The Future of Health and Social Care

Since the formation of the NHS, we’ve seen three substantial periods of political change. In 1951, the Conservatives began what turned out to be 13 years in office. Following that, Labour  took control for five years, before power switched back to the Conservatives, before then going back to Labour. Then, the UK had 18 years of the Conservatives, followed by 13 years with Labour. And now, at the time of writing this, we have had 13 years of Conservative rule. During all those twists and turns, and throughout, the NHS has remained one organisation, founded on a clear set of principles: 

To provide a comprehensive service, available to all and based on clinical need rather than an individual’s ability to pay. 

To aspire to the highest standards of excellence and professionalism with the patient being at the heart of everything it does, working across organisational boundaries and providing the best value for taxpayers’ money.  Additionally, the NHS set out to be accountable to the public, communities and the patients that it serves. 

That consistency is both admirable and necessary. It inspires a consistency that should give this often frustrating, fascinating and fantastic institution its very foundations. Those principles remain the same today. However… 

From 1950, we have had 21 different manifestos from all parties. And to say they’ve  been the same and consistent relative to the principles of the NHS may be stretching the truth a little. And therein lies one of the source issues we face today. 

When political philosophy gets entangled with the NHS - underpinned by limited parliamentary terms - it does not make for good medicine for an institution whose sustainable future depends upon longevity and values. 

I write this not through the lens of any particular political party, but more from a position of the need for a long-term NHS strategy which should transcend political ideology through the removal of its very involvement. Not only should that strategy be decoupled from variation following every new election change, but it should be taken away from SW1A and stand alone as a 40 year programme which recognises the need to engage with all partners as articulated so well in its aspiration to work across all organisational boundaries. 

This is not a new request. Far from it. But I would go a step further, and accept that firstly, money alone is not the answer. Secondly, we need to recognise the power of the community in affecting change. The team at the Department of Health and Social Care would do well to take a walk over to Great Smith Street to meet their colleagues in the world of education. Now that's a conversation worth starting. If we are going to take this issue seriously, we must first look at how we reset the way we all do things. If we are to have any chance of resetting the dial - which stems the tidal shift that has been ever present from the intended National Health Service to the National Reactive Service - and reverse its ongoing disjunction with the world of social care, we need to look at how we can educate a generation in a way that empowers a social environment that, creates a more preventative approach to life.  

And this is not about academic learning per se, or passing an exam. It is about engendering an approach as to how community life is led. Could it be that creating environments where the health and wellbeing of each person is wrapped around the values of community, what that means, and how helping others will benefit whole sections of society? 

It may go without saying that education can also play a large part in showing how working in health and social care - as a job - is a natural extension of how a society behaves. I sometimes think that social care needs a “rebrand” to counter perceptions, and to show what an amazing job it can be. Attracting great people into this sector is a critical success factor as is the message that is given. But this is far more than a job. For the one in eighteen of us who work in the health and care sector in the U.K., the role transcends the functionality of what is done. This is about care and compassion for strangers and creating the right environment not only in a care home, or a hospital, but within communities. It’s arguably a duty of each citizen. 

It is hard to think of words strong enough to articulate the enormity of the Covid years. When I think of the pain and suffering and the dedication that came to the fore, I also think of the random acts of kindness - the flowers, the chocolates, the cakes left at the front door of care homes, with just a note to say thanks. The stories of people who got to know their neighbours for the first time, as they simply checked in on them to make sure they were okay, delivered food, offered support or chatted when clapping out in the street. Now I know that this alone will not achieve what we all strive for - and many people practise this already to great effect – but, as a preventative measure on a societal level over a long, long, time, I can’t help thinking that it is a pretty good one to work on. How well do you know your neighbour?