The British Medical Journal has taken the somewhat extraordinary step of calling on the next UK government to declare a “national health and care emergency”.

In an editorial released alongside the journal’s first report into the future of the NHS – Britain’s publicly-funded national health service – medical experts have called for the system to be effectively relaunched.

Likening the ‘societal shock’ of the COVID-19 pandemic to that of the Second World War, which was the trigger for the NHS being introduced under the Attlee Government in 1948, the opinion piece singles out several challenges confronting the British health system, among them  recruiting medical professionals amid a “political environment hostile to immigration” and low clinical quality outcomes.

It argues that it is possible to provide high-quality healthcare through general taxation. Authors Liam Smeeth, Parveen Kumar, Victor Adebowale and BMJ editor-in-chief Kamran Abbasi conclude “The national health and care crisis we are facing requires an urgent, robust and values-based response”.

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NHS amid gravest crisis in its history

The editorial introduces the first report of the BMJ Commission on the Future of the NHS, written by a specially selected group of medical experts and overseen by British peer Nigel Crisp.

It describes the service as underdelivering for Britons in need of the service’s “excellent treatment and care”. It identifies austerity, the COVID-19 pandemic, and other financial and staffing issues as leaving the NHS in the “gravest crisis in its history”.

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Calling for radical change, Crisp and his colleagues set out the principles for a future NHS and called for the next UK government to declare a national health and care emergency and to be up-front on the scale of challenges confronting the system.

Britons are expected to go to the polls later this year.

The NHS has long been considered a shining example of publicly owned healthcare upon which other nations have based their state-funded models. It’s also a source of national pride. In 2023, an Ipsos poll found more than half of UK citizens said the NHS makes them most proud to be British – ahead of the nation’s history, culture, democracy or the royal family.

But the report says stresses facing the NHS are making it less effective at meeting the needs of the population. While life expectancy has risen since the establishment of the service, the analysis finds it is now straining under the challenges of an aging population requiring a greater range of services to address long-term conditions and disability; community access to cheap alcohol and processed food  (both of which are shown to negatively affect health);  high-stress working conditions and growing socioeconomic inequality that is linked as a cause of ill health.

While it finds that the NHS’ founding principles of a universal healthcare system that is ‘free at the point of need’ still applies today, it recommends updating service models for the present day, adopting greater use of technology and data, all-of-society approaches to addressing and preventing disease, greater social engagement and education of healthcare professionals.

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