A review of Humanising healthcare: Patterns of hope for a system under strain by Dr Margaret Hannah
Nigel Lawson famously once remarked that the NHS is the nearest thing we have to a national religion, and it is certainly true that it has a unique place in British society and in our affections. But it is also true that, like all health systems in the developed world, it is increasingly under strain. This has of course been enormously exacerbated by the coalition Government’s unnecessary, expensive and counterproductive ‘reforms’ of 2013, and the many years of sub-inflationary funding growth. But there are deeper problems with our approach to health and health services, which Margaret Hannah explores in this timely and readable short book.
As countries grow wealthier (in GDP terms), demand for healthcare grows disproportionately. At the same time, the med-tech industries are constantly inventing new ways to add marginal health benefits, sometimes at eye-wateringly high marginal cost. So, despite the fact that we are incomparably healthier than in decades past, (and in no small part because we are living so much longer, and thus living with chronic diseases that accompany old age) the NHS struggles, and sometimes fails, to deliver the health care that we demand of it. As Aldous Huxley remarked: “Medical science has made such tremendous progress that there is hardly a healthy human left.”
Margaret Hannah’s exploration is in three parts. First, she analyses why health care is consuming an ever increasing proportion of our national income, and still demands more. The second part explores the various responses that have been tried to this, and why none of them have succeeded in finding a way to make our health care system affordable. It is in the third part that she offers some alternative solutions, based on her observations of health systems elsewhere in the world, and in particular the ‘Nuka’ model of health care in Alaska. She observes that good health is the result of healthy living and healthy relationships, of quality of life held in common. She then identifies instances of this thinking and practice in the NHS, and describes how she thinks these could be the basis for a widespread transformation of the way in which healthcare is thought of and provided in our country.
This is certainly a vision that Greens can endorse. The recognition that good health is derived from harmony with the rest of society, and with nature and the environment, is welcome. But whether the approaches she describes to staying healthy, and the different ways of supporting people whose functional capacity falters would be enough to ‘save the NHS’, and in particular lead to health services no longer being such enormous consumers of natural resources and users of energy, remains moot.
Much of the ground covered in this book will be familiar to people with an active interest in health services policy, but it is a book written for the general reader, and as such is very accessible. It should be read by anyone with an interest in how our national religion can continue to provide what its worshipers seek.