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The Wanless NHS report
Derek Wanless
Derek Wanless will publish his final report next year
A major report into the future of the NHS says it should continue to be funded by general taxation, albeit at higher levels.

The interim findings of a study into the future of the health service, by former Natwest bank chief executive Derek Wanless, published Tuesday, suggests the NHS will face growing financial pressure in the coming 10 to 20 years.

However, he argues that continuing to fund the health service through general taxation is the most cost effective and fairest system for the future.

Mr Wanless believes the biggest sources of pressure on the NHS over the next decade will come from technological innovation and rising public expectation.


I would welcome views on this interim report from as many people as possible

Derek Wanless
But he played down fears that an ageing population will adversely impact on the health service, saying that the pressure will not be as high as expected.

"It is possible the effect of an ageing population will be to postpone rather than increase health service costs," he wrote.

But Mr Wanless added that patients will want much shorter waiting times. "For months, read days or weeks and for weeks read hours or days."

He said patients will also expect comfortable accommodation - "not the Ritz, but not the YMCA" - and will reject a "one size fits all" NHS.

The report entitled "Securing Our Future Health ...Taking a Long-Term View", commissioned last year by Chancellor Gordon Brown, will be used by the government to develop a long-term funding strategy for the NHS over the coming decade.

Mr Wanless said many of the NHS's current problems stemmed from "a history of under-investment over 50 years and a long-term lack of capacity".

The 220-page report also highlights the gap between health funding in the UK and elsehwere in Europe.

Cost-effective

But Mr Wanless concluded that a health service funded by general taxation was cost-effective.

"My conclusion is that there is no evidence that any alternative financing method to the UK's would deliver a given quality of healthcare at a lower cost to the economy.

"Indeed other systems seem likely to prove more costly. Nor do alternative balances of funding appear to offer scope to increase equity."

Mr Wanless suggested that "more self-care by patients" could help to reduce financial pressure on the health service. This would mean patients would be encouraged to stay at home and take care of themselves instead of visiting their GP or local hospital.

Chancellor Gordon Brown
Mr Brown commissioned the study
He added that "better use of information and communication technology," which is currently "poor", could improve efficiency and therefore cut costs.

There is also evidence to support "radical changes in the skill mix of the workforce", which would mean extending the role of nurses and breaking down professional boundaries.

A significant increase in contact time with patients and the use of cost effective treatments would also boost productivity, he concluded.

He also appeared to criticise government plans to give patients bedside televisions and telephones saying patients could pay for such services so that money is not diverted away from those in need.

Patient charges

He suggested that patients could also pay for non-clinical services in the future as a way of reducing the overall NHS bill.

However, he ruled out asking patients to pay for clinically-necessary treatment.

"On equity ground I do not think it right that some individuals should be able to access clinically necessary services through the NHS by paying when others whose need is at least as great could not, simply because they could not afford to pay.

"As patient expectations increase, the UK will need to consider whether to provide a mechanism to allow patients to express their preferences for greater choice in non-clinical services.

"Such patient charges for non-clinical services may offer a way to extend choice for these services without diverting NHS resources away from clinical care."

Mr Wanless is expected to consult patient and doctors groups and other relevant parties in the coming months before publishing a final report early next year.

"This is the first time in the history of the NHS that the government has commissioned a long-term assessment of the resources required to fund the health service.

"The quality of the health service affects us all and I would welcome views on this interim report from as many people as possible."

The government's pre-Budget report will be on 27 Novewmber


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27 Nov 01 | Health
27 Jul 00 | NHS reform
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