Sunday, December 24, 2006

Chapter 35 - The Future of the NHS (The final chapter)



This is a summary of chapter 35 - Funding Expectations. It was written by Jennifer Rankin and Jessica Allen. Dr Jessica Allen is Senior Research Fellow and Head of Health and Social Care at the Institute for Public Policy Research. At IPPR, she is currently working on a project exploring public expectations and a sustainable health system. Prior to joining IPPR, she worked at the Kings Fund and at Unicef. She holds a PhD from the University of London and has lectured at the University of Greenwich and LSE. Ms Jennifer Rankin is a Research Fellow in Health and Social Care at the Institute for Public Policy Research. At IPPR, she is currently working on a project exploring public expectations and a sustainable health system.

They explain in this chapter that rising public expectations are one of the main cost pressures on the NHS.

Since the NHS was founded people’s expectations have risen dramatically. They explain that the political process must bear considerable responsibility for creating excessive expectations and disillusionment. They cites the example that in 1997, Tony Blair came to power with the heady phrase that “we have twenty four hours to save the NHS”. The Government they suggest have subsequently adopted some more realistic language, talking about a process that would take years rather than months. Opposition parties are also guilty of using loose language around the NHS, citing how David Cameron said that the “NHS could no longer ration treatments”. They maintain that in a system where resources are limited and demands are infinite, rationing will remain a necessity - clearly, the NHS has to ration treatments according to need. It has always done and will continue to do so.

They continue with examples of the media fuelling unrealistic expectations. They suggest that politicians and the media are locked in a dialogue of mutual distrust and suggest the need to fashion a new political dialogue about how we value the NHS. Policymakers need to communicate what people are entitled to and how these entitlements can be fairly distributed among the population. The public should have high expectations, but they should also be fair and realistic expectations. Ultimately, a better understanding of health and health services will enable the NHS to pull off the difficult balancing act of maintaining public support, doing more for health and remaining affordable.

To comment further on this chapter, then please do post here or join the debate at www.thefutureofthenhs.com

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