+44 (0)20 7799 6677

Future of the NHS depends on greater personal responsibility

New Civitas publication includes contributors with a wide variety of political perspectives ranging from a former Health Secretary to leaders of professional organisations to a former Downing Street adviser to prominent academics and journalists.

Protecting free and equal access to healthcare for all is likely to require individuals to take greater responsibility for their own wellbeing and a more determined public policy focus on preventative medicine, a new Civitas book suggests.

The Health of the Nation: Averting the demise of universal healthcare, a collection of essays by leading health commentators, demonstrates there is a growing consensus about the need to look beyond clinical services for the answers to the difficulties facing the NHS.

This will need to involve initiatives to minimise ill health among the nation’s expanding, and ageing, population, including a much greater emphasis on public health and preventative medicine as well as a renewed drive for individual initiative and personal responsibility.

Health-enhancing objectives will need to be central to policy areas as diverse as urban planning, education and employment, for example, while there needs to be greater awareness of the extent to which some diseases are often the result of poor health choices.

But it will also require healthcare to become more individualised and more integrated into daily life, including widespread personal healthcare budgets.

There are also calls for charities and large patient organisations to play an enhanced role in helping to prevent and then combat diseases such as cancer and heart disease.

These concerns emerge from a diverse collection of essays by commentators from a wide range of healthcare backgrounds and political perspectives.

Edmund Stubbs, the book’s editor and Civitas healthcare researcher, writes: ‘From the collection of chapters in this publication it seems the issue for the 21st century will be not so much one of how the NHS should be redesigned, but one of what needs to be done at its fringes or even completely outside the organisation so that we might become less dependent upon it.

‘I hope our publication will bolster the case for increased investment in improving these pre-clinical determinants of the health of the nation.

‘If not, the NHS is likely to remain in crisis, faced with ever-increasing demand from a rapidly ageing population, often debilitated by extremely unhealthy lifestyles; a situation which threatens the service’s stability and perhaps even its survival.

‘We need to wean ourselves from a total reliance on the NHS and become more mature in accepting a measure of responsibility for our own health and wellbeing.’

The Health of the Nation features contributions from eleven authors from the across the political spectrum.

They include:

John Ashton (President of the Faculty of Public Health)

‘hospital care, has come to be seen as THE system with public health an increasingly marginalised and unvalued add on.’

Melanie Reid (writer and columnist at The Times)

‘People must be made aware of their responsibility to their own health. Educating them in diet and exercise should be hard-wired into all government policy.’

‘The healthier and more aware the base population is, the better it will cope in future.’

Mark Porter (leader of the British Medical Association) and Sally Al-Zaidy (Head of health policy at the BMA)

‘Our NHS for tomorrow would, fundamentally, be built around the needs of people. Treating them as patients where appropriate, but within an integrated system that recognises the central importance of care organised around people’s needs, in pursuit of the fullest definition of healthcare – a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’

Stephen Dorrell (Former Secretary of State for Health)

‘after over 70 years of rhetoric, it is high time that we shifted our priorities to focus less on rationing access to treatment and more on enabling citizens to lead healthy and enjoyable lives’

Steve Melton (Chief Executive of Circle Health)

‘the NHS risks being the classic sort of organisation that fails to champion change, even if it would benefit in the long-term – simply because it is so focused on what it does now’

Phil Hammond (NHS doctor and broadcaster)

‘Universal healthcare in a society that is poor at prevention and in denial about death is like attempting to rescue a never ending stream of people from a river of illness.’

Paul Corrigan (worked in the NHS and is now a management consultant and an executive coach)

‘For too long the Public Health service has been confused with the public’s health. Whilst the former is an important aspect of our services, it is the latter that really matters.


The Health of the Nation: Averting the demise of universal healthcare is published by Civitas on Tuesday April 12. A PDF of the text can be accessed below.

The full list of contributors: John Ashton (President of the Faculty of PublicHealth), Melanie Reid (writer and columnist at The Times), Mark Porter (leader of the British Medical Association), Sally Al-Zaidy (Head of health policy at the BMA), Steve Melton (Chief Executive of Circle Health), Phil Hammond (NHS doctor and broadcaster), Paul Corrigan (worked in the NHS and is now a management consultant and an executive coach), Stephen Dorrell (Former Secretary of State for Health), Richard Murray (Director of Policy), David J. Hunter (Professor of Health Policy and Management), Richard B. Saltman (Professor of Health Policy and Management at the Emory University School of Public Health), Marco Viceconti (Chair of Biomechanics at the Department of Mechanical Engineering and Professor Associate at the Department of Oncology and Metabolism at the University of Sheffield).

For further information contact:

Jack Mason, communications officer
T: 0207 799 6677


Edmund Stubbs, healthcare researcher
T: 0207 799 6677

The Health of the Nation: Averting the demise of universal healthcare

Download Associated PDF


Keep up-to-date with all of our latest publications

Sign Up Here