NHS@75 - the debate on the future of the health service begins

01 March 2013

By Ed Bramley-Harker

What might the future hold for the NHS in 2023? On 26 February, we brought together a range of stakeholders from across the health sector, and beyond, to think about this question, exploring the possibilities for the NHS over the next decade.

The potential visions for the future that we arrived at on the day were both exciting and inspiring – yet also clearly emphasised the massive challenge ahead for the NHS as it approaches its 75th anniversary in 2023.

As part of our NHS@75 programme, we are also engaging with the public to hear how they feel about the NHS, asking about patient choice, individual responsibility and the use of technology in healthcare – all within the context of increased financial pressures on the NHS.

We asked the public about personal health budgets - whether people thought that they should be able to look after their own or family budgets, using support to make healthcare decisions for themselves. We found that almost a quarter (23%) of people surveyed agreed with the idea, while 41% disagreed and over a third (36%) didn’t know, or couldn’t decide either way, perhaps suggesting that the public needs more information to understand how personal budgets could work for them.

While the idea of personal responsibility for managing budgets does not currently have widespread support, the public felt that people should take responsibility for their own behaviour if it was having a negative impact on their health. Specifically, a majority surveyed - 59% - thought that if people are given advice to lose weight to help their condition, they should not receive any further treatment for that condition until they lose weight.

Despite this focus on individual responsibility, however, when faced with the possibility of the NHS being unable to fund all treatments, a minority of those surveyed – 23% thought that patients should be expected to contribute payments towards the treatments for conditions caused predominantly by lifestyle choices, such as heart disease.

We also surveyed the public about the role of technology in healthcare, asking whether people thought that it was more important to receive face-to-face medical advice than via their computer or smartphone, even if the quality of advice was the same. Only about one in five (19%) thought that it was more important to receive advice via digital technologies. The majority – 56% - still saw it as more important to be able to see somebody face-to-face.

Over the coming months we will continue the debate about what the NHS could - and should - look like in ten years’ time, and begin to map out the steps that need to be taken to help plan effectively for the future.

We want your views to do this, so join the debate at www.pwc.co.uk/nhs75 where you can also watch our inspiring specially commissioned film examining attitudes to the NHS through the decades from foundation to today.

Contact details
Email: Ed Bramley-Harker
Tel: 020 7804 5684



Hi Ed,

Thanks for posting this.

How many people took part in the survey?



Hi Alex

Glad you found this of interest.

We surveyed 2,021 nationally representative UK adults.


Great to see the discourse outside the NHS directly with the public.

NHS must grasp the opportunities in IT and data analytics.

However, this will only truly be of benefit if both the system and the centre (Dept of Health) ensure a culture and environment that allows multiple parallel projects to develop - this requires a way to incubate and protects innovative ideas that may well lead to successful disruptive innovation.

Deborah, thank you for your comment, which I entirely agree with, especially in relation to data analytics.

In other parts of the public and corporate sectors - and even in fields like the analysis of sporting performance - you have seen competition among analysts and service developers result in the creation of a range of interesting tools and approaches.

In contrast, in the NHS information and the analysis of it has historically been quite tightly controlled, and this has not led to the development of a truly open culture of innovation. All of the players in the health system - providers, commissioners, regulators and third parties - should be challenged to innovate both in relation to analytical methodologies and in relation to ways of clearly presenting and communication information.

And you are absolutely right when you say that this innovation will need to be supported, both financially and culturally.

Verify your Comment

Previewing your Comment

This is only a preview. Your comment has not yet been posted.

Your comment could not be posted. Error type:
Your comment has been saved. Comments are moderated and will not appear until approved by the author. Post another comment

The letters and numbers you entered did not match the image. Please try again.

As a final step before posting your comment, enter the letters and numbers you see in the image below. This prevents automated programs from posting comments.

Having trouble reading this image? View an alternate.


Post a comment

Comments are moderated and will not appear until the author has approved them.