The Health Foundation podcast

In another year shaped by the COVID-19 pandemic, we explore some key health policy developments and look ahead to what 2022 might have in store.  With Omicron dominating the headlines and a public inquiry into the handling of COVID-19 on the horizon, has government learned – and acted on – the lessons from the start of the pandemic?   As the NHS faces the huge task of COVID-19 recovery, how will the debate about NHS performance and funding play out? Will the Health and Care Bill going through parliament be ready to come into effect next April, and what might it mean for the health system?  And do the social care cap and recently published white paper move us any closer to the ‘fix’ that is so desperately needed for social care? Our Chief Executive Dr Jennifer Dixon is joined by: Lord Victor Adebowale, Chair of the NHS Confederation. Victor was awarded a CBE for services to the unemployed and homeless people and became a crossbench peer in 2001. Hugh Alderwick, Head of Policy at the Health Foundation. Hugh leads our policy team’s work to understand and inform national policies on health and social care in England. Useful links Read about the Health Foundation's COVID-19 Impact Inquiry, including the final report. Explore the Health Foundation's ongoing work on the Health and Care Bill. Lady Hallett was announced as chair of the COVID Inquiry following our recording. Read more. Taxes and health care funding: how does the UK compare? (The Health Foundation, 2021) Adult social care and COVID-19 after the first wave: assessing the policy response in England (The Health Foundation, 2021) New vision for social care will feel like hollow words without the money to deliver it (The Health Foundation, 2021)

For years public satisfaction with the NHS has been highest for general practice.  But even before the pandemic, rising workloads and workforce shortages had left many GPs dissatisfied and stressed. Then add a pandemic into the mix, with GPs instructed to move rapidly from face-to-face consultations to telephone or digital advice as a first step. As the pandemic eases, signs of public frustration are now spilling over to the tabloids, MPs’ in-trays and adding to demand to hospital A&E departments.  Is this a sign of general practice crumbling or are we seeing its rebirth as the old model of care enters the digital age? Do we need a fuller vision for the future of primary care? And what are the government and the NHS doing to manage the fallout from growing frustration among the public and GPs? Our Chief Executive Dr Jennifer Dixon discusses with three expert guests:  Professor Katherine Checkland is Professor of Health Policy and Primary Care at the University of Manchester and until recently was a practising GP in rural Derbyshire.  Shaun Lintern is Health Correspondent at The Independent.  Dr Rebecca Fisher is Senior Policy Fellow at the Health Foundation, leading policy work on primary care, and is a practising doctor, working two days a week as a GP in an area of high urban deprivation. Useful links Rebecca Fisher (2021) 'Levelling up' general practice in England  Rebecca Fisher, Ruth Thorlby and Hugh Alderwick (2019) Understanding primary care networks Martin Roland, HEE Primary Care Workforce Commission (2015) The future of primary care NHS England (2014) Five Year Forward View

Climate change is a global health emergency. What can we learn from how ‘green’ has gone up the agenda? And how might we apply useful lessons to getting further improvements in another complex and difficult challenge – improving the health of the UK population and reducing inequalities?    The increasing frequency and intensity of heatwaves, floods, droughts and storms is already devastating lives and livelihoods around the world. While other countries are far more vulnerable to the health risks of climate change, the UK is not immune.    The UK government and the health and social care system must actively contribute to climate change solutions as part of our global responsibility. In the weeks ahead the UK (along with Italy as a partner) will host COP26, and countries will be showing what action they are taking towards the Paris Agreement goal to limit global warming. Making progress on climate change will be very challenging. Like improving health, it is a complex problem needing long-term policy commitment and action. What can we learn from efforts and progress so far? And can going greener actually improve the health of people in the UK? In the latest episode of our podcast, our Chief Executive Dr Jennifer Dixon discusses these issues with two expert guests: Dr Fiona Godlee is Editor in Chief of the British Medical Journal, a post she’s held since 2005. Fiona is on the board and executive committee of the Climate and Health Council and the UK Health Alliance on Climate Change.  Professor Andy Haines is Professor of Environmental Change and Public Health at the London School of Hygiene and Tropical Medicine. Andy is a member of several major international and national committees, including the UN Intergovernmental Panel on Climate Change. Useful links: The Health Foundation (2021) What do the public think about the NHS and climate change? UN Environment Programme (2021) The production gap 2021 Academy of Medical Sciences and the Royal Society (2021) Climate change and health HM Government (2021) Net Zero Strategy: Build Back Greener  HM Government (2020) The Ten Point Plan for a Green Industrial Revolution Council for Science and Technology (2020): Achieving net zero carbon emissions through a whole systems approach

