As the NHS completes 70 years, a cross party independent review of the health and care system tries to answer the tough questions about the future of the beleagured NHS, says Lord Darzi

Birthday cake

Sir Bill Kirkup’s Independent Review of the Liverpool NHS scandal makes for a distressing read. Published just over a week ago, it details the “harm caused to patients over a period of several years” and the “appalling instances of staff treatment” at the hands of a management team obsessed with achieving foundation trust status.

The story of Liverpool’s Community Health Trust – whilst untypical in its extremity – is an example of what can happen when improving the quality of care is not the “organising principle” of the NHS.

This drift away from the quality agenda can be seen across the service as a whole. Targets are being missed, operations cancelled and transfers between the NHS and social care delayed.

The Care Quality Commission finds that two-fifths of acute services are still failing to reach the required safety and quality standards. And things are even worse in social care where there has been a staggering 27 per cent decrease in the number of people eligible for state support.

This year is the NHS’s 70th birthday. It is right that we celebrate its achievements. At its best, it is a vital lifeline during our moments of greatest need, offering both care and compassion.

Difficult questions

Sir Bruce Keogh, former medical director at the NHS, is not over exaggerating when he says that it is “Britain’s greatest medical innovation”. However, we must also use this as a moment for reflection. We must come together to ask and answer the difficult questions about the future of both the NHS and our social care system.

How can we undo the damage done by the chaotic reforms of 2012? And how will we fund the health and care system sustainably in the future?

How do we make sure every patient gets high quality care when they need it? How will we keep up with advances in technology, therapies and treatments? How can we deliver parity of esteem for patients receiving support for mental health problems?

How do we join up health and care around the patient? How can we undo the damage done by the chaotic reforms of 2012? And how will we fund the health and care system sustainably in the future? It is time to confront these questions, not brush them under the carpet.

Answers

That’s why I am leading a cross party independent review of the health and care system with the Institute for Public Policy Research. This will make clear tangible proposals for improvement and reform, rather than setting out endless options to be discussed and debated.

And it will do all this in time for the 70th anniversary in July: not falling into the trap set by those who propose a Royal Commission, which would simply see action delayed for years to come. I hear colleagues’ frustration at the lack of momentum at the top of the system, and I hope to see a change in that.

Change only works when it is locally led and clinically driven

However, I will not be able to achieve this alone. When I was a minister, I led the NHS Next Stage Review in time for the 60th anniversary of the NHS, resulting in the report High Quality Care For All.

I was clear then—and I’m clear now—that change only works when it is locally led and clinically driven. That’s why the review of 2008 engaged with 2,000 clinicians and other health and social care professionals from every region across the country. Their ideas and opinions formed the backbone of my final report.

Hearing out NHS staff

It is no different this time round. I still believe that the NHS is as much a social movement as it is a health system. NHS staff have been sidelined in a decade of disruption caused by botched reforms and insufficient funding.

The impact on patients has been kept to the minimum possible through the commitment, compassion and expertise of staff. It is for this reason that we have launched a Call For Evidence to gather the views of frontline clinicians, managers, commissioners and everyone else interested in the future of the health service.

Politically motivated change in our health and care system – frequently deaf to the opinions and expertise of those of us who work on the frontline – has poisoned the case for reform

All too often politicians and policy makers think they know best. But in truth, politically motivated change in our health and care system – frequently deaf to the opinions and expertise of those of us who work on the frontline – has poisoned the case for reform.

We must not allow this to happen any longer: the health and care service needs to change in order to respond to the future and undo the damage of the past. But, instead of leaving the decisions of the future reform of the NHS solely to the politicians, I want your help in setting out the best way forward. Together, we can find the right treatment for this most beloved of patients on its 70th birthday.