The NHS Sustainability and Transformation plan in a macro economic context
For me this journey started 16 years ago with three documents written by a banker – Sir Derek Wanless.
He was asked by Brown, then Chancellor, and HMT to review where we were with respect to the % of national wealth (GDP) devoted to the health service.
Report 1 – NHS
he concluded that we significantly underspent on NHS as a proportion of GDP compared to similar countries.
Net result – large cash injection into NHS. Was welcomed at the time
Postcript – rolling forward to now ….we’re back in the schtum again as demand increased inexorably, outstripping the system ability to afford it.
Report 2 – public health.
Three scenarios – slow progress to fully engaged.
We never really moved beyond slow progress.
Implication – Wanless told us…. Don’t forget to prevent stuff or you’ll be doomed.
We ignored him.
And are in danger of ignoring him this time round too……
Report 3 – social care
Many haven’t read it
It’s an amazing report. Still carries currency today!
Again, he basically said … Don’t forget to sort out social care, or you’ll be doomed.
We largely ignore him.
Roll forward 15 years ago Simon Stevens published his Five Year Forward View.
First thing I thought when I read it was ‘wow I buy this’ (and I’m a cynical old so and so), second thing I thought was ‘this is basically Wanless Rebooted’
So in my head I have FYFV as a policy response to Wanless.
Roll forward to 2016, we have the STP.
In my head I have this down as the service response to the policy.
In a macro economic context, we are ALL bound to the fate of the economy in terms of whether the economy grows or not.
A healthier population will help the economy grow.
We under focus on the link between employment, health, economic growth at our own peril……
I hope we can learn the lessons of history from Wanless…..
This is maybe a once in a career opportunity