On the eve of the 1997 election, Tony Blair famously told voters they had ’24 hours to save the NHS’ by voting Labour into Government. By 2000, however, the NHS was still in decline with falling standards and failing public support. Supporters of the NHS began to question its viability, whilst its enemies were eager to catalogue its faults.
The political slogan had become a real question. Could the NHS recover? Could the UK maintain the wonderful and liberating ambition of providing healthcare to every citizen regardless of their ability to pay? Could the NHS survive into the 21st Century?
Five years later we had an answer. Radical change and investment had secured the survival of the NHS. Standards were improving and the NHS was expanding. Public satisfaction doubled and fewer people opted for private healthcare. By the 2010 general election, all of the major political parties went into the election committed to developing and continuing to improve the NHS.
The NHS has survived but is it sustainable?
This book, written by the man who ran the NHS from 2000 to 2006, tells the inside story of the reforms – the successes and the failures – and draws out the lessons for the future. He argues that further radical reform is needed if the NHS is to remain affordable and sustainable. The reforms need to integrate the NHS into other local services, break down barriers between the professions, engage local business and social entrepreneurs and be designed to help people have as much independence as possible to live “a life that they have reason to value” in a healthy society and a healthy world.
The NHS is the largest health system in the world with 1.4 million employees and a turnover of £100 billion. During these years it was a test bed for many reforms and innovations and the story told here will be of interest to people from other countries as they work to improve and develop their own health and health systems.
Nigel Crisp is one of the key thinkers and policymakers who has shaped our modern NHS. He has had a ring side seat when crucial and controversial political decisions have been made. He has also made those very decisions himself. For the first time he now gives his personal insights and perspectives on a lifetime of NHS reform. This book comes at a critical moment in the history of the NHS. It is essential reading for politicians, policymakers, professionals, and the public.
—Richard Horton, Editor of The Lancet.
This remarkable account of the major reforms of the NHS – the largest health system in the world – offers vital lessons for politicians and the public everywhere. It is full of practical examples both of what can be achieved and of what the pitfalls are.
—Julio Frenk, Dean of the Harvard School of Public Health and formerly Minister of Health for Mexico 2000 to 2006
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