The NHS recently reached its 65th birthday, but it is not settling down into its golden years with ease. Instead, it is faced with a triple-pinch of an economic downturn, fiscal tightening and ongoing demographic change. These conditions have brought to the fore the uncomfortable truth that our health system is becoming more and more costly, with productivity stubbornly low. The Coalition Government’s response to this was a radical shake up of the structures of the NHS, in the hope that this would make it more sustainable in a time of thrift, but the success of such a policy is far from certain.
This collection brings together a series of papers on the impact of austerity on health policy. It takes a holistic approach – considering the NHS and inequalities of public health, questions of structures and behaviours, and regional and historical trends. These topics are approached by an equally mixed group of contributors – academics, politicians, practitioners – who paint a broad picture of the challenges facing health policy makers through a period of economic turmoil and reduced spending.
The collection presents compelling evidence of the public health impact of economic decline – higher unemployment, job insecurity, fuel poverty, homelessness and other social ills – that has a direct effect on the NHS. It also emphasises that, though current budget restrictions may be tough for the frontline, it is the longer-term trend of an ageing population which will prove to be the NHS’s biggest challenge. However, the question that remains is whether health policy makers will grasp this nettle, and make the necessary response to demographic change which is redefining our understanding of health and healthcare.