Can Labour fix the ‘broken’ NHS?

5 July 1948 was the ‘appointed day’ on which a Labour government brought into the world the National Health Service. Exactly 76 years later, a Labour government declared that ‘the NHS is broken’. Since this declaration the government has commissioned Professor Lord Darzi to produce an ‘honest and raw assessment’ of the state of the health service and telling ‘hard truths’.

The Darzi report could be read as the obituary for the NHS. An institution once called ‘the most civilised thing in the world’ but not able to withstand the demand and pressures of the twenty-first century.

Or perhaps more precisely, the Darzi report will be read as the obituary for one version of the NHS. The most civilised endeavour which the NHS was created for in 1948 was to ‘put the welfare of the sick before any other consideration’. A service focused on the treatment, or amelioration, of sickness may have made sense for the population of mid-century Britain, but now we face a different set of challenges. The population is of much greater size, is living longer, and will experience more intersecting health conditions. If the NHS is to survive it must adapt and stand up to this new challenge.

Rather than focusing on sickness the NHS must become an institution which creates, enables and sustains healthy and independent lives. By investing in this, and raising the health of the whole nation, the NHS will be able to provide urgent and emergency care for those in acute need, the sick and the gravely ill.

This transition requires politicians, and in particular the new set of Labour ministers, to set the policy landscape and signal to local leaders that preventative and community-based services matter. When this signal comes we at IMPOWER know that there are solutions available which will make the shift to a community-orientated and preventative health and care system real. We have seen this in Hospital at Home services which support the acutely unwell in their own homes and so improve people’s recovery trajectory and reduce the chance of mortality. We have also seen it in areas like the Royal Borough of Greenwich who are embedding outcome-based commissioning across the life course. There is a wealth of innovative practice to tap into should the new government really support the shift to prevention.

In the coming weeks we will be publish a report with the Academy of Medical Royal Colleges which recognises that there have been many calls to action to achieve the shift to community-based services and will include guidance on how we can make it real now. We’ll have more to say when the report is published, but it is not an exaggeration to say that the future of the NHS depends on this shift.

The new government faces a choice; bury the NHS or give it new life and make it fit for the next 76 years.