Being chief executive of the NHS is one of the most challenging jobs in the country.    Since the role started in 1985 there have been nine postholders, with Amanda Pritchard taking over from Sir Simon Stevens this year. Like her predecessors she faces formidable challenges ahead: managing the pandemic’s impact, tackling waiting lists, boosting technology, managing a growing population of older people with multiple conditions and dealing with workforce shortages to name a few.   The role means being a leader and a national figure, working with the NHS itself as well as with government, the media and the wider health sector. The bandwidth needed to do the job is huge. How is it doable? Our Chief Executive Dr Jennifer Dixon discusses with Sir Alan Langlands, NHS chief executive number four, from 1994–2000. After leaving the NHS, Alan went onto a number of roles including Principal and Vice Chancellor of the University of Dundee, chief executive of the Higher Education Funding Council, Vice Chancellor of the University of Leeds and chair of the Health Foundation (2009–2017).   Related content Listen to our podcast episode on the Wanless Review and read the related publication, The most expensive breakfast in history Listen to our podcast episode with Rt Hon Jeremy Hunt MP Read more about the role of health secretary in Glaziers and window breakers Explore NHS policy developments in the Thatcher years, Major years and Blair years in our Policy Navigator Read more about 'targets and terror' Read more about the NHS internal market (see 'the context' by Jennifer Dixon)

Food is crucial to our health, but it is also a driver of ill health, health inequalities, and damage to the environment.  The second part of the National Food Strategy, led by Henry Dimbleby, was published in July 2021. It is the most comprehensive review of the entire food and drink system in the UK for many years. It recognises the upsides of the food system in providing affordable, convenient food for a growing population. But it is strong on the downsides – the current system is unsustainable and the food produced and consumed is injuring health and the environment. The strategy made 14 radical recommendations for England’s food system – many requiring legislation. The government is currently reviewing the report and is due to produce a White Paper in early 2022.  In this podcast, we discuss two areas covered by the review – reducing the amount of junk food, and diet-related inequality – as well as viewing this alongside the government’s 2020 obesity strategy. What should the government do next to make a difference to these large and complex challenges? Our Chief Executive Dr Jennifer Dixon discusses this with two expert guests: Anna Taylor is Executive Director of the Food Foundation, where she’d been since 2015, and is a national and international expert in nutrition. She’s advised the Mayor of London and the GLA, on the food matters that affect Londoners, and also served as Chief Independent Adviser to Henry Dimbleby for the development of the National Food Strategy. Sarah Hickey has been leading the childhood obesity programme at Guys and St Thomas’s Foundation as Programme Director since 2016. This programme aims to close the inequality gap in childhood obesity in Lambeth and Southwark working with communities, schools business and others on the ground. She previously worked as a Senior Policy Advisor in the Cabinet Office. Related content Find out more about the National Food Strategy Find out more about the government's obesity strategy Listen to our podcast episode on the government's approach to tackling obesity Find out more about our podcast

