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The Lancet: The UK's approach to health needs radical rethinking -- its boldest since the founding of the NHS in 1948

October 07, 2016

As the NHS lurches from crisis to crisis, the UK's approach to health needs radical rethinking to create a healthy and health-creating society. Just as the founding of the NHS in 1948 was a great national movement creating a health service for everyone, today all sectors of society - from employers, teachers, designers, manufacturers, as well as citizens, community groups and government - need to come together to improve the health of the nation.

The call to action comes from a group of clinicians, scientists, social entrepreneurs and crossbench peers writing in The Lancet and setting out a manifesto for a health-creating society - a positive vision of how the UK can promote and improve health and at the same time strengthen the economy of the country.

"The NHS faces severe financial constraints, and leaving the EU is likely to exacerbate many problems including staffing. With a new government comes the opportunity for a clear, bold new strategy. We need a new approach to health that recognises on the one hand the enormous contribution health and biomedical sciences make to the economy, and on the other that every part of society has a role to play in improving health. The responsibility for creating a healthy society is much broader than leaving it to health professionals and politicians alone", says Lord Nigel Crisp, crossbench peer and former NHS Chief Executive. [1]

The UK is a world leader in health, biomedical and life sciences and these must be at the heart of the UK's future industrial strategy. Their success will crucially depend on having an effective and sustainable health system which can provide a platform for the development of science, expertise and products. However, the authors argue that the health and care system requires a fundamental shift towards providing many more services in homes and communities, working with partners outside health, and embracing new technology. At the same time communities, employers, educators and other organisations can do far more to develop healthy and resilient communities where people can thrive. This transformation will require planning, time and funding.

"For too long, the NHS has been firefighting. The system is struggling to maintain old services whilst creating new ones - and as a result is facing double running costs and failing to invest in the future. We need to fund modern services and take some of the strain off the NHS by creating a society where everyone has a role in promoting health", says David Stuckler, Professor of Political Economy and Sociology, Oxford University. [1]

National and local governments can create healthy environments through taxations and laws, but businesses and other organisations have important contributions to make to health as employers, designers, educators, service providers, and manufacturers. The manifesto points to several successful examples such as the St Paul's Way transformation project - a massive regeneration project in East London driving an integrated approach to health, housing, education and business to promote health, economic growth and wellbeing.

"It's time to write a new contract between the UK's NHS and society. The relationship between Government and the medical profession is broken. Morale among young doctors is at an all-time low. It's therefore urgent to set out a new, positive vision for health and the health service - a modern NHS that delivers the best care for patients wherever they live, supports world-class scientific research, is supported by all sectors of society working to create a healthier nation, and takes on a global leadership role in advancing the objective of universal health coverage", says Dr Richard Horton, Editor-in-chief, The Lancet. [1]

Professor Sir Robert Lechler, President of the Academy of Medical Sciences says: "We cannot ignore the significant health challenges facing our society as a result of an ageing and growing population, rising obesity levels and environmental and economic change. Finding ways to keep the population healthy matters - a healthy society is also a wealthy and happy one. Most of us would like to think we are doing the best to stay healthy as individuals, but some of the most effective preventative measures are initiated at a national level by government - based on the best available evidence and research - and need to be taken up by all sectors of society including teachers, employers, designers, and businesses. We will see big changes if we can move towards a society that values health, where everything, from healthcare systems to architecture, education and transport infrastructure are focused on maintaining and promoting good health." [1]
The full list of authors is:
  • Lord Nigel Crisp, House of Lords and former NHS Chief Executive
  • Professor David Stuckler, Professor of Political Economy and Sociology, Oxford University
  • Dr Richard Horton, Editor-in-chief, The Lancet
  • Lord Victor Adebowale, House of Lords and Chief Executive of Turning Point, a social care enterprise supporting people affected by drug and alcohol misuse, mental health problems and those with learning disabilities
  • Professor Dame Sue Bailey, Chair of the Children and Young People's Mental Health Coalition, Chair of the Academy of Medical Royal Colleges and Vice-Chair for the Centre for Mental Health
  • Professor Maureen Baker, Chair of the Royal College of General Practitioners
  • Professor Sir John Bell, Regius Professor of Medicine, Oxford University
  • Lord John Bird, House of Lords and founder of the Big Issue
  • Professor Dame Carol Black, Principal of Newnham College, Cambridge University and expert adviser on health and work to Public Health England and NHS England
  • Baroness Jane Campbell, Disability Equality and Human Rights Campaigner and Adviser.
  • Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing
  • Professor Sir Robert Lechler, President of the Academy of Medical Sciences
  • Lord Andrew Mawson, House of Lords, social entrepreneur involved in numerous community regeneration projects including St Paul's Way Transformation Project (Tower Hamlets), Well North programme and the Olympic Park Legacy Company
  • Professor Patrick H Maxwell, Regius Professor of Physic, Cambridge University
  • Professor Martin McKee, Professor of European Public Health, London School of Hygiene and Tropical Medicine
  • Heather Henry, co-Chair of the New NHS Alliance, a grassroots organisation of 10,000 individuals and organisations working to improve community health
  • Professor Cathy Warwick, Chief Executive of the Royal College of Midwives

[1] Quotes direct from authors and cannot be found in the text of the manifesto.


The Lancet

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