Helen Rainbow: A new model of healthcare

Helen Rainbow is a Senior Researcher at Reform.  The report 'Making the NHS' the best insurance policy in the world is available at www.reform.co.uk.

Competing successfully on a global stage is essential for any modern economy.  The ability to do this is a result of a number of key factors, one of which is undoubtedly maintaining a healthy population.  At present, the signs in this area are not good, we are at the bottom of the international league table in comparison with other leading economies in terms of health outcomes. 

Analysis in a new report by Reform suggests that the best performing health services have two key characteristics – universal cover and the use of insurance incentives.  Insurance incentives are responsible for achieving greater value and a focus on prevention.  Most importantly, as a result of defining individual entitlements, they are capable of empowering service users by giving them real control over their healthcare.

The report proposes a new model of healthcare, a National Health Protection System, which draws on the successful elements of international systems while retaining the key strength of our current system, universality.  The new system would see every individual spend a tax-funded premium of £2,000 per year (the amount the Government currently spends per head a year on the NHS) on a Health Protection Provider of their choice. Individuals would be able to choose who was responsible for looking after their health.   

The model will lead to de-politicisation of the health service, with the role of government being transformed from a provider of services to a regulator.  This fits in with the Conservative ideas around the need for an independent NHS board.  Other essential elements would be access to high quality information on health conditions and outcomes, and the development of a supplementary insurance market to cover rare drugs and luxury items.

Andrew Haldenby and Helen Rainbow: Reform is the only way to unlock value in the NHS budget

Andrew Haldenby is Director of Reform and Helen Rainbow is Reform’s Senior Research Officer.  The report “NHS reform: national mantra, not local reality” is available at www.reform.co.uk.

To say that the health service is big and complex is an understatement – it has the biggest budget in government (£90 billion in England alone and counting), a staff of 1.35 million (5 per cent of the entire workforce) and more political issues than any Secretary of State for Health can cope with.  But today’s annual NHS report by the think tank Reform suggests that the challenge of health policy reduces down to something manageable: redesign and improve services within a ceiling of 9-10 per cent of GDP.

There is a massive need for services to improve.  The quality of the NHS and the outcomes that it delivers remain behind other peer group countries.  We identify a “cradle-to-grave gap” – from infant mortality, to maternity services, to chronic care, to life expectancy.

This means a need for new investment in many areas – within a restricted level of funding.  Taxpayer funding is (and should be) limited for the next five years given the immediate pressures of a slowing economy and longer term concerns over economic competitiveness.  Greater productivity is the answer to this strategic challenge.