Glasnost has well and truly broken out in the UK in relation to the National Health Service.
More and more staff, patients, carers and observers are openly questioning whether the NHS is actually a world class service. Suggestions that it might, instead, be antiquated and dysfunctional with pockets of scandalously low performance, increase every day. The brutal reality is that the NHS contains, in fact, a complex mixture of brilliance and lamentable ineptitude.
The NHS is consistently excellent in some of what it does. Overall, as the Commonwealth Fund International Ranking testifies, it performs very well if compared to equivalent services overseas. But, there are huge unjustified regional variations in the effectiveness of the NHS within the UK in services such as the treatment of diabetes. And most of us are aware that survival rates for various types of cancer are not improving in relation to countries that have the best survival rates.
In this context of a very open public debate about the future of the NHS, the launch of the Ham Inquiry by Norman Lamb, Minister of State for Care and Support, is a timely and very positive development. The Inquiry, to be led by Professor Chris Ham of the Kings Fund, will investigate how to increase employee engagement and employee ownership in the NHS, including in acute hospitals, community services and Foundation Trusts.
The Inquiry has a tremendous platform to build on. Employee owned public service spin out businesses already deliver more than £1bn of NHS services each year. There is compelling evidence that these spin outs maximise productivity, raise the quality of services received by users, increase returns on investment for service funders and for employees improve their well-being and the conditions within which they work. I am proud that so many of the spin outs are energetic Members of the Employee Ownership Association and that we have helped a large number of them to start up and grow. The brave pioneers who have created these enterprises deserve all the recognition they get.
The NHS and its beneficiaries would incontestably benefit from a dramatic increase in the number of these spin outs and the range of services they provide. For productivity reasons alone this has to be a great way forward with the NHS required to achieve more than £30bn of cashable efficiency gains by 2021. More fundamentally, unleashing the potential of employees to innovate and design better services is the optimal way of addressing two of the biggest challenges in the architecture of the NHS, namely the separation of general practitioners from hospital based specialists and the institutionalised but artificial divisions between health and social care.
It is frankly absurd that parts of the NHS including Foundation Trusts have obligations to involve in all of their work local communities and patients, but have no duty to deeply engage employees or to create ownership routes for them. The Ham Inquiry offers a chance for people to escape from what is a moribund paradigm. And perhaps above all else it creates the opportunity for the NHS to promulgate a brand new modern language that advocates employees and employee owners working with patients and service users to design care and to create integrated care delivery.
I wish Chris Ham and his colleagues all the very best for the Inquiry and to its findings becoming a major catalyst for change.