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The sixtieth anniversary of the NHS should be used to unleash a wave of political and social imagination similar to that which drove the original concept of a national health service which was freely available to all. Geoff Mulgan, Director of the Young Foundation and former Director of Policy at 10 Downing Street, argued at a Fabian seminar that only in this way could we address the challenges posed by changing social demographics. The integration of health and social care, which had thus far failed to engage a public and political debate, he stated was "going to absolutely dominate politics for the next twenty years" and required an innovative approach that adopted "an experimental and evolutionary model of change".
The seminar, which considered the big picture health policy themes of the next thirty years, was led by Geoff Mulgan, Professor Julian Le Grand (LSE) and Mary Creagh MP (Chair Labour Manifesto Group on public health) and was chaired by Sunder Katwala (Fabian Society). Participants celebrated the longevity of the NHS which had, Julian Le Grand observed, survived the "economic hurricane and ideological blizzard of the 1980s" and was performing well across a series of process indicators.
The discussion focused in particular on public health. Hilary Armstrong MP demanded a "new attitude" towards public health which had become ‘too synonymous with a nanny state’ that ‘preached’ at people. Instead, she held up family-nurse-partnership as an exemplar of how successful strategies could empower people. Geoff Mulgan concluded that these embodied the key future funding challenge - the highly personal and intensive support offered required higher investment per person and necessitated the political appetite to move towards personal budgets
Yvonne Roberts, Senior Associate, Young Foundation, warned of the Government’s continued focus on a "consumer model which prioritised self management and choice" and which left the system in danger of becoming a "middle-class paradise" when looking at the future of the health service. The emphasis on "choice", she argued, alienated many working-class people who felt that they had "paid their money and want to be looked after". The consumer model and an increase in choice for individuals, however, was defended by Professor Julian Le Grand, who commented that the status-quo worked well for the middle-class who manipulated the process, and that research showed that choice was most demanded by disadvantaged groups.
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