The unprecedented burden on the NHS in the past two years has made us all aware of the precarity of our healthcare system. A recent parliamentary debate about a National Strategy for Self-Care signals a potential shift in the direction of health policy in the UK post-COVID-19 – something which both sides of the house see as needed. With nationwide delays in access to treatments and severe staff shortages, new, patient-led models of healthcare are now being taken more seriously. 74 years ago, the NHS was created with the vision of providing “cradle to grave” medical care – but what that support involves might look and feel completely different in a few years’ time.
The latest debate explored some key questions around how a greater emphasis on self-care in health policy would affect the healthcare system and patients across the country. Promoting self-care involves allowing patients to take on a more active role in managing their own health, and providing the information and tools to prevent problems occurring, take care of self-treatable issues and manage the symptoms of chronic conditions. Eventually, patients becoming less reliant on GP services should alleviate the pressure on the NHS and make healthcare provision more sustainable.
While this may sound like a win-win situation for both patients and the health system, the true winner of a transition to a self-care-based health policy would be the pharma and life sciences sector. In other markets that have adopted a similar model, the industry has been quick to step into the role previously filled by health professionals. With patients seeking to manage their health issues independently, over-the-counter drug sales have skyrocketed, and the demand for better self-management tools has led to flourishing innovation in the medical device and digital health space.
But can these self-care solutions really replace traditional healthcare services in the UK? While MPs in favour of the proposed reform emphasised that “self-care is not no care,” the criticism levelled by more sceptical voices is that it will be a deflection of responsibility by the Government for taking care of the wellbeing of the population. This is particularly pertinent in a country that tends to pride itself on the quality and accessibility of its public healthcare system, with the Prime Minister referring to the NHS as the UK’s “greatest national asset.”
What the parliamentary debate on self-care has shown is that policymakers understand that a balance must be struck between taking advantage of the opportunities offered by digital health technology, empowering patients to self-manage their health issues, while also maintaining a well-functioning, well-resourced public health service that is available to those who need it, whenever they need it. The Minister for Health emphasised that while self-care is an integral element of the Department’s objectives for the future of the NHS, it is not a one-size-fits-all solution for the many challenges currently facing the healthcare system in the UK.
Indeed, the dialogue on self-care segues into other key facets of health policy. Closely relevant are the issues of health literacy and health inequality. Any self-care strategy can only be successful if the population has access to high-quality, accurate medical information, as well as the knowledge and confidence to act on that information. This requires doubling down on nationwide health education efforts. As for health inequality, there is much to do for the Government in terms of removing the structural barriers that prevent marginalised groups from accessing quality healthcare. As the findings in Cicero/amo’s latest update of the Rebuilding Britain Index (RBI) show, health inequalities must be understood – and addressed – within the broader context of socio-economic disparities that are prevalent across the population.
With the Government’s Health Inequality White Paper due to be published soon, we can expect further policy proposals and parliamentary discussions about pathways for sustainable and equitable healthcare provision in the UK. Clearly, there is a need to move away from the status quo and adapt the healthcare system to the evolving needs of our society. The question remains whether reforms and innovation will put at risk the spirit and ethos of the NHS.
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