Solving the NHS care and cash crisis: routes to health and care renewal

Document type
Warner, Norman; O’Sullivan, Jack
Date of publication
25 March 2014
Health Services, Social Work, Social Care and Social Services
Social welfare
Material type

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This comprehensive plan argues that tackling the “care crisis” requires the NHS to turn into a “National Health and Care Service (NHCS), based on a new partnership between State and citizen, with integrated health and social care available locally in the community and consolidation of hospital specialist services on fewer sites of higher quality”. The report proposes an NHS Membership scheme for all UK residents, including an annual health MOT to set new responsibilities each year for both the NHS and the individual.

The report claims that the “care delivery model, largely unreformed since 1948, inflates NHS costs and limits many people’s potential to live longer and healthier lives”. It recommends preserving virtually all current hospital sites but refitting many as primary care centres delivering more integrated care. Specialist services would be concentrated on fewer, more highly skilled, safer centres with 24/7 consultant cover.

The authors argue that, “even with major changes to care, it is now irresponsible to pretend to the public that current forms of taxation alone will be sufficient to provide a good quality health and care system”. Instead governments should introduce higher hypothecated “sin” taxes on alcohol, cigarettes, sugary foods, betting and gambling. NHS “Continuing Care” should be means-tested like social care. The numbers of people paying inheritance tax should rise, so that more cost is borne by the wealth of older people rather than by younger income tax payers.

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