If you think of health in the UK as a fabric, it is the most threadbare in Glasgow. Here, life expectancy is lowest, and one in four men will die before their sixty-fifth birthday. But even after adjusting for poverty and deprivation, next to comparable deindustrialised cities such as Liverpool and Manchester, Glaswegians have a 30% risk of dying prematurely. That’s from cancer heart disease stroke as well as deaths of despair: suicide, drugs alcohol. It isn’t getting any better, and that’s not even taking into account the pandemic. In this episode, we explore: What is fraying health to this degree in Glasgow? What is being done to help? And what can we all learn from Glasgow’s longstanding efforts to try to mend the health fabric, as we all attempt to build back better after the pandemic? Our Chief Executive Dr Jennifer Dixon discusses this with two expert guests who have for many years been central to this story: Dr David Walsh is Honorary Senior Lecturer at the University of Glasgow, and a senior academic at the Glasgow Centre for Population Health. Over the years David has carried out a large body of work aimed at understanding Scotland’s (and Glasgow’s) high levels of ‘excess’ mortality, deindustrialisation and health across European regions, and the impact of government ‘austerity’ measures on mortality.  Sir Harry Burns is the Professor of Global Public Health, University of Strathclyde. Harry was the Chief Medical Officer for Scotland for almost ten years from September 2005 to April 2014, and is well known for his tireless work on health inequalities. He is a member of the Council of Economic Advisers in Scotland. Recommended reading: Walsh D, Bendel N, Jones R, Hanlon P. Investigating a 'Glasgow effect'. Glasgow Centre for Population Health; 2016. Walsh D, McCartney G, Collins C, Taulbut M, Batty GD. History, politics and vulnerability: explaining excess mortality in Scotland and Glasgow. Glasgow Centre for Population Health; 2016. Walsh D, Lowther M, McCartney G, Reid K. Policy recommendations for population health: progress and challenges. Glasgow Centre for Population Health; 2016. Dixon J, Everest G. The government’s levelling up agenda: An opportunity to improve health in England. The Health Foundation; 2021. Suleman M, Sonthalia S, Webb C, Tinson A, Kane M, Bunbury S, Finch D, Bibby J. Unequal pandemic, fairer recovery: The COVID-19 impact inquiry report. The Health Foundation; 2021. Useful links: Wising up to levelling up - with Professor Diane Coyle and Sir Howard Bernstein [Episode 7] 'Deaths of despair': A tale of two countries - with Professor Sir Angus Deaton and Sarah O'Connor [Episode 4] Find out more about the Health Foundation podcast

It’s easy to forget the state the NHS was in 20 years ago – long waiting lists, heartrending delays in care, winter crises – and heated debate on whether the NHS model was obsolete.   But the Wanless Review set the NHS on course to receive record catch up funding. So in this episode, we ask, given the pandemic and the mounting challenges facing the NHS to deal with a huge backlog of care, is it time for another Wanless? Our Chief Executive Dr Jennifer Dixon discusses this with two expert guests and former Treasury officials, who were very close to the original Wanless Review: Anita Charlesworth, Director of the Health Foundation’s REAL Centre and our Director of Research. Anita led the secretariat for the original Wanless Review within the Treasury, where she was Director of Public Spending from 1998 to 2007. Nick Macpherson, Permanent Secretary to the Treasury from 2005 to 2016. Nick was Permanent Secretary to three chancellors, and managed the department through the financial and wider economic crisis which began in 2007. Nick joined the House of Lords in 2016 as Baron of Earls Court. Useful links: The most expensive breakfast in history. The Health Foundation, 2021. Find out more about the REAL Centre Find out more about our podcast A note on audio quality in this episode Unfortunately, we were unable to record this episode using our normal recording platform, so the audio quality is lower than we would like. We'll be back recording the podcast in our normal way next episode.

