All three political parties agree that NHS and social care services have to change radically. And they are right to do so.
Those of you with elderly relatives will recognise the picture of care fragmented between GPs, practice nurses, various specialist doctors in the hospital, district nurses’ domiciliary care and so on through the many specialisms
The basic problem is that over the recent past the pattern of disease has changed so that over two-thirds of the resources of health and social care are now spent on people who have long-term conditions.
As the name suggests these patients have their condition for life rather than a short episode of illness with, for example, a problem with their appendix or their hip. The rise in the number of long-term conditions come from two sources. As a 66-year-old I am convinced that both of these issues are very good things and refuse to see them simply as problems.
First, there are an increasing number of people living into very old age, and as we live much longer many more of us get these long-term conditions. Arthritis, high blood pressure, diabetes, breathing problems, dementia are all diseases which younger people can get but in 20 years’ time the chance of me having three or four of these conditions is very high.
Second, as a result of the success of modern medicine diseases that in the past killed most people are now survived by most. When I was growing up in the 1950s if you had a heart attack you almost certainly died. One of the many successes of the last Labour government was to transform survival rates for heart attacks. The same is true for cancer. In our fight with that disease it was a few years ago when the majority of people started to survive for five years beyond diagnosis. Surviving acute diseases means that you then have them as a long-term condition.
While very old age and survival from acute diseases cause problems for the NHS and social care let us be clear that these are the problems caused by success.
But it means that the burden of diseases has changed and the average patient facing the NHS and social care is now an older person in their 80s with three or four conditions that occasionally get worse and need emergency stays in hospital.
Given the NHS has learnt to treat bits of us rather than the whole person, it is this that leads to the experience of fragmentation from health and social services.
The current provision of health and social care is out of step with the new healthcare needs and is bankrupting the service.
Both in healthcare and in financial terms the problem is very urgent and in May 2015 any new secretary of state will have to deal with it or watch the NHS crumble on their watch.
Unlike some I believe that the NHS is strong enough to learn from the independent sector how to solve this problem. NHS patients need a service that can learn from other industries how to deliver a service coordinated around the whole person.
Some NHS providers share my view of their ability to work with the independent sector to learn to provide whole person care. They recognise that the future of an NHS that will continue to be provided with equal access for all free at the point of need, needs those services to change radically so that they are coordinated around the patient, not the needs of their own organisation.
In making these changes our NHS needs all the help we can get.
Paul Corrigan was a health adviser to the last Labour government. He tweets @Paul_Corrigan
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