The key questions for the NHS

Doctor with stethoscope

Welcome to Hugh's Views - as the first health editor for BBC News it will be my topical take on all things health related.

Around Whitehall and senior levels of the NHS in England I am hearing the view that there needs to be a cross-party debate on what can be delivered over the next five years and beyond.

That might sound naive with a General Election looming, but there is a growing belief that the financial and demographic challenges require non-partisan discussion, with the public made aware of what can realistically be expected.

That was very much the theme of today's letter to The Times by some leading lights in the health world. The president of the Royal College of Physicians and two non-executive directors of NHS England are among the signatories.

They argue that pressure on health and social care budgets are such that difficult decisions have to be made over financing the service. While acknowledging the need for further efficiency savings in the NHS, they say that the next government will have to find new sources of funding - either from higher taxation or charging patients for some services. Without new money, they argue, there will have to be a review of what is available on the NHS.

The NHS has been providing care free at the point of use for 66 years. A recent report by the US think-tank, the Commonwealth Fund, said it was the most efficient and safest healthcare system out of 11 leading economies.

But there are major challenges ahead.

The population is expanding, demand for a wider range of drugs and treatments is growing and people are living longer.

Yet all main parties are committed to tight controls on public spending for a few years in the drive to bring down government borrowing.

What can the UK afford? What do we want from the NHS? Should the service do things differently? How should big health issues such as diabetes and obesity be tackled?

These are all big and important questions - and there are many more. I look forward to exploring what the answers might be,

Hugh Pym Article written by Hugh Pym Hugh Pym Health editor

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  • rate this

    Comment number 25.

    Key question..Where is the money going?
    It certainly doesn't appear to be on front line services as beds reduced,wards closed,hospital closure threats and waiting times increasing if you believe various reports.
    Maybe more transparent accounting and accountability amongst top execs would be a start.
    Still as others say a demonisation of the service prior to privatisation should do the trick.

  • rate this

    Comment number 24.

    Five words to save the NHS: give the doctors more money. That is literally it. Nothing further required. Stop privatising, stop creating "choice" for people who don't have the capacity to make one, just literally, give. the. doctors. more. money.

  • rate this

    Comment number 23.

    I posted only last week ''another day, another negative story about the NHS''. And so it continues.

    We are obviously being set up for privatisation and the liars and thieves in Westminster haven't the guts to say it.

    I welcome cross-party discussions on the NHS - but it's a pity that any politician has to be involved as they all have vested interests and very few of them ever use the NHS.

  • rate this

    Comment number 22.

    One key question might be "When are we going back to being a National Health Service as the initials infer, instead of the International Health Service that we have become".

  • rate this

    Comment number 21.

    Parts of the nhs have already been privatised. This was allowed by our MP's, many of them with direct interests in the providing companies. Should the nhs be seen as safe in their hands when you discover that MP's can pay for private health insurance then claim back all expenses against tax, thus effectively making private healthcare free.
    Don't trust the politicians, they aren't like you or me.

  • rate this

    Comment number 20.

    On conception the NHS provided relatively basic services, there were no heart bypass operations, organ transplants, knee replacements, let alone the technology used in scanners etc. It is inevitable that costs rise and we are lucky that it is performing all of those new things with little impact to our own pockets. The NHS is a World beater and we should all be proud of the healthcare we receive.

  • rate this

    Comment number 19.

    Something's up. What is to gain from this constant feed of anti-NHS propaganda?

    I would have thought the answer to that question was obvious - privatisation!

    Royal Mail was "failing" up until it was sold off. In the 80s state owned services were "failing", and then sold off.

    Our govt (of all colours) like their counterparts in the US would rather have no state ownership.

  • rate this

    Comment number 18.

    A key question re the NHS is whether or not we want it to be a streamlined super-efficient cost-neutral provision for everyone in society, or

    What it should be; a health-focused dynamic resource to address the developing needs of society.

    The focus on affordability and cost-effectivensss is why we have a major antibiotic problem. A balance sheet will not support expensive tactical solutions.

  • rate this

    Comment number 17.

    Here's a question....Why, despite recent reports finding it one of the best healthcare intitutions in the western world. With less % of GDP spent than it's foreign counterparts are we getting constant 'stories' of it failing?

    Something's up. What is to gain from this constant feed of anti-NHS propaganda?

  • rate this

    Comment number 16.

    Questions for the NHS?
    How do we stop the Government using it as a political football?
    How do we get resources focused on customer care rather than managers and Bureaucracy
    How do we stop the government selling off the profitable parts of the NHS to their mates in the city?

  • rate this

    Comment number 15.

    The key question is, who is getting fat packet wages when the service is failing the people?

    Once privatised, and more machinery takes over more people's jobs, and more nuke stations to power the machines which we will end up paying for even though power has been privatised, fewer people in work.....think about it. We are all on the short rope thanks to blindness by all. Greed vs health.

  • rate this

    Comment number 14.

    Funny how so many MP's think we should commit to 0.7% of GDP to overseas aid while starving the NHS... I'll get me coat.

  • rate this

    Comment number 13.

    Personally I think the NHS is great, the only problem is people taking advantage of the system. Who decides that a depressed woman can have a boob job? or an overweight person having a gastric band? There should be strict processes to eliminate this abuse of the system. Give people a benefit from not using the NHS, I would love to be given £5k eye correction by the NHS i never use!

  • rate this

    Comment number 12.

    @ 10

    public sector workers earn on average 17% more than the private sector, they get amazing pensions and can retire on full pension at 45.

    that might explain why the NHS is so expensive, the people that work for it are over paid, yet they will strike on thursday.

    The International Health Services main purpose is to pay those that work for it

  • rate this

    Comment number 11.

    Why are we talking about this when our political system is in such a mess?
    Why are the BBC protecting our dirty politicians?
    What do we have to do to get democracy and justice?

  • rate this

    Comment number 10.

    There is only one question for the NHS:

    Why can't you provide universal healthcare within a capped budget that is £2000 per head per year ?

    That is a lot of money (120 billion per year) and it should be quite possible, yet the NHS can't seem to do it.

  • rate this

    Comment number 9.

    There is only one question. How long before we have to accept that publicaly funded healthcare as envisaged in 1948 isn't going to work in the 21st century?

    Most other European countries deliver quality social medicine "at the point of demand" with effective mixed public/insurance funding. Why can't we?

    The horrors of the US system are always held up as the only alternative. This is wrong!

  • rate this

    Comment number 8.

    The NHS will have to be like every other public service and do more with less. It is not a religion and should not be treated as sacred.

    Getting shot of the the Management Consultants and the endless layers of useless bureaucrats would be a start.

  • rate this

    Comment number 7.

    Watch how good your GP would become if they had to start paying patients £10 per minute, for every minute they you waiting after your appointment time. Give them a grace period of say 10 minutes, then start charging. And pay patients say, £50 for everyday over three, that it takes to get test results back.

  • rate this

    Comment number 6.

    When you have governments who ignore & deny that the UK as a country, that is, the surface area of the planet known as the UK, can only sustain 16.7 million people and that the current population is 66.1 million; then you have a problem.


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