The pandemic has created profound challenges for young people over the past year – with education, work, relationships and social time all affected. We also know about the wider economic trends which pile pressure on teens to make it to college to have a better job in the future, and the social trends which might undermine their security as they transition from child to adult. Combined with big changes in how young people are living their lives – such as a huge increase in the use of social media – it’s perhaps unsurprising that we’ve seen trends of increasing levels of depression, self harm, anxiety, eating disorders and other mental health issues in teens. In the latest episode of our podcast, our Chief Executive Dr Jennifer Dixon discusses these issues with two expert guests: Jean Twenge is a professor of psychology at San Diego State University, who has focused much of her research on generational differences, including work values, life goals, and speed of development. She is also known for her books including iGen and Generation me. Yvonne Kelly is Professor of Lifecourse Epidemiology, Department of Epidemiology and Public Health at University College London. She is Director of International Centre for Lifecourse Studies and leads work on health and development during childhood and adolescence, on which she has written extensively.  Reading materials referenced in this episode: iGen. Twenge J. Atria Books, 2017. Generation me. Twenge J. The Free Press. 2006, updated 2014. Children of Katrina. Fothergill A, Peek L. University of Texas Press, 2015. A healthy foundation for the future. The Health Foundation, 2019. Useful links: Find out more about our COVID-19 impact inquiry Watch our Surviving COVID film about the impact of the pandemic on young people Find out more about the Health Foundation podcast

‘Levelling up’ has become an earworm. It featured highly in the Conservative manifesto in 2019, which was referring to improving infrastructure, skills, productivity and economic growth across the country. The idea is to make the UK economy less lop-sided, and less focused on London and the South East.  The aim of ‘levelling up’ has gained even more potency because of the pandemic. For those working in health, policies to level up might also help tackle avoidable inequalities set out by Marmot and others, caused by factors injuring health like poor housing, low quality work, and low skills. In short, poverty and deprivation. But the government’s levelling up strategy is still under construction. The recently announced Levelling Up Fund is mainly focused on basic infrastructure like transport, not health. So is levelling up a real and serious aspiration? What would a strategy look like that might also help reduce health inequalities? In the latest episode of our podcast, our Chief Executive Dr Jennifer Dixon discusses these issues with two expert guests: Professor Diane Coyle is an economist and the Bennett Professor of Public Policy at the University of Cambridge. Diane has many other distinguished roles, including advising the government on economic policy during the pandemic, and leading an independent review for Greater Manchester, which shaped its industrial strategy Sir Howard Bernstein was the Chief Executive of Manchester City Council from 1998 to 2017 and is honorary chair in politics at University of Manchester. He led the devolution of power and budgets to Greater Manchester – the ‘DevoManc’ deal signed between the Government and Greater Manchester Combined Authority in November 2014. He is also a member of a new taskforce set up by the government to advise on the regeneration and development of town and city centres in the wake of COVID-19. 

The new Biden administration has a lot to deal with in the next four years: the US economy, the environment, public services and infrastructure, and healing America’s cultural and political divisions. Then there's health, inequalities and ensuring the US’s recovery from the pandemic. On health and care alone there’s a long list of wrongs to right, and progress to make. The recent Lancet Commission report Public policy in the Trump era was searingly critical on President Trump’s legacy – not just in managing the pandemic, but in reversing progress on covering uninsured Americans, and much more. But what can the Biden administration really do on health and health care? What will be its priorities? And what lessons might there be for us in the UK, as ideas so often seed from across the Atlantic? In the latest episode of our podcast, Health Foundation Chief Executive Dr Jennifer Dixon discusses these issues with two US health policy experts: Dr David Blumenthal is President of the Commonwealth Fund, a Foundation based in New York that carries out independent research on health and social policy issues. He is a distinguished physician and academic, and amongst many other things has recently published the book Heart of power: Health and politics in the Oval Office. Professor Ashish Jha is currently Dean of the School of Public Health, and Professor of Health Services Policy and Practice, at Brown University in Providence, Rhode Island. Ashish is on the frontline of the COVID-19 response, leading national and international analysis of key issues and advising state and federal policymakers. Useful links: Listen to our interview with Sir Angus Deaton on why life expectancy stalling more in the US and UK compared to other OECD countries Listen to Jeremy Hunt's interview about the role of the health secretary in the UK in our first podcast episode Find out more about the Health Foundation podcast