The rising tide of obesity, the over-reliance on hospitals and the adult social care funding shortfall have left the National Health Service in a state of “crisis”, according to a new House of Lords report.
The report by the Long-term Sustainability of the NHS Committee calls the NHS the country’s “national religion” and “an iconic part of Britain's social fabric”, but argues it is not sustainable in its current form.
It calls for a new campaign to highlight the obesity “epidemic” and urges ministers to look into the possibility of an insurance scheme to enable people to prepare for their care needs in older age.
It says the health service should remain free at the point of use, which would require “a shift in government priorities or increases in taxation”.
The report, written by a House of Lords Select Committee that looked specifically at the question of the long-term sustainability of the NHS, criticises the “short-sightedness” of successive governments to plan ahead.
It argues for the creation of an office for health and care sustainability to look 15 to 20 years ahead to “counter the endemic NHS disease of short-termism”.
Peers say preventable health problems, particularly obesity, are putting a “significant burden” on the system. The report also drew attention to the funding crisis in adult social care, which it described as "on the brink of collapse".
“The funding crisis in adult social care is worsening to the point of imminent breakdown,” the report says.
“Pressures in social care are the greatest external threat to the long-term sustainability of the NHS.”
Social care is currently funded directly by local authorities, separately from the NHS. The report suggests the Department of Health should fund this centrally, and be renamed the Department of Health and Care.
It suggest a social care insurance system could replicate similar schemes in Japan and Germany, both of which involve compulsory long-term care insurance schemes shared between an employer and employee, like the workplace pension scheme.
The committee’s chair, cross-bench peer Lord Patel, said: “The Department of Health at both the political and official level is failing to think beyond the next few years.
“There is a shocking lack of long-term strategic planning in the NHS.
“This short-sightedness stems from the political importance of the NHS and the temptation for politicians to reach for short-term fixes, not long-term solutions.”
A Department of Health spokesman said: “We are totally committed to an NHS, free at the point of use, providing world-class care – and we agree that means taking decisions to ensure the sustainability of the service in future.
“That's why we are already expanding the number of medical training places by 25 per cent to ensure we have all the doctors we need, investing in social care and working on a long-term funding solution in a green paper, and putting £325m into local transformation plans to improve services, with more to follow in the autumn.”