Public Services Lab Blog

A very public health service

Laura Bunt - 17.08.2009

Health is more than a question of institutional provision, it is also a social issue shaped by social conditions and collective behaviour

After 60 years of the NHS we are living longer, recovering quicker and expecting more tailored, personalised services that respond to our needs. The growing presence of chronic health conditions means more of us require ongoing, complex care and support.

Long term health problems already account for 80% of GP consultations, pressure that's only set to increase as effects of an ageing population take hold. Current demands are very different to the acute health challenges the NHS was originally designed to cope with, driving ambitious, relentless innovation and reform to keep the service up to date. 

However, health is more than a question of institutional provision. Much of the current policy (and public) debate still tends to think about health in terms of hospitals, GP surgeries, drop in clinics and so on.

But health is also a deeply personal issue, requiring personal participation and responsibility. And perhaps more fundamentally, health is a social issue, shaped by social conditions and collective behaviour. These dimensions of health are still neglected, despite being vital to individual and collective wellbeing.

Looking beyond the buildings and the equipment to the people who use the NHS - the staff, the patients, the friends and families - gives a different emphasis to the types of problems that new services and initiatives try to tackle.

New knowledge about the effect of relationships and social networks on physical health adds to the case for the re-emergence of social innovation, centred on people. Pioneering innovators working with health services are going beyond the user as consumer model of provision and reaping the benefits of seeing the user as a co-producer.

Where to draw the line of government 'say-so' over public health is a political battleground. But in the context of 21^st century health challenges, overshadowed by financial restrictions, involving the public and local networks may offer some imaginative solutions to ensure us a healthier future.