Bismarck versus Beveridge revisited: Does the model shape the outcome? | IPPR In this context, old questions have re-emerged with renewed force: are the NHS’s core principles – free-at-the-point-of-use and funded through general taxa

But the model is our strength, not our weakness.

Follow the evidence. Fix the problems. Don't change the model.

Full report 👇

ippr.org/articles/bis...

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Also vital in this context to do the boring, very unsexy work of fixing NHS approach to performance and financial management (more on this)

And to have a hard nosed conversation about what we can afford and what we can't (particularly given innovation coming down the line!).

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Resources will be tight for years to come (thanks low economic growth and geopolitics!).

That makes it even more important to direct investment to where it will generate the best outcomes at lowest cost: capital, social care, primary and community services.

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The NHS's problems are real and deep, but they stem from long-term underinvestment and resource misallocation, not the funding model.

Capital spend sits at half the average of the 22 countries we analysed, and we spend less on long-term care (i.e. rehab) and social care.

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Tax-funded systems hold real advantages - lower out-of-pocket costs for patients, less reliance on voluntary insurance and significantly lower admin costs.

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We analysed 22 high-income countries and the evidence is clear: there is no systematic difference in performance between tax-funded and social health insurance (SHI) systems.

Performance varies far more within funding model types than between them.

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Calls to shift the NHS to a European-style insurance model grow lounder when the system is under pressure. Despite some green shoots of recovery, the NHS is still in its most difficult period.

But is changing the funding model the answer to the NHS's performance woes?

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Great to release Bismarck versus Beveridge Revisited this morning at an even with the Secretary of State for Health and Social Care.

Here you can see me in my centrist dad outfit explain the findings, but quick 🧵 below

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UK - heading for another energy induced CoL shock? Maybe but not huge 🤞

1) It's at the moment an oil price issue not yet gas. We'll pay more at the pump. ~2/3 of UK oil comes from US/Norway, more expensive but not threatened.

2) Gas prices don't really track oil. 40% of UK gas is imported...

And Toby Young will lead a commission looking at how to "end the institutional self-censorship that stops people from doing the right thing". Not 100% sure what that means.

I think a merged Providers and Confed could be a very powerful idea. But they've missed a trick on the name IMO.

The NHS Syndicate, the NHS Entente, the NHS Bloc all preferable...

Or maybe to draw on an adjacent sector, NHS United, NHS Rovers, NHS Rangers or NHS Wanderers would have worked.

A graph showing a negative trend in HLE

What's one of the best ways to measure population health?

We'd argue it's Healthy Life Expectancy - capturing not just how long we live, but how many of those years are spent in good health.

New figures are out today. The picture isn't good. At a national level, England's HLE continues to fall.

And doing better with dental data is important to improving access www.bmj.com/content/391/...

A man who heroically tackled and disarmed one of the Bondi Beach gunmen has been unmasked.

The hero has been named as 43-year-old Ahmed al Ahmed, a Sydney local who owns a fruit shop in Sutherland.

www.news.com.au/national/nsw...

NEW: Hospital productivity growth is beating the government’s targets. So why hasn't the NHS made more progress on cutting elective waiting times?

In a new @theifs.bsky.social comment, we examine what’s driving the divergence between two of the government’s biggest NHS priorities.
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America can not be trusted with the World Cup

It’s time to rethink how the #NHS listens to patients.

Our new report shows the Friends and Family Test isn’t giving the insights the NHS needs and sets out a plan for a reformed, co-produced replacement.

Read the full release here: bit.ly/FFTReport25.

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I read the performance tracker with great interest! Particularly this section on staff sickness and catchment areas by deprivation. Did you find any other interesting associations with catchment area deprivation and performance?

Want to learn more or get involved? Reach out! And watch this space – we’ll be sharing updates on our work in the coming weeks. 🚀

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The Centre for Health and Prosperity aims to close this gap. By working in partnership and creating new platforms, we’ll drive meaningful, lasting change in health and care!

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A troubling gap exists: Policymakers often feel powerless to make lasting improvements; Operational leaders feel they are drowning in frameworks & guidance that don’t seem to connect with frontline challenges 🤯

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But we’re not stopping at ideas. Our focus is now on making change happen. Too often, ambitious health programmes struggle to survive the messy realities of delivery. ⚡

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The Centre will build off the brilliant work of the Commission on Health and Prosperity, continuing to demonstrate that investment in health is Britain’s greatest untapped route to prosperity. 💷

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Exciting news from @ippr.org HQ today as we officially launch our Centre for Health and Prosperity, a permanent home for progressive thinking on all things health and care. 💡

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1/ One of the privileges of writing 'It Takes A Village' with @ippr.org has been hearing from parents about what it’s really like raising healthy children today.

Together with a @publicfirst.bsky.social survey of 1,500+ parents, we held 6 focus groups across England.

Here are my key takeaways 👇

The broken care chain—report from a country with a low number of hospital beds Approximately 30% of older adults admitted to hospital in Sweden are readmitted within three months. Short hospital stays and readmission can lead to further functional decline, as recovery appears to be poor at home after discharge. To explore ...

Sweden has a self-declared hospital bed crisis, linked to higher levels of mortality and premature discharge (which often leads to higher rates of readmission) (see for instance: pmc.ncbi.nlm.nih.gov/articles/PMC...)

Commentators often hold up Sweden (with lower beds per head) as an example of how bed numbers can be reduced with investment in primary and community care.

Most of those commentators don't really ask any critical questions about Sweden...

When we look at international evidence on bed numbers, it is clear that total and level of occupancy in England are currently not safe. There are few 'transformational' approaches to delivery that would fix this problem.

FWIW I find it very implausible that the NHS will need less G&A beds over time - even with shift to more digitally provided care and options closer to home.

Increasing bed numbers is not a 'good' thing in itself but it certainly would do a lot to help with flow.