Updated Nov 2016
Health & Social Care
Good health is a pre-requisite for social mobility - though we are all living longer, there is nearly a ten-year gap in life expectancy between people living in the poorest and richest areas.
The NHS was designed to meet the needs of Britain in the 1950s, when lifestyles and demographics were very different. To meet the challenges of this century, it will need to adapt significantly to the way we live now.
A new approach to funding and reforming the NHS
The health system is under enormous strain as the population ages and more people are diagnosed with chronic diseases and mental health problems. IPPR’s modelling has shown that there will be a funding gap of £9bn for health and £13bn for social care by 2030/31. We believe that the public would support a dedicated ‘NHS Tax’ to help fund one of Britain’s most valuable and successful public services.
But more funding is not the only answer to the challenges facing our health system. Integrating expensive health and care systems and focussing on early intervention is essential. This would help to ensure that more NHS funding is spent on care services that keep people out of hospital in the first place. Devolving more power over the health system to city mayors could be an important way of achieving this – as it would provide a means for local government providers of care services and the NHS to work together and offer healthcare that is designed around the person’s holistic needs.
A stronger emphasis on preventative care and on empowering patients and family carers
Most care is provided by family members, rather than the state or the private sector– a fact that saves the Exchequer an estimated £55 billion every year. But as the baby boomer generation continue to live longer, there is an increasing gap in capacity for this family care. The government should work to build strong community institutions that can bring people and their family carers together within their neighbourhoods. These could include neighbourhood networks where people come together to work to stay active and support each other in providing care, neighbourhood based care coordinators to replace the case management system and possibly even allowing the sharing of personal budgets to pay for the provision of neighbourhood-based care. Creating these will support people in producing the best possible care package to suit their needs and improve wellbeing overall.
The government and NHS should also support people to better manage their conditions themselves. When people have more control over their own care and conditions, they are better equipped to take early preventative actions that lessen their reliance on expensive and intrusive acute care. This can be done through better access to personal budgets, co-designed healthcare plans, and peer support as well as better data and information management.
Making sure people with mental health problems are better supported
One in four people in England will now experience a mental health problem in any given year. The number of people suffering from poor mental health has been increasing over time, and it has been shown that there is a link between poverty and mental ill health. Tackling mental health problems is therefore an essential part of improving social mobility in this country.
Early intervention is essential when it comes to mental health. More than half of all adults with mental health problems were diagnosed in childhood, yet children’s mental health services are not up to scratch. Schools should become mental health hubs of the future, diagnosing and meeting the needs of their pupils. We believe that funding from the NHS should be ring-fenced and used to pay for a trained mental health professional to be placed in every school at least one day per week.
But it is not enough to just focus on children and young people. We also need to ensure that adults can access the support they need to manage their conditions, stay in work and continue to live in their communities. We believe that the government should respect, reward and empower mental health social workers, who are well placed to deliver this support. That is why in 2014-15 we established an innovative new organisation – Think Ahead, a fast track graduate recruitment programme designed to attract high calibre individuals into becoming mental health social workers. In its first year it attracted 20 applicants for every place, making it more competitive than PwC’s graduate programme.
Creating healthy cities and communities
Health inequalities in England are large and growing. Millions of preventable illnesses each year cost the NHS large sums of money. These inequalities largely stem from factors including people’s lifestyles, their employment, their housing and the environment. Only through changes in policy across government will the UK really be able to get to grips with these problems.
There is growing evidence that the environment impacts significantly on people’s health. Our ground-breaking research has shown the true impact of air pollution on the health of people living in Britain’s biggest cities. We believe that cities such as London and Manchester should extend road charging schemes and ban diesel emitting vehicles.
Close to half of the burden of illness in Britain is related to unhealthy lifestyles. That means we need to look at delivering health interventions outside of the NHS. We need to find ways to incentivise healthier living, For example, banning smoking in public parks and incentivising employers to promote better health in the workplace.