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Matthew Taylor: a more ambitious national social contract for healthcare

Matthew Taylor, Chief Executive of the NHS Confederation and one of the UK’s most influential health leaders, visited the Royal Society of Medicine on Monday 15 May 2023 to give the annual Stevens Lecture, an RSM flagship public engagement event founded in 1970 by philanthropist and inventor Edwin Stevens.

Mr Taylor used his speech to propose that the occasion of the NHS’s 75th birthday should be used to develop a more ambitious national social contract for healthcare, something he believes to be ‘more practical and more achievable than it might sound’.

But to achieve this for the nation, he said, will require us to make a more profound commitment and to rise to two sets of challenges. “Firstly, the need to re-set relationships: between the public and our own health; between the centre and the NHS; and between all organisations involved in health and care. And secondly, the urgent demand for investment – not just the amount, but also where we invest.”

In his wide-ranging speech, Mr Taylor went on to discuss health disparities and the need for us to understand and acknowledge more fully the economic consequences of poor public health, together with the importance of empowering and enabling patients and communities to manage and improve their health and wellbeing.

He went on to discuss the state of primary care, giving examples of ‘fantastic’ practice led by ‘inspirational’ GPs and primary care managers. “Standing out in this work is a commitment, on the one hand, to improve population health and reduce health inequalities and, on the other, to work with partners in the health service and beyond and with community organisations”, he said. According to Mr Taylor, the most inspiring primary care leaders see themselves as ‘street-level entrepreneurs knitting together networks, services and bits of funding, focused always on working with others to improve the health and wellbeing of communities’.

Proceeding to tackle the ‘complicated and contested’ debate about the resources of the NHS, Mr Taylor told the audience that, undeniably, ‘to meet rising demands and expectations and to make the most of advances in medicine we need better, more sustained, and more equitable funding for health and social care’.

He went on to describe research commissioned by the NHS Confederation showing that for every £1 invested per head on the NHS, £4 is returned to the wider economy, pointing out the £43 billion cost to the UK economy of loss of earnings caused by long-term sickness.

Reiterating the need for investing proportionately more money into primary, public health, prevention and community-based services, Mr Taylor said that most health leaders – including those who run acute trusts – recognise the need to shift resources ‘if we are ever to get off the hamster wheel of trying to meet ever more demand for hospital-based care’.

Ending his speech, Mr Taylor said: “Despite all the challenges we face I believe the best days of the NHS still lie ahead. Sufficiently funded, properly supported, devolved, preventative, empowering – our health service can be ready to grasp the opportunities offered by science and technology for a transformation in health outcomes. It is a future worth fighting for.”

To read Mr Taylor’s speech in full visit the NHS Confederation website

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