A call to action
Researcher
Wes Streeting has suggested that the Darzi Review will be a platform for reform. But will it tell us anything we don’t already know?
A trickle of well-placed leaks have already made headlines:
- England has spent almost £40 billion less than peer countries on health assets and infrastructure;
- Rates for key childhood vaccinations are falling, making measles and other infectious diseases more common and resulting in avoidable deaths; and
- Children from deprived backgrounds are twice as likely to be obese than their richer peers.
But speak to any healthcare professional, and they will almost certainly tell you that this information is not new.
Last year, a sobering article marking the 75th anniversary of the NHS had senior doctors publicly lamenting on the NHS being in the worst state they had seen, with care “dire”.
And such bleak assessments are compounded by multitudes of government, third sector and academic reports which have all analysed and warned about the rapid deterioration of population health and the state of the NHS.
One place that Wes Streeting could make immediate inroads is in primary care. Ninety percent of NHS activity happens in general practice and the community, but money is overwhelmingly tied up in hospitals. As the Darzi Review has already pointed out, if we were to have had the same capital investment as our peers since the 2010s, than the primary care estates could have been rebuilt or refurbished. Even small investments can be transformative — and other reforms require no money at all.
Today, Re:State published a three paper series in our ‘Reimagining Health’ programme, Prescription for Prevention, highlighting the broken primary care system and calling for a new model. Some of the recommendations involve low-cost reforms which can indeed make a huge difference. For instance, to be able to intervene earlier, the Government could help to maximise proactive, low-cost high impact roles, such as Community Health Workers who conduct personalised health outreach in deprived communities.
There are a number of well evidenced policy measures that can be taken to immediately better healthcare. So, we might again wonder what is the point of the latest review?
Its proposed aim is to focus on ‘assessing patient access to healthcare, the quality of healthcare being provided and the overall performance of the health system’. This is a fairly broad remit for a two month review.
An optimist might hope that the review is being conducted so that the new Government has given itself enough of a mandate to enact major reforms that will genuinely lead to health improvements.
For instance, the emphasis on childhood health is important. Health policy has tended to focus on the shift to a preventative model, key-holing in on issues such as obesity, smoking and lifestyle factors across the course of the life cycle. Yet so much of the evidence tells us that the most impactful interventions are the preventative ones in childhood and adolescence. So it is good to see the Darzi Review taking this seriously and drawing attention to it.
The question that follows, therefore, will be whether Wes Streeting will act on this and develop policy to make change by, for example, redirecting resources toward our struggling system of primary care.
The ultimate value of the Darzi Review won’t be in the analysis it provides, but whether it compels the Government into radical action.