Foreword

Facing up to the NHS challenge

By John O'Leary

There will be no more delicate subject at the general election than health. Not only does spending on health now account for an estimated 9 per cent of GDP, but the approach to the NHS has become the key test of the credentials of any political party, and particularly for the Tories. Margaret Thatcher recognised as much when she declared that the NHS was “safe in our hands” and David Cameron’s pledge not to cut spending is as much symbolic as it is practical.

Yet the sheer scale of the deficit ensures that the era of big spending on health (or any other public service) is well and truly over. And with the population living longer and demanding access more expensive treatments, even ring-fencing of the current budgets will not save the NHS from massive and painful economies. In this month’s Policy Review magazine, leading figures look at how the service will cope.

Andrew Lansley, the Shadow Health Secretary, outlines plans for efficiency savings in hospitals and primary care trusts, but also promises to tackle inequalities in the system and improve survival rates for cancer and lung disease. He puts flesh on the bones of the Tories’ draft manifesto, pledging separate local budgets to develop long-term strategies.

Ann Keen, the Health Minister, argues that the NHS can improve without huge injections of cash by paying more attention to the patient experience. She says that the new ‘NHS 2010-2015’ strategy will give patients more control over their treatment, with hospital budgets linked increasingly to satisfaction levels.

Bill Moyes looks back on his time as executive chair of Monitor, the foundation trust regulator, and forward to a system that expects more of GPs. And Nigel Hawkes, the former health editor of The Times, questions whether the Government’s downgrading of charity and private bids to run NHS services is sustainable.

In the second section of the magazine, David Walker looks at reservoir of experience available to a prospective Tory administration from local government, while Judith Judd examines the party’s proposals for the school curriculum. This month’s policy tracker focuses on the Total Place initiative, linking local services, and there are articles on the value of regional funding bodies like Finance South East, and the prospects for the Scottish government’s ambitious carbon emission targets.

26 February 2010

John O'Leary. Editor, Policy Review Magazine