Power to the People: The mutual future of our National Health Service



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Publication Details

A new ResPublica publication

The National Health Service is at a critical juncture in its long and illustrious history. Tighter public finances brought about by the most significant programme of fiscal contraction for a generation, together with an ever-ageing population, mean that the current system of healthcare enjoyed by all in England is simply unsustainable.

Under current arrangements, the NHS in England will see a funding shortfall of £34 billion by 2021/22 and it is predicted that long term conditions alone will bankrupt the health system before the end of the decade.

Power to the People: The mutual future of our National Health Service argues that the key to saving one of our most valued institutions would be to move away from the bureaucratic and fragmented health system we currently have, towards an integrated system of healthcare provision that makes it possible to offer whole-person, holistic care to patients. This report highlights the valuable role mutuals could play in integrating disparate public, private and third sector bodies to both improve patient outcomes and plug the impending funding gap.

The rewards of institutional reform are real: successfully integrating current health care provision would drastically reduce A&E admissions and save the NHS at least £4.5bn over the coming decade. These savings ignore the additional gains that could be had from integrating and tackling unreformed residential care and unaddressed public health concerns. This would, in short, help to ensure that the NHS remains free at the point of use without the need for additional taxation or charging.

The new, mutual-centred model of integrated care envisaged in this report would be completely funded within the current efficiency commitments established under the Quality, Innovation, Productivity and Prevention (QIPP) programme, and would realise further savings of £4.5 billion through providing more integrated and community based services. As part of this new system, a revised role for Monitor, the economic regulator for the NHS, would also need to be developed, with a more pro-active role envisaged that has integration at its heart.

  • Adam Wildman

    Principal Research Consultant

    Adam originally joined ResPublica as a Research Manager in  2013 and rejoined in 2016 as a Principal Research Consultant. He mostly co-ordinates ResPublica’s research output on business and the economy. His coming work will focus on EU reform, the future...

    Adam Wildman
  • Karol Sikora

    Research Associate

    Karol is Medical Director of Cancer Partners UK which is creating the largest independent UK cancer network with private and NHS contracts. He was Professor and Chairman of the Department of Cancer Medicine at Imperial College School of Medicine and...

    Karol Sikora
  • Mo Girach

    Research Associate

    Mo has a BSc (Hons) in Podiatric Medicine, an MBA in Business Administration, holds membership of the Institute of Directors, is an accredited assessor for Investors in People and is Special Advisor to the NHS Alliance. He is also an...

    Mo Girach