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 is a social pioneer, writer and campaigner. She studied visual science at City University and became a member of the College of Optometrists in 1991, later specialising in visual impairment and diabetes. During her career in optometry, she lectured at City University, was a visiting clinician at the Royal Free Hospital and worked with Primary Care Trusts. She ran a domiciliary practice across south London and was a Director of the UK Institute of Optometry. Julia formed 20/20Health in 2006. Becoming an expert in digital health solutions, she led on the NHS–USA Veterans’ Health Digital Health Exchange Programme and was co-founder of the Health Tech and You Awards with Axa PPP and the Design Museum. Her research interests are now in harnessing digital to improve personal health, and she is a PhD candidate in Human Computer Interaction (HCI) at UCL. She is also dedicated to creating a sustainable Whole School Wellbeing Community model for schools that builds relationships, discovers assets and develops life skills. She is a member of the Royal Society of Medicine’s Digital Health Council. Julia has shared 2020health's research widely in the media (BBC News, ITV, Channel 5 News, BBC 1′s The Big Questions & Victoria Derbyshire, BBC Radio 4 Today, PM and Woman's Hour, LBC) and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week.
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