Afleveringen

  • We're all familiar with some of the challenges ahead in the UK: a fiscal squeeze, limp productivity, a labour shortage and an ageing population with increasing needs.

    As Andy Haldane put it in our recent REAL Challenge lecture, two routes to prosperity for the UK include increasing the number of workers and their productivity. But both of these routes now appear to be hampered by increasing ill health.
    Since the pandemic, 600,000 working people have become economically inactive – that’s the size of the city of Manchester taken out of the economy. Two-thirds are the over 50s who've left and aren't looking for work. And at the other end of life, younger people entering work are reporting markedly more ill health due to depression and anxiety, and more young men in particular are economically inactive.

    Can we carry on like this if our economy is to recover? Or is it now time for us to get serious about these trends, and how?

    To discuss, our chief executive Dr Jennifer Dixon is joined by: Sarah O’Connor, employment columnist at the Financial Times. James Banks, Professor of Economics at the University of Manchester and Senior Research Fellow at the Institute for Fiscal Studies.Show notesHealth is wealth? REAL Challenge annual lecture (2022) The Health Foundation Is poor health driving a rise in economic inactivity? (2022) The Health Foundation Proportion of UK workers on low pay at lowest level since 1997 (2022) Financial Times There is a deepening mental health recession (2022) Financial Times Is worsening health leading to more older workers quitting work, driving up rates of economic inactivity? (2022) IFS The rise in economic inactivity among people in their 50s and 60s (2022) IFS Half a million more people are out of the labour force because of long-term sickness (2022) ONS Reasons for workers aged over 50 years leaving employment since the start of the coronavirus pandemic: wave 2 New Polling for Phoenix Insights (2022) Public First Mental health conditions, work and the workplace (2022) Health and Safety Executive Labour Market Statistics, October 2022 (2022) Institute for employment studies Economic inactivity and the labour market experience of the long-term sick (2022) Jonathan Haskel and Josh Martin (this piece is currently a work in progress and a preliminary download has been made available by the authors)

  • We don’t like to think about death. To many, death and dying have no value and are relegated to the margins of our lives.

    But about half a million of us in Britain die each year, mostly in our 80s, with half of us dying in our usual place of residence – in our own bed.

    With palliative care stretched and family and friends often left unsupported, what could be an enriching and meaningful phase of life can become over-medicalised, transactional and feared.

    There have been many attempts over recent years to normalise conversations on death, and in January this year The Lancet published its commission on the value of death following a five-year inquiry.

    So how could we die better in the UK? Or as The Lancet commission puts it, how do we bring death back into life?

    To discuss, our chief executive Dr Jennifer Dixon is joined by the two lead authors of the commission:
    Richard Smith, currently Chair of the UK Health Alliance on Climate Change. Richard’s former roles include editor of the BMJ, chair of the board of trustees of the International Centre for Diarrhoeal Disease Research, Bangladesh and director of the UnitedHealth Chronic Disease Initiative. Libby Sallnow, Palliative medicine consultant at CNWL & UCLH and honorary senior clinical lecturer in new public health approaches at St Christopher's & UCL.Show notesThe Lancet Commission on the Value of Death (2022) The LancetOverdiagnosis and overtreatment during the covid-19 pandemic (2021) BMJNeighborhood Network in Palliative Care (2022) Centre for Health Market InnovationsWhat is an End of Life Doula? (2022) End of Life Doula UKThe Lancet Commission on Palliative Care and Pain Relief (2018) The Lancet

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  • A new Prime Minister, government and health secretary, all facing a formidable array of challenges.

    Prime Minister Liz Truss has said that putting the NHS ‘on a firm footing’ is one of her top three priorities (alongside the economy and energy). Meanwhile, Health Secretary Thérèse Coffey has said her priorities are ABCD (ambulances, backlog, care and doctors and dentists), and since the podcast recording she has set out the government's plans.

