Hewitt review misses need for far reaching change

Richard Bourne discusses how past policy failings still haunt the current health policy debate, as he explores the changes proposed in Patricia Hewitt’s review of the integrated care system and the recently published paper by Chris Ham on the political failings in NHS policy – 2010-20


Even at the high point of 2010 the NHS and social care system faced severe challenges.  The basic NHS principles (universal, comprehensive, free at point of need and tax funded) were strongly supported and the NHS did well on international comparisons, but the much improved NHS had not adapted to the new reality that millions could live independent lives for many years with appropriate care and support – it was rooted heavily in curative care.

Whilst the NHS came near the top of health care systems in international comparisons, on some measures of quality of care the NHS performed badly.

The unspoken reality was that the NHS delivery model, loosely based on a pretend market, was dysfunctional and badly managed. The economy was being impacted by poor health.  The Treasury regarded healthcare as a cost to be cut, not as an investment.

It is all far worse now.

Full article in The Lowdown, 25 April 2023