The Health Foundation podcast

Is the government’s 10-Year Health Plan the medicine the NHS needs? We ask two former health secretaries.  In the second of two special episodes, we speak to Alan Milburn about the future of the NHS and his thoughts on the government’s 10-Year Health Plan. Alan was Secretary of State for Health from 1999 to 2003, during the Blair governments, with his tenure seeing the development of the NHS Plan (2000) and record levels of investment. As Lead Non-Executive Director at the Department of Health and Social Care, Alan also had a hand in writing and developing the new plan.  In conversation with our Chief Executive Jennifer Dixon, Alan reflects on the key challenges facing the NHS today and why he believes the new plan sets the right direction of travel. But is the plan clear enough about how change will be delivered? How will the plan ensure the health service pulls in one direction across varying objectives and programmes? And will the pace of change be sufficient by the time of the next election?    Show notes The Health Foundation (2020). Glaziers and window breakers. Former health secretaries in their own words. The Health Foundation (2025). Jeremy Hunt on the 10-Year Health Plan.  The Health Foundation (2025). 10-year ‘Plan for Change’ or ‘plus ça change’? The Health Foundation (2025). Neighbourhood health is the right ambition – but will the 10-year plan deliver? The Health Foundation (2025). Dazed and confused? Policy ideas behind the 10-Year Health Plan. 

Is the government’s 10-Year Health Plan the medicine the NHS needs? We ask two former health secretaries. In the first of two special episodes, we speak to Jeremy Hunt about the state of the NHS and his reaction to the government’s 10-Year Health Plan. Jeremy was Secretary of State for Health and Social Care between 2012 and 2018, in the Cameron and May governments, making him the longest serving health secretary to date. He later served as foreign secretary (2018–2019) and Chancellor of the Exchequer (2022–2024). In conversation with our Chief Executive Jennifer Dixon, Jeremy reflects on his time as health secretary and whether he believes the new plan presents a coherent blueprint for reform. Does the plan strike a positive balance between top-down targets and decentralisation? Will the decision to scrap NHS England and cut the numbers of ICBs help or hinder delivery? And what is the future role of regulation in improving patient safety and care quality? Show notes The Health Foundation (2020). Glaziers and window breakers. Former health secretaries in their own words. Nuffield Trust (2025). Exploring earnings of NHS doctors in England.   The Health Foundation (2025). Taking a chainsaw to NHS England is not the sign of a healthy state. HSJ (2025). Cuts to ICBs and NHSE slammed by ex-health secretary.  HSJ (2025). Patient Safety Watch: Dash Review opens a crucial door.  BMJ (2025). Government’s 10 year plan for the NHS in England.

Hilary Armstrong, former cabinet minister and Chair of the Independent Commission on Neighbourhoods, and Andrew O’Brien, their Head of Secretariat, delve into how our environments shape health. They discuss the dire state of 'left behind' neighborhoods, where residents face significant health disparities. The duo emphasizes the importance of social capital and community engagement in revitalizing these areas. Additionally, they highlight effective grassroots initiatives and advocate for sustainable funding to empower local institutions, ultimately aiming for healthier communities.

Sacha Romanovitch, Chair of the Commission for Healthier Working Lives, and Jon Ashworth, Chief Executive of Labour Together, dive into the pressing issue of health-related economic inactivity in the UK. They discuss how 8.2 million working-age individuals struggle with long-term conditions, emphasizing the need for flexible work environments. Solutions involve reforming Statutory Sick Pay and advocating for early intervention strategies. The conversation also highlights innovative approaches like AI scheduling, aiming to enhance workforce wellness and tackle mental health challenges head-on.

‘Today we are abolishing the biggest quango in the world,’ – Wes Streeting, 13 March 2025  Many people were surprised by the government’s decision to abolish NHS England and fold its functions into the Department of Health and Social Care. Not least Richard Meddings, Chair of NHS England since 2022. Having formally completed his term in March, Richard joins our Chief Executive Jennifer Dixon to discuss.  In a wide-ranging conversation, Richard reflects on his time at NHS England and how the organisation has changed. With the NHS facing growing demand for care, and continuing to top the public’s list of priorities, where does the forthcoming 10-year health plan need to focus? How should ministers lead the service in the future? And what needs to happen to ensure the NHS reaches its 100th year? Show notes The Health Foundation (2020). Glaziers and window breakers. Former health secretaries in their own words. OECD (2025). How do health system features influence health system performance? Department of Health and Social Care (2023). The Hewitt Review: an independent review of integrated care systems. The Health Foundation (2025). Taking a chainsaw to NHS England is not the sign of a healthy state.  The Health Foundation (2025). Labour’s 10-year plan for the NHS in England: what should it look like? NHS England (2025). Review of NHS performance and delivery (27 March 2025). NHS England board meeting.

It’s 2 years since Keir Starmer first set out his five missions for government, including a health mission to build ‘an NHS fit for the future’ and ‘a fairer Britain, where everyone lives well for longer’. Missions were supposed to mean a new way of doing government – focused on ambitious, long-term objectives that provide a driving sense of purpose for the country. So, with Labour now in office for 9 months, what have we learned about how mission-driven government works in practice? Are clues emerging about how government plans to improve the nation’s health beyond the confines of the NHS? And do missions show signs of bringing about durable changes in policy and how the state works?  To discuss, our Chief Executive Jennifer Dixon is joined by: Hannah White, Director at the Institute for Government.  Jo Bibby, Director of Health at the Health Foundation.  Show notes Institute for Government (2025). Inside Briefing. Keir Starmer rewires the state.  Institute for Government (2024). What does a mission-driven approach to government mean and how can it be delivered? Health Foundation (2024). Health at the heart of government.  UK Government (2024). Plan for change: Milestones for mission-led government.  Future Governance Forum (2024). Mission-critical: statecraft for the 21st century. 

