“There is now a thought that we’re not going to tell patients what we think is best anymore, but rather say ‘Here are the options, here are the pros and cons, and it’s for you to decide.” - Dr Annabel Bentley, Chief Medical Officer, AXA Health
The challenge of an ageing population will see the NHS continue to ration treatment – and it may even have to withdraw parts of what it offers.
Over the next ten years, the population will continue to age – and so will the workforce. This will increase the strain on the National Health Service.
The demands on the NHS will always exceed the ability of the Government to pay. While no Government will pull the plug on the service – not if it wants to stay in power – no Government is likely to have the funds to keep supporting the service as it stands either.
The result is likely to be a further rationing of treatment.
“By 2032, the number of people aged over 65 is expected to grow by more than a third and the number of people aged over 85 is expected to double.” - Office for National Statistics
What this could look like
Rationing might involve taking parts of the service away. For example, it’s already hard to get varicose veins treated on the NHS. A year ago, the General Medical Council (GMC) published a list of sixteen treatments that the NHS should no longer provide.
But we believe it’s more likely to involve making services harder to access, through lengthening waiting times, or raising the bar for qualification.
Less likely, but still possible, is a more profound change in who can access the service. The Government might insist that better-off people need to insure themselves, and that they would no longer get elective procedures on the NHS. This would drive greater demand for private healthcare. If this income threshold remains into retirement, meaning that better-off elderly people also need to fund their own care. It could even cause some people to work longer rather than lose corporate benefits – a parallel problem to the one created by inadequate pension provision.
“By 2030, the Government will have to be taxing more or spending less. The gap between taxes raised and expected spending by 2050 is estimated to be £340 billion.” - Institute of Public Policy Research
How could the private sector respond?
One potential future could see the development of a middle ground between public provision and full private medical insurance – so, the equivalent to the Health Maintenance Organisations (HMOs) that exist in the United States, scaled-back offerings where procedures are closely monitored and pathways are mandated.
Our view is that curated pathways are a better option. In this future, we collect data on outcomes, benefits, costs and risks and share them freely with individuals, before leaving the choice to them.
We also see a role for the private sector in supporting employees with elderly relatives. We don’t believe the private sector will step in to provide social care, but it could signpost people to sources of more support, or provide technology that allows them to keep eyes and ears on elderly relatives.
“We need to start thinking as a society about how we deal with care of our own parents.” - David Mowat, Care Minister, January 2017
How can business prepare?
Whilst it’s impossible to plan accurately for any future events and impacts on your business you can take steps to ensure that your organisation has policies and services in place to support both the organisation and its employees along the way. You’re probably doing many of them now. Five simple steps to take are:
- Get to know your employee population, their needs and monitor how these change over time
- Monitor absenteeism – reasons and underlying factors
- Review health and wellbeing service provision on a regular basis
- Review and revise policies to adapt to changes in employee needs and organisational requirements. For example, flexible working which could include time to organise care, reduced / condensed hours and provision of support services providing support and guidance to care services catering for the needs of a loved one.
- Review, review, review – it’s essential that you keep up to date with what’s going on inside your organisation as well as in healthcare provision. This is possible working with a healthcare provider to help fill the gaps in knowledge and provide solutions that grow and adapt to the needs of your business.