The NHS is unsustainable, but the UK is not alone in this issue

hospitalAt the current time, the state of the National Health Service is perhaps the most controversial theme in the on-going general election campaign of 2015 with strong concerns about the lack of funding for UK health services.

However, the UK is not alone in this issue. A recently published international study of healthcare systems (of which I was a co-author) and which covered countries across both the developed and developing world, has suggested that most existing health systems are unlikely to remain sustainable in the absence of additional funding and/or the adoption of new, innovative approaches to delivering healthcare services. Only 9% of respondents indicated that the existing approach to financing health services in their country was sustainable in the long-term while 64% stated that it is unlikely or impossible to continue with the status quo.

Alongside health funding and configuration issues, it is clear that the demographic, technological and economic changes are creating additional demands on healthcare services at a time when the public are seeking further improvements in both the quality of services provided and scope of treatments available.

The study, also uncovered significant challenges for policymakers, across the globe, tasked with pushing through major changes to respective healthcare services and systems in the face of a very resistant public, and during times of austerity and budget cutbacks. While there is no doubt major change is needed when it comes to the provision of healthcare worldwide, policymakers need to find a way to communicate this difficult message when the public often fiercely resists changes.

Overcoming such an array of challenges is a formidable task with no simple solutions. Two factors present themselves as the biggest barriers to those looking to implement change – one technical and one political. The technical factor concerns the organisation of the change process within healthcare systems with one of the biggest problems being that change has not always been done well and the public has a long memory when it comes to badly run projects undertaken within their beloved healthcare system.

The lack of political consensus over healthcare reform is also a major barrier. There is a strongly held view that, because of the high priority given to healthcare policy by electorates, politicians use ‘health’ as a political football for scoring points against their political opponents, rather than focusing on what needs to be done. A key message for politicians is they must devise ways of communicating the essential need for major reformation of the way healthcare is provided across the world.

The early stages of the 2015 UK general election campaign suggests that politicians from all the main political parties are not prepared to heed these messages and try and communicate with the electorate about the need for reform of the current UK health system, for fear of losing votes. Instead they try and compete with one another about who can promise to  spend the most public money on the NHS – money which we don’t have and will have to be borrowed thus adding to national debt.

Malcolm Prowle B&W for webProfessor Malcolm Prowle
Professor of Business Performance
Nottingham Business School
Nottingham Trent University


The full report can be found at:

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