02 September 2016
A four day week, which feels like five! There is a lot going on in the wider NHS, junior doctors announcing further industrial action and lots of people talking across England about STPs and what may or may not be in them. This reminds me of something I said probably four years ago that at the time created quite a stir in the media.
We all know consumption of healthcare is increasing in the population, because the good news is that people are living longer. But we also know that much of that consumption is not required if people were to think more about what they could do for themselves. At the time I said I was afraid that some members of the population treated the NHS “like an all you can eat buffet” and that if this continued, we wouldn’t be able to afford everything people needed from the NHS in the future. So why are we surprised by the debates and discussions now? We all know that prevention is better than cure and yet in too many cases simple health needs are met by a trip to the GP or the local A&E department rather than through self-care or a trip to the pharmacy.
I have said for many years that we need a discussion with the population about what we can and cannot afford in circumstances where consumption of healthcare continues at present levels. We need to encourage and support people to look after themselves and stay well rather than treating illness. Sir Derek Wanless, in his report for Gordon Brown in 2004, talked about future scenarios for the NHS. One was that the population was fully engaged and the NHS could continue free at the point of use. Another was that the population wasn’t engaged in their healthcare and costs continued to rise and became unaffordable in a system free at the point of use. Therefore, after six years of austerity and rising demand from an aging population the choices are simple. We continue to manage a difficult scenario - or we involve the public in discussions around what is required of them to help us continue to provide a health service that is available to all in the future.