    So how will this translate to the NHS, social care and improving the UK’s health? Will government have the bandwidth before an election to address more than the day-to-day pressures? And if a Truss government won a general election with a mandate to do more, what form would it take?

    To discuss, our chief executive Dr Jennifer Dixon is joined by:Rachel Wolf, Founding Partner at Public First. Rachel is also on the Board of the Centre for Policy Studies, co-authored the Conservative Party’s Election Manifesto in 2019 and was previously education and innovation adviser to the Prime Minister at 10 Downing Street. Isabel Hardman, Assistant Editor at The Spectator. Isabel has authored two books – Why We Get the Wrong Politicians and The Natural Health Service – and is currently finishing a third on the NHS.Show notesRachel Wolf, Public First, A few thoughts on the Downing Street policy unitRachel Wolf, Conservative Home, Truss’s in tray 3) Rachel Wolf: Levelling Up. There is no time for another new approach. The new Prime Minister must focus on deliveryIsabel Hardman, The Spectator, Is Coffey good for health? Thérèse Coffey is expected to become Deputy Prime Minister and Health Secretary. What's the significance?Isabel Hardman, The Spectator, Can Liz Truss deliver, deliver, deliver?Hugh Alderwick, Health policy priorities for the next prime minister: Avoid zombie policies and invest in growing the workforce and reducing inequalities. BMJ MJ 2022;378:o1726The Health Foundation, Public perceptions of health and social care: what the new government should knowThe Health Foundation, Waiting for NHS hospital care: the role of the independent sector

  • In meeting the huge challenges facing the NHS, technology is often looked to as the great hope. Yet studies suggest good management is a more active ingredient for success.

    Over the years numerous reports have called for more clinicians to manage the NHS, highlighting their deep knowledge of clinical care, and insight and credibility to make effective change.

    Now, over a third of all NHS chief executives hold a clinical qualification and about a third of jobbing clinicians have part-time management roles too. But that’s still only a third, and getting trained in management is patchy and haphazard – a finding echoed in the recent Messenger Review of health and social care leadership.

    How can we support more clinicians to manage the NHS, and learn from those who already do it well?

    To discuss, our chief executive Dr Jennifer Dixon is joined by:

    Dr Stephen Swensen, Senior Fellow at the Institute for Healthcare Improvement. Stephen worked at the world-leading Mayo Clinic in Minnesota for three decades, overseeing the development of over 4,000 physicians and 200 leaders. Dr Dominique Allwood, Chief Medical Officer and Academic Health Science Network Deputy at UCLPartners, where her focus is on clinical engagement and management. Dominique is an experienced medical leader and an expert in quality improvement.Show notesManagement Lessons from Mayo Clinic Inside One of the World's Most Admired Service Organizations (2017) Leonard L. Berry, Kent D. SeltmanMayo Clinic Strategies To Reduce Burnout: 12 Actions to Create the Ideal Workplace (2020) Stephen Swenson, Tait ShanafeltStrengthening NHS management and leadership: Priorities for reform (2022) The Health FoundationLeadership for a collaborative and inclusive future (2022) Sir Gordon MessengerFive recommendations for strengthening NHS management and leadership (2022) The Health Foundation

  • The pandemic challenged every health care system in the world. But what can we learn from one another aboutin the way we responded, and how we might improve for future threats?
    In this episode we look up close at the experience of two large academic teaching hospitals embedded in two different health care systems – the Charité in Berlin, Germany’s largest teaching hospital, and Imperial College Healthcare NHS Trust in London, one of the UK’s largest.

    How do these two health care systems compare when dealing with the pandemic and its aftermath? And what can we learn?

    Our Chief Executive Dr Jennifer Dixon is joined by:

    Professor Heyo Kroemer, chief executive of Charité – Universitätsmedizin Berlin, one of the largest hospitals in Europe. A pharmacologist by trade, Heyo joined Charité in 2019 from the University of Göttingen’s Medical Center, where he held the positions of Dean and Chairman of the Managing Board.

