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NHS England Chief Executive Simon Stevens spoke at the Institute of Directors Annual Convention today (6 October) at the Albert Hall in London.
On the challenges facing the NHS, Simon said: “Our National Health Service is what the public say makes them proudest to be British. And the good news is that over the past decade the NHS has clearly got better. Your chance of dying from heart disease – down 40%. Your chances of surviving cancer – now at an all-time high. Your maximum wait for most routine operations slashed from 18 months to 18 weeks.
“But here’s the challenge. A tax funded health service – the right choice for Britain – butting up against the after effects of the deepest recession since the Second World War. All at a time of a growing population, an aging population, and an expanding set of wonderful new treatments.
“To respond to that challenge, the NHS came together to set out our own plan for the next five years. Which we’re now rolling up our sleeves and implementing.
“But alongside all the things that we in the NHS can and are now doing to improve health, redesign care, and drive efficiency, it’s time to think hard about the wider opportunities we have in this country to improve health and sustain care.
“Because all the big national debates – on work and benefits, on immigration, on infrastructure, on devolution – create opportunities or challenges for the National Health Service. It’s time for the NHS voice to be heard, in support of more creative economic and public policy.”
On the role of employers in workplace health Simon said: “Because we have a tax-funded National Health Service in this country, rather than employer-based health insurance like the French or Germans or Americans, we don’t saddle business with the costs of health care. But one by-product is that we tend to neglect workplace health. Yet the NHS spends over £40 billion a year on treating working age adults, much of which could be prevented. That’s on top of the estimated £32 billion cost of sickness absence caused by 130 million days off work. Some larger employers are now – as the Financial Times put it – “waking up to the cost of ill employees”. But for small business this is harder.
“The NHS will therefore now work with the Institute of Directors, and other employers and staff organisations to explore whether there is a case for suggesting to Government consideration of fiscal incentives – perhaps an employers’ national insurance rebate – for those small employers who provide their employees with credentialed health and wellbeing programmes proven to cut long term costs to the NHS.”
On immigration and the NHS Simon said: “Understandably we’re having a national discussion about how to get immigration right. My responsibility is to point out that at time when the need for nurses is growing, when publicly funded UK nurse training places will take several years to expand, and when agency staff costs are driving hospital overspends right now, we need to better ‘join up the dots’ on immigration policy and the NHS.
“However most nurses I speak to struggle to understand why our immigration rules define ballet dancers as a shortage occupation – but not nursing. And most hospitals tell me that the idea that we would seriously consider deporting some of our most experienced and committed nurses solely because they’re not earning £35,000 clearly needs a rethink.”
Mr Stevens also said that the NHS could not duck the debate about the funding of social care. He said it was time to “get creative” about policy in this area and suggested it was worth exploring ideas to release housing equity to pay for these services.
Mr Stevens added that prevention was also an economic imperative, with obesity among children in particular storing up ill health for the future.