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What next for the NHS. A time to ‘modernise or die’?
As the dust settles on yesterday’s results, it is far too early to take a view on how the NHS will fare with the new government.
Labour’s manifesto offered the hope of building a health and care system that supports people’s wellbeing, rather than one that is limited to sticking plaster solutions as the NHS lunges from crisis to crisis. Slashing waiting times for cancer treatment, operations and A&E are headline priorities and what the public are demanding. Labour is taking the reins in the middle of summer with the NHS facing unprecedented demand, but the winter crisis is just around the corner. There will be no honeymoon period for health ministers.
“Our NHS must modernise or die”, said the then Shadow Health Secretary, Wes Streeting, at Labour’s 2023 party conference, as he outlined an ambitious package of reforms. So what will Labour’s choices in government actually look like and what are the key challenges they now face?
Keir Starmer steps into Downing Street with ambitious commitments for health and care that include the creation of a National Care Service, delivery of the new hospitals programme, a new Royal College of Clinical Leadership and much besides.
But at the heart of Labour’s reforms are proposals to move the NHS towards a ‘community first’ system of care. It’s an approach that recognises that hospitals should not be where healthcare begins, and that the challenges that come with a growing and ageing population can’t be solved by more hospital beds alone.
The proposals are significant, but as is often the case with election manifestos, the detail of when and how it will happen remains to be seen. To have impact, it will require a massive shift of resources away from hospitals and into our communities. That’s a shift that will be controversial and need political muscle to achieve.
Labour’s reforms will need time to build understanding, support and consensus. Many people will fear the loss of what they have today – local hospital services – before they can applaud the benefits of Labour’s Neighbourhood Health Centres – something that currently doesn’t exist.
This government has the chance to transform healthcare for the better, but major NHS-wide service changes come with significant challenges. They hinge on thorough planning, communication, and community involvement to ensure that the people who rely on and use the NHS, and its staff, have a say in how it should work. This means taking the time to meaningfully engage, getting the message to chime with the people who need to come on board, and making sure there’s a coordinated approach across the country.
There will be a huge number of local issues and concerns that will come into play. Labour’s team will need to listen and respond to those attentively, while also keeping their eye on the end goal.
From years of experience helping NHS clients to navigate service change, we know that even small changes don’t happen overnight. There are legal obligations and guidelines in place to make sure that those who use and rely on the NHS have the chance to help shape services. However fast the new Labour team hits the ground running, it will be a considerable time before any of us see the benefits of these reforms.
Our sense is that the public will continue to demand short-term fixes on waiting times, access to primary care, staffing and the condition of NHS estates. Without that, public goodwill may start to dwindle and, if the NHS loses it’s ‘much loved’ public status, the mountain will get that much harder to climb.
There will be some efficiencies to uncover to help stabilise services in the short term, but that may not be enough without additional funding. And Labour’s reforms will need to be backed up with a huge amount of political will and resource. So, the big question is, now that Labour is in office, will it back the NHS with the financial and political muscle needed to make a difference?
There is a huge task ahead and there will inevitably be some bumps along the way. Labour has done it before in the 2000s, but it was well into its second term that the improvements became clear.
Once again, it will take more than one term in office to start seeing the green shoots. However, public support can be temperamental and demand quick returns. It’s going to be quite a challenge to show sustainable progress after just five years.
Steve Davidson is an Account Director with our healthcare division, which provides consultancy and support to NHS trusts across the country. Find out more about our healthcare communications services.