Coalition health challenge (needs to reduce demand)

I have written the opinion piece in the Health Service Journal published today, which you may not be able to access unless yo subscribe, so here’s an out-take:

The savings that need to be found are attributed to the rising costs of an ageing population and the cost of technology and the medicines bill. As the number of people living longer increases and both medical and surgical interventions increase, of course the bill rises.

But this does not account for much of the huge increase in spend over the past decade. The NHS has been spoilt and efficiency took a back seat while practice variation remained unchecked. Contracts were poorly negotiated and evaluation was neglected, leading to vastly higher costs than anticipated, with no improvement in productivity.

Power remained in the acute sector, thwarting more care in the community and integration of care pathways. Pensions remained excessive and unreformed. Demand was also fuelled by self care, responsibility and first aid becoming unfashionable in a dependency culture. Unravelling this profligacy is no mean task but has to be done.

Speaking to one senior doctor yesterday he immediately started to ask me whether the new team understand the desperate need to reduce demand. I wrote much more on this in our manifesto. It wasn’t one of the five ‘departmental objectives’ listed by the Permanent Secretary at the end of Andrew Lansley’s welcome reception, but I hope it’s a theme running through them.


About Julia Manning

Julia Manning is a social entrepreneur, writer, campaigner and commentator. She is based in London and is the founder and Chief Executive of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal. Through networking, technology, research, relationships and campaigning 2020health has influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer at City University, a visiting clinician at the Royal Free Hospital, working with south London Primary Care Trusts and as a Director of the UK Institute of Optometry. She specialised in diabetes (University of Warwick Certificate in Diabetic Care) and founded Julia Manning Eyecare in 2004, a home and prison visiting practice for people with mental and physical disabilities using the latest digital technology, which she sold to Healthcall (now part of Specsavers) in 2009. Experiences of working in the NHS, contributing to policy development, raising two children in the inner-city and standing in the General Election in Bristol in 2005 led to Julia forming 2020health at the end of 2006. Julia is a regular guest on TV and radio shows such as BBC News, ITV’s Daybreak/ GMB, Channel 5 News, BBC 1′s The Big Questions, BBC Radio, LBC and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week. She is mum to a rugby-mad son, a daughter passionate about Shakespeare, and wife of a comprehensive school assistant head-teacher. She loves gardening, ballet, Zimbabwe, her Westies Skye and Angus, is an honorary research associate at UCL and a Fellow of the RSA.
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