EIT economists set out a blueprint for a sustainable 21st century health system
A major new report from EIT’s Economics programme sets out how the UK can reverse the downward spiral linking poor health, slowing growth and stretched public finances.
The Ellison Institute of Technology (EIT) has today published A Sustainable Health System for the 21st Century, a landmark report from its Economics programme. Drawing on research within EIT, it sets out how the UK can build a health system in which good health outcomes support a strong economy, and a strong economy funds further investment in health. The focus is not on internal reforms within the health system but on alignment across UK policy. The report recommends a health system that targets good health outcomes rather than tackling disease and for the NHS and H.M.Treasury to take into account the future health and economic benefits when investing in health today.
The report is written by Dr Shaun Danielli, Dr Tiernan Evans, Dr Mike Keoghan and Professor Andrew J. Scott CBE, with contributions from a wider team of more than 20 researchers.
A health recession
The UK now spends more than 11 per cent of GDP on health, up from around 7 per cent at the turn of the century. Yet quality-adjusted life expectancy has been falling since 2014, and a record number of people have left the labour market because of ill health. The report argues that this health recession, slower economic growth and pressure on the public finances share a common cause: the rising prevalence of preventable, chronic conditions among working-age adults.
At the heart of the report is the argument that the UK treats health and the economy as separate. Overcoming that separation offers the prospect of a national double dividend: substantial improvements in the nation’s health and a significant boost to economic growth.
From treating disease to building health
The NHS has been remarkably successful at fighting disease. But health is more than the absence of disease; it is a state of capability, capacity and resilience. As chronic conditions become the main burden, people are living more years in poor health, and a system that responds only once disease appears cannot close that gap. Health is also dynamic: our health today shapes our health in the future, so investment now yields returns for years to come.
The report sets out three pillars for reform:
Measurement: The report proposes and shows how to construct a national measure of health based on people’s physical and cognitive functioning, which new technology now makes possible at low cost.
Targeting: directing resources towards better health outcomes, not simply the treatment of disease, and recognising the importance of health to GDP and the wider economy.
Alignment: a new Live Well Commission, reporting annually to Parliament against a clear, forward-looking health target, so that short-term decisions serve the nation’s long-term health rather than always allocating expenditure to deal with illness rather than create health.
The authors stress that these proposals complement existing plans for the NHS and do not question its importance or equal access at the point of use. They argue that the UK is in a uniquely strong position to benefit: as a single-payer system with rich health data, it already has many of the foundations that reform requires.
Why now: science is changing what is possible
The authors argue that advances in science and artificial intelligence make change both possible and urgent. Cheaper sensors and wearable devices can now measure what a person is able to do, not only what they have been diagnosed with. Together with rapid growth in health data and a deeper understanding of the biology of disease, AI offers the prospect of identifying risks early and intervening to keep people healthy before disease develops.
This work reflects EIT’s core mission: to reimagine how science and technology translate into end-to-end solutions for humanity’s most challenging problems. The report argues that scientific breakthroughs alone are not enough. Unless health systems recognise the economic returns to better health, they will struggle to finance new treatments and technologies. Without reform, those who can pay will benefit privately, while others will be dependent on a system that responds only once disease appears leading to widening health inequalities.
Linking health and the economy
The team has built a health-to-economy model that estimates how changes in health affect employment, earnings, inequality and the public finances. One application shows that the decline in mental health since 2009 has reduced labour force participation, increased long-term sickness and disability, raised benefit spending and reduced tax receipts substantially.
Professor Andrew J. Scott CBE, Principal Scientist (Economics) at EIT and Professor of Economics at the University of Oxford, said:
“Few things are as important to us, individually or as a nation, as our health. Few things match the potential impact on GDP that health improvements could bring about. However, our health system is not in good health, our economy is ailing, and health inequalities are endemic. The source of the disease burden has changed, and technology and treatments have evolved. Together, this means our health system must change. This report, and the research behind it, sets out how to make that change and build a sustainable health system for the 21st century.”
Access the short report here, or click here to read the full report.