model is better for public health and public finances than alternative models of healthcare financing, which it describes as ‘red herrings’.
IPPR’s new ideas and evidence will be considered by the Commission on Health and Prosperity in making its final recommendations in Spring 2024.
Lord Ara Darzi, former health minister, Paul Hamlyn Chair of Surgery at Imperial College London, and co-chair of the IPPR Commission on Health and Prosperity, said:
“The NHS and social care system is vital to our individual and national health and prosperity. Too many people are struggling to get high quality care, when they need it most. As a result, there are growing calls for us to change our ‘free at the point of need’ system.
“But now is not the time to abandon the principles which underpin the NHS. Instead, we must renew and extend them in order to deliver better health, a stronger economy and a fairer society. This report sets out a plan to achieve this.”
