Anita Charlesworth

Do you regard the NHS as an efficient organisation that provides good value for the huge sums that sustain it? 

How much bang do UK taxpayers get for their NHS buck? 

In the latest podcast this is the topic discussed, as Niall and Roy consider the controversial and challenging topic of NHS productivity, the subject of new report from the Health Foundation’s NHS Productivity Commission.  

Their guest is Anita Charlesworth CBE senior economic advisor  at the Foundation and co-chair of its Commission. Anita is one of the most prominent economists focussing on the public sector having been Director of Public Spending at the Treasury under Gordon Brown, and overseeing the seminal Wanless report into NHS funding;  in 2018 she co-authored the influential study titled "Securing the future: funding health and social care to the 2030s," with Paul Johnson then of the Institute for Fiscal Studies. She is a member of the advisory panel for the Office of Budget responsibility. 

The Commission’s report Breaking the Cycle - how to build a more productive NHS concludes that the NHS in England is simply not set up to deliver sustained productivity growth. The health service, it claims, often obstructs sound decision making and impedes efficient delivery, with local NHS organisations subject to structural instability, competing priorities, and relentless short-term pressures. The commission concludes that significant productivity gains will not come from short term fixes.  And it rejects suggestions that our tax funded system is in any way to blame for our performance against other advanced healthcare system in the OECD. Instead it recommends the creation of a system with greater stability, a shared purpose, an engaged workforce, clearer accountability, more freedom at local level and one that can develop the capability to improve care.

Few may disagree with the diagnosis, but as well as exploring why our NHS is not delivering to its potential, the podcast considers the potentially huge impact of AI and technology, the role of professional vested interests and whether Anita and her fellow Commissioners have the right solutions. Crucially, it also considers whether the Commission has worked out how these reforms can be delivered and whether there is the political insight and will to bring them about.

If you want to understand the debate about productivity and how the NHS might be transformed, please do join Niall, Roy and Anita for a fascinating discussion.