What on earth does this mean?
Transformation: EHFF was launched in 2013 because a number of us believed that the current model of healthcare (or sickness care, strictly speaking) was not sustainable. Recent events tend to confirm that it’s not resilient to stress (such as the pandemic) and that there are major unresolved threats to its integrity (such as the continuing and increasing shortfall of professional staff across Europe and the increasing level of health inequality).
We argue that rather than continuing to try and improve a model that isn’t fit for purpose its necessary to construct and deliver an entirely new model, keeping the parts that work well but investing heavily in re-profiling the parts that don’t, something likely to deliver adequate return on that investment, as better health means both better lives and less expenditure on sickness care.
Essential aspects of this transformation:
- a) what kind of re-building? Our view, shared by a number in the policy field, is that the structure of the healthcare and wellness systems needs to be inverted. Currently the institutionalised, high profile, highly technical hospital facilities take pride of place in the politicians’ and the publics’ eye. A more sustainable system puts community health and social care, wellness (disease prevention) and management of long-term conditions as the priority, with the devolution of specialist services and centralised governance, to becoming more local.
- b) why an ecosystem? Health in society has complex interactions with other aspects of societal activity including the environment, the financial system, education and social justice. Trying to change the health system without acknowledging the significant impact of and interaction with these other systems is unrealistic. The implication of this is that, for effective change, there have to be relevant changes in society itself.
- c) why now? Our view is that despite a degree of denial in some quarters, the situation can be described as a burning platform. The analogy stems from the dilemma of men on an oil rig that has caught fire: either they stay and burn to death, or they risk jumping into the sea, where there is burning oil but some chance of survival. In other words, the situation is critical, and in such circumstances, accepting a degree of risk in the alternative to the status quo is preferable to a certain disaster.
What can be done?
- a) We need gradual steps, but firmly in the direction of building a more ideal system, rather than sustaining the status quo. The concept of a transformational catalyst is that, with appropriate vision and specific strategies, even a small organisation can have a significant facilitating impact on the change necessary.
- b) a vital lever for change will be considerable progress in collaboration between like-minded organisations. For observable change to occur there will need to be alliances between different stakeholders to support the emergence of innovative developments. This is something we feel that needs urgently to be explored and piloted.
- c) finally, it is imperative that a compelling and accessible vision of the shape of a future health ecosystem is created, that will engage a wide range of stakeholders and contribute to the change in public mind-set necessary to support transformational change of the kind envisaged.