Think tank sets out how government can drive change in health sector

Project led by Ara Darzi and Sally Davies calls for "Climate Change Commission" approach to push cross-departmental working
The Department of Health and Social Care's Victoria Street headquarters. Photo: Google Maps

By Jim Dunton

17 Sep 2024

Independent think tank the Institute for Public Policy Research has called on the new Labour government to use its upcoming 10-year NHS reform plan to radically shift the focus of the health service, making it a "health creation system".

The final report of the IPPR's cross-party Commission on Health and Prosperity says boosting the nation's health will only be possible by moving away from a "sickness model" of health policy. It says that doing so would significantly aid the UK's economic prosperity.

The commission, which is chaired by by former government chief medical officer Prof Dame Sally Davies and ex-Labour health minister Lord Ara Darzi, says the independent Climate Change Commission could provide a model for pushing the shift across government.

The report comes less than a week after the interim findings of Darzi's rapid review of the state of the NHS, which painted the health service as in "critical condition" following 14 years of under-funding and the rigours of dealing with the Covid pandemic.

The IPPR projects that unless the NHS takes a more prevention-focused approach, the number of people who are economically inactive because of sickness could increase to 4.3 million by the end of the decade, up from 2.8 million today.

It argues that better population health could save the NHS £18bn a year by the mid-2030s and is calling for the introduction of a range of positive changes alongside the NHS's continuing work to respond to emergencies and illness.

The IPPR commission wants to see the establishment of "health and prosperity improvement zones" modelled on clean-air zones that would have new powers and resourcing to build health-promoting infrastructure such as swimming pools and new green spaces in health-deprived areas.

The plan also includes the delivery of new "neighbourhood health centres" in every part of the country that would serve as one-stop shops for diagnostics, primary care, mental health and public health.

Under the IPPR's proposals, a "right to try" would be introduced for people on health and disability benefits that would give them the chance to attempt work for a period of months with a commitment that they would not risk their welfare status if things do not go successfully.

Additionally, it calls for a range of interventions to give children the firmest possible footing for future good health. They include universal free school meals, the reintroduction of the Sure Start programme for early years and childcare, and the end to the two-child limit on Universal Credit and some other benefits.

Increased taxes on "health polluters" such as tobacco, alcohol and unhealthy food have a major role in funding the IPPR's proposals. It says the move could raise £10bn a year by the end of this parliament to fund "good health schemes" like subsidies for food such as a fresh fruit and vegetables. It says the government could borrow money to fund "growth-generating infrastructure" related to the proposals without breaking general-election manifesto commitments.

"Net-zero" approach to health improvement

The report says the government should take a similar organisational approach to dealing with improving the nation's health to that which it has taken to dealing with climate change – and set an equivalent to the 2050 target for making the UK a net-zero carbon emissions economy.

It suggests one such target cold be legislating for a 30-year goal of adding 10 years to healthy life expectancy in the UK, with a "mission infrastructure" built around it.

The report says that a new "healthy life expectancy" mission could help to "crowd-in" the "vast array of actors" that would be required for delivery.

It says: "Alongside a health mission board with broad membership – from major employers, government departments beyond health, local government and innovators – we suggest a new body modelled on the Climate Change Committee to drive accountability, coordinate delivery (including across but also beyond government) and break down the mission into five-year plans."

The commission said evaluations had shown that the CCC's successes had come down to key factors including: its statutory footing and good reputation; its ability to reach across Whitehall rather than one department; and its political independence.

It said a CCC equivalent for the health mission would perform a function "not easily led by non-independent bodies like the Office for Health Improvement and Disparities", and could protect long-term progress in the face of ministerial and leadership changes.

Committee co-chair Davies said the culmination of the panel's almost three years of effort had provided "irrefutable evidence" that better health was Britain's greatest untapped resource for happiness, economic growth and national prosperity.

"A government that wants to deliver growth, sustainable public services and fairness throughout Britain needs to take note," she said.

"One of the most impactful choices they could make is to prioritise a new beginning on childhood health. No one would question that education is both about a child's immediate wellbeing and their long-term economic prospects. The same is true for health. We simply should not tolerate decline in our children's health any longer – it is time for bold action to ensure a health inheritance for future generations."

Darzi, who is an eminent surgeon as well as being a former minister, said the commission's work had provided a "ready-made policy vision for a new approach to public health".

The IPPR commission's members also included former Labour health secretary Andy Burnham – now mayor of Greater Manchester – and former Conservative health minister Lord James Bethell.

Health secretary Wes Streeting is due to speak at an event tomorrow marking the report's publication.

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