The English National Health Service in a cold climate: a decade of austerity

Abstract

This chapter examines the NHS in a cold climate of a decade of austerity. This period has first seen a broad move from the optimism of its 60th anniversary and greater pessimism of its 70th anniversary. Second, it has seen a game of two halves from a preoccupation with the reorganisation of the Lansley Health and Social Care Act towards ways of working around or undoing that reorganisation. One sad constant in the period is the continuation of Inquiries into failings in the NHS. The chapter concludes with an assessment of the ‘birthday present’ of increased funding associated with the NHS’ 70th anniversary, and some thoughts of the outlook of things to come. While the increased funding is welcome, it is unlikely to have the promised ‘transformatory’ effect because it is less than the NHS’ historical rate of funding increase; it includes promises that have been made in the past but have not been delivered, and excludes wider elements of health-related activity and social care. If life is to begin at 70 for the NHS, futures birthday presents for its 75th or 80th birthday must include greater integration with social care, perhaps a phoenix-like transformation into a National Health and Social Care Service.