‘Think like a patient, act like a taxpayer’

Simon Stevens the new CEO of the most important NHS organisation in the country, NHS England, started his speech on Wednesday with this sharp stress on how they need to think and behave to the leaders of the NHS at their annual conference in Liverpool.

To thrive the NHS needs to be able to achieve both these injunctions at once. The first may be an obvious necessity for the NHS. But still too many patients experience the NHS as organising its services around the needs of the organisation and not the needs of the patient. Simon uses the normal example of a 79-year-old woman who has several conditions at once. Each doctor expert in each condition would be prescribing their own disease-specific drugs, leaving the woman with 19 daily doses of conflicting drugs. Those of you with older parents will recognise that this is a normal, not an unusual, example.

So we really do need to think more like a patient. But why is it a progressive political activity to think like a taxpayer? Simon’s commitment to a tax-funded NHS free at the point of need was shared by his old boss Tony Blair.

Famously, Tony, advised at the time by Simon, doubled the amount of taxpayer funding that went into the NHS, But the very belief in the importance of taxpayer funding for the NHS means that it is essential for those running it – whether managers or politicians – to think like a taxpayer.

Taxpayers have limited resources. They will make judgements about how well the state is spending their taxes. If the people spending the money do not think like the taxpayers that the money has been taken from, then they will not be in a good position to make the case out for that expenditure.

The NHS spends over £110bn of taxpayers’ money. If you believe in the future of a tax-funded NHS this is a golden gift from the public (what John Reid called, ‘The best gift that the British people have ever given to themselves’) and we all need to be sure that we can make the case that it is well spent.

All three political parties agree that we need to develop coordinated NHS and social care around the patient. But they mainly want this to happen without any change to the way in which existing services are organised. Simon’s speech made it clear that if you want to bring about new forms of services then you will need to radically change the way in which those services are provided. The speech pointed out that the hospital he was born in, the one he was sick in as a child and the first hospital he managed, had all closed.

To succeed and keep up with modern medicine, over the next few years the NHS is going to radically change.

At the election following his departure from No 10 Tony Blair left the NHS with much broader and deeper support for its principles than at any time before. He succeeded in delivering this deeper belief in the principles of the NHS because he was not afraid of the radical changes that would deliver better care for NHS patients with equal access free at the point of need.

The NHS managers’ house journal is called the Health Service Journal. Last week as the header for their first interview with Simon it said ‘Simon Stevens’ skills were honed in a No 10 that had a firm view of the legacy that it wanted to create’

Radical change in how it delivers services by thinking like a patient and acting like a taxpayer will ensure the NHS thrives.

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Paul Corrigan was a health adviser to the last Labour government. He tweets @Paul_Corrigan

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Photo: NHS Confederation

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