We urgently need to turn the NHS from being a barrier to technology to being a champion
To unlock the potential of our health services we must incentivise the uptake of innovation, says George Freeman
To heal the divisions of the Brexit referendum it is vital that we recast Brexit as an inspiring moment of electrifying and comprehensive national renewal. Nowhere is this more urgent than the NHS.
I have worked in and around the NHS most of my career and served as minister for health innovation in the coalition government under David Cameron. As most frontline NHS staff will tell you, our health service faces many long-term challenges: how to structure and fund integration with social care; how to improve localisation and liberalisation from Whitehall controls and targets; the spiralling costs of technology, and, most critically of all, the disease timebombs of the baby boomer generation such as diabetes and dementia.
No one welcomes the recent announcement of increased health funding more than I, but it must come with a major warning too. We need to make this funding moment the trigger for a much bigger conversation. This has to be the catalyst for a new funding settlement based on incentives for success, and incentives for reforming and modernising the system through local leadership. In short, money alone isn’t enough. We need smarter thinking too.
Central to smarter thinking is accountable care and prevention. By moving towards a place-based system, we can start rewarding places that are healthy rather than just tipping money into treating disease. Indeed, that was the central insight to the accountable care revolution that I worked on with Simon Stevens and Jeremy Hunt when I was a minister. But how do we do that?
First, that means a much better use of technology. We urgently need to turn the NHS from being a barrier to technology to being a champion and pioneer of it.
Take the example of digital health. Everyone in the medical world and beyond knows digital health is the future. But, up until now, every digital health scheme has been run from the top in Whitehall and NHS England. By running the schemes through the usual silos, we have no incentives for prevention and earlier intervention. Instead, we’re locked into yet more calls for extra funding.
But it doesn’t have to be like that. All we need to do is change the incentives. We should be saying to NHS Trusts: if you can reduce the forecast incidents of late-stage diabetes and dementia, we’ll reward you. Almost immediately, those Trusts would start working with the most innovative digital health companies. Instead of being a technology tick-box exercise, this would give public services an incentive to become a much earlier procurer of technology. The more they innovated and the better their results, the more money they’d have to invest in patient care.
Second, we should set up a cross-party commission to look in detail at how the NHS operates and how it could be improved. I believe there are a number of people – Norman Lamb, Liz Kendall, a number of distinguished peers like Lord Darzi and Lord Warner, and former health ministers like me, Patricia Hewitt, Stephen Dorrell and Alan Milburn – who could happily and effectively work together to frame a nonpartisan model for a 21st-century health and care system.
Third, with costs rising due in part to an ageing population, we must have a more profound debate about how the NHS is funded long-term. We have to end the idea that co-payments and top-ups are somehow antithetical to the NHS. Part of that conversation, as I set out when I was minister for life sciences, must also be about how we harness the value of the NHS as a research engine.
Fundamentally, the future of our health service must be based on a new model of empowered “health citizens”. That means relaunching our NHS so it puts 21st-century technology and innovation at the heart of everything it does. Incentives are the only way for this to happen. Quite simply, the choice is now down to us.
George Freeman is Conservative MP for Mid Norfolk and was minister for life sciences from 2014-16