ABSTRACT
The challenges for the NHS are many. At this stage, the role of politicians and the social contract needs to be addressed. In addition, workforce planning is crucial, and this needs to look at recruitment as well as retention. There must be a long-term NHS plan which goes beyond a single parliament. The politicians should be encouraged but must have experience of the service. Dr Hallett emphasises the strengths of the NHS which are to do with care from preconception to post-death. The fact that it is free at the point of contact and need is the founding principle and needs to remain so. Wider societal and public health factors choices made by the government result in poverty, poor education and resulting lack of proper employment poor housing, underfunding Sure Start centres, reducing support for mothers, limited or poor peri-natal care when social services are incredibly stretched all contribute to poor health of children so the next generation suffers. In addition to workforce planning, there needs to be a degree of interconnectedness with other areas such as education, housing, employment and city design. Delivering services in the community can help reduce transport to hospitals and make services sustainable.