    Professor Tim Orchard, chief executive of Imperial College Healthcare. NHS Trust. A consultant physician and gastroenterologist, Tim was appointed chief executive in June 2018 after having been the director of clinical studies at St Mary’s Hospital. Show notesHow does the NHS compare internationally? big election questions (2017) The King’s Fund NHS hospital beds data analysis (2022) BMA How does the UK compare internationally for health funding, staffing and hospital beds? (2017) The Health Foundation Performance of UK National Health Service compared with other high income countries: observational study (2019) BMJ What can England learn from the long-term care system in Germany? (2019) Nuffield Trust Taxes and health care funding: how does the UK compare? (2021) The Health Foundation

  • Ask the public about health, and they often put the responsibility on the individual and the NHS.

    And yet we know the context in which we live and make choices really matters. The context that governments, businesses, employers and investors have a big hand in shaping.

    Polling shows the public is increasingly seeing the government as having an important role to play in improving people's health, and there's public appetite to reduce the health inequalities highlighted by the pandemic.

    So how does the public think about health? And what can be done to engage local communities in improving health?

    Our Chief Executive Dr Jennifer Dixon is joined by:

    Dr Jacqui Dyer MBE, co-founder and CEO of Black Thrive Global, a community interest company established in 2016 to address the inequalities affecting the mental health and wellbeing of black people in Lambeth. Jacqui is also a local councillor. John Hume, Chief Executive of the People's Health Trust, a charity focused on reducing health inequalities through community development. Show notesA matter of life and death: explaining the wider determinants of health in the UK (2022) FrameWorks InstituteAddressing the leading risk factors for ill health (2022) The Health FoundationWhat Works Centre for WellbeingThe NHS as an anchor institution (2020) The Health Foundation

  • The NHS is experiencing an unusual set of pressures at the moment, with waiting lists of 6.5 million, staff shortages, ambulance delays, long waits and much more.

    Meanwhile, public satisfaction with the NHS has nosedived, according to the recent British Social Attitudes survey. While politicians acknowledge the challenges and repeat their support for the NHS, outriders on the political right are flexing muscles and calling for more fundamental reform – despite the ink only just drying on the last set of NHS reforms with the Health and Care Bill receiving royal assent.

    Lord Norman Warner has been top civil servant, health minister from 2003 to 2007 and in the House of Lords for over 20 years, and has written about it all in his new book In Pursuit of Competence. He joins our Chief Executive Dr Jennifer Dixon to share his insights and reflect on what might be ahead.

    Show notesNorman Warner (2022) In Pursuit of Competence: A Life as a Westminster Nomad
    NHS (2019) The NHS Long Term Plan
    NatCen Social Research (2021) British Social Attitudes Survey 38
    The Health Foundation (2021) Health and social care funding projections 2021
    Department of Health and Social Care (2006) Our health, our care, our say: a new direction for community services
    Duncan Campbell-Smith (2009) Follow the money: the Audit Commission, Public Money and the Management of Public Services, 1983-2008

  • This year households across the UK are facing the biggest squeeze in living standards since the 1950s. Most of us will feel the impact, but poor households are being hit the hardest. We know that poverty and the stress of debt harms our health in the short and long term.

    One role of the state is to provide a welfare safety net. After last month's Spring Statement, what should the government do now to support those experiencing the worst effects of rising costs? What impact on households and health are we already seeing? And what more can be done to help?

    Our Chief Executive Dr Jennifer Dixon discusses this with expert guests:

    Dame Clare Moriarty is chief executive of Citizen’s Advice. She’s a former senior civil servant and served as permanent secretary at the Department for Environment, Food and Rural Affairs and the Department for Exiting the European Union. She was also chair of our COVID-19 Impact Inquiry. Bim Afolami MP has been the Conservative MP for Hitchin and Harpenden since 2017. He's on the advisory board of the Money and Mental Health Policy Institute and is chair of the All-Party Parliamentary Group for Financial Markets and Service. