In 1997, an Economist Intelligence Unit publication, Healthcare Europe, predicted: "No political party will deliberately kill off the National Health Service. This masterpiece of 1940s social equalisation has long been one of the UK's few untouchables." So far, the prediction stands.
However, a system of universal healthcare creates high expectations on the part of its end-users. Faced with an ageing but articulate population, demands on the NHS—and, by extension, the UK government—will increase. "Patient expectations are in part caused by notions of consumerism but also because patients now regard healthcare services more as a right," says Ceri Phillips, Professor of Health Economics and Head of the Institute for Health Research at Swansea University.
The government has spearheaded a range of reforms to try to get future ends to meet, but perhaps its most ambitious experiment has to do with health reforms to promote patient-centred care. After several failed attempts in July 2007, the government launched its so-called World-Class Commissioning (WCC) programme for delivering "outstanding performance in the way we commission health and care services". A key element of WCC is the inclusion of patients and the public, who are meant to assist in deciding local priorities and how best to deliver them.
To catalyse communication between local healthcare commissioners and patients and the public, the UK government has launched a separate but parallel initiative to "give citizens a stronger voice in their health and social care services"—a vehicle called LINks (Local Involvement Networks). LINks are individuals and voluntary groups that come together with a duty to find out what local people want. LINks monitor local services, and use their policing powers to hold healthcare providers to account. The commissioners of local healthcare in the UK are now expected to base their decision-making on evidence of what really matters to patients, public and staff.
