One Year To Save The NHS – What Would You Do?

The NHS needs to learn from organisations like the John Lewis Partnership that show what can be achieved when employees see that their actions benefit themselves, the organisation they work for, and customers, says Professor Chris Ham in this week’s BMJ.

This is just one of several responses to the question: what would you do to save the NHS?

The chaos currently engulfing the NHS is due entirely to its “marketisation,” argues Allyson Pollock, Head of the Centre for International Public Health Policy at the University of Edinburgh.

She believes that what is needed to save the NHS is “a total abolition of the market and market mechanisms like payment by results, foundation trusts, and commissioning within healthcare, and the abolition of all contracts with private providers, including the compulsory repurchase of PFI hospitals.”

But Jennifer Dixon, Director of Policy at the King’s Fund backs current health policy as “going in the right general direction.” She believes that the principle of introducing new incentives to try and improve performance is the right one. However, she admits that there are “teething problems” in other areas of the health services that need “modification or amelioration.”

Peter Carter, General Secretary at the Royal College of Nursing calls for an end to short term cuts and the development of a long term recovery plan. He also urges ministers to safeguard education and training budgets and improve nursing recruitment and retention levels. “We need to stop treating our NHS workers like overheads to be cut and start treating them like assets to be valued,” he says.

A US view comes from Donald Berwick at the Institute for Healthcare Improvement in Massachusetts. He chooses not to dwell on the sense of distress and demoralisation that is circulating through the NHS at the moment, preferring to focus instead on the “tremendous amount of progress” that has been made in the eight years he has been watching the modernisation of the UK’s health services. He calls for better collaborative patient management but, in the long run, he is very optimistic about the NHS being a star among international health services.

Finally, Steven Ford, a GP in Northumberland argues that the NHS never has been and can never be a business. He would like to see “wholesale localisation” introduced throughout the NHS. “A coherent, locally responsive service, answerable to users directly is preferable to a national business failure with a demoralised workforce,” he says. “Let diversity flourish and to hell with the market.”