There are around 350,000 synthetic chemicals in use today and only a small fraction have been robustly tested for their long-term effects on our health. Many of these are used in manufacturing plastics and microplastics – the production of which has doubled since 2008 and is projected to triple by 2060.  Unknowns remain, but research is suggesting pervasive exposures to these manufactured substances is shaping human health. In particular, links are being identified with a range of non-communicable diseases, including some cancer types, metabolic disorders, neurological conditions and reproductive and developmental issues.  So, what do we know about how the chemical environment is influencing our health? Could AI and other emerging technologies shed new light on the effects of synthetic substances? And what does it all mean for regulation and wider policy protecting public health?  To discuss, our Chief Executive Jennifer Dixon is joined by: Tracey Woodruff, Professor at University of California, San Francisco, and Director of the Program on Reproductive Health and the Environment (PRHE).  Thomas Hartung, Professor at Johns Hopkins University, and Director of the Centre for Alternatives to Animal Testing (CAAT).   Show notes Woodruff et al (2025). Manufactured chemicals and children’s health – the need for new law.  Kleinstreuer & Hartung (2024). AI – it’s the end of tox as we know it (and I feel fine).  Nihart et al (2025). Bioaccumulation of microplastics in decedent human brains.  Financial Times (2023). ‘Global sperm counts are falling. This scientist believes she knows why.’  Programme on Reproductive Health and the Environment (PRHE). Scientific principles to protect public health.  Programme on Reproductive Health and the Environment (PRHE). Toxic matters. 

Nigel Edwards, former Chief Executive of the Nuffield Trust, and Hugh Alderwick, Director of Policy at the Health Foundation, dive into the pressing need for a transformative 10-year plan for the NHS. They discuss the importance of learning from previous reforms and engaging stakeholders to improve primary and community care services. The conversation explores the balance of collaboration and competition within the NHS, the role of technology in healthcare, and the public's unwavering support despite challenges like long waiting lists and access to mental health services.

We look back at our pick of the pod from 2024.  As 2024 draws to a close, what to make of the year’s developments in health and care?   As yet, a murky picture on NHS reform and on how the new Labour government’s five missions will work in practice; a pressing need to improve the health of the working-age population; and some promising ways forward for technology to improve care, quality and productivity in the NHS. In this episode, we also revisit how to drive the economic growth we need to fund high-quality public services, search for clues about what might be behind the worrying rise in cancer rates among younger adults, and explore what the latest evidence tells us about inequalities in health across ethnic groups in the UK. This episode also marks our 50th – meaning there’s a great back catalogue for you to enjoy. Join our Chief Executive Dr Jennifer Dixon as we reflect with guests who appeared on the podcast in 2024. All-time top performing episodes  Health Foundation (2020). Low life expectancy in Glasgow, and what to do about it.  Health Foundation (2021). Inside the teen mind: what’s happening to mental health? Health Foundation (2020). What should nanny do next? The government and obesity. Health Foundation (2023). AI in health care: hope or hype? Health Foundation (2021). We are what we eat: food, health and inequality. Show notes John Burn-Murdoch (2024). What if the UK isn’t actually the sick man of Europe? Financial Times.  Barnsley MBC (2024). Pathways to Work: Commission Report.  Edwards & Dayan (2024). Leagues tables for the NHS.

Health secretary Wes Streeting has set out three big shifts the NHS must deliver – including moving from analogue to digital. National strategy on health technology and digital is developing at pace, with a 10-Year Plan for the NHS expected to set out new priorities in the spring. We’ve seen no shortage of initiatives, roadmaps and plans for tech and innovation in recent years – yet delivery has often lagged behind. Today, acute pressures on health and care services, demographic headwinds and trends in disease burden mean there’s an imperative to deliver at pace. Much recent attention has focused on AI and its revolutionary potential, but leveraging this depends on a range of other digital capabilities that not all NHS trusts and services have.  So, where is the NHS on its journey to digitisation? And, given all of this, what will it take for the NHS to become a truly digital health system?    To discuss, our Chief Executive Jennifer Dixon is joined by: Holly Krelle, Assistant Director at the Center for Healthcare Innovation & Delivery Science at New York University's Langone Medical Center. Erik Mayer, Consultant Surgeon at Imperial College Healthcare and the Royal Marsden NHS trusts, and Director of Imperial's clinical analytics unit.  Show notes Darzi et al (2024). Independent investigation of the NHS in England.   The Health Foundation (2025). Briefing on digital maturity in the NHS [forthcoming].   The Health Foundation (2023). What do technology and AI mean for the future of work in health care? Horwitz & Krelle (2023). Using rapid randomised trials to improve health care systems. Annual Review of Public Health.  Honeyford et al (2022). Challenges and recommendations for high quality research using EHRs. Frontiers in Digital Health. NHS Confederation (2024). Frontline digitisation: creating the conditions for a digital NHS.  Dearing & Cox (2018). Diffusion of innovations theory, principles and practice. Health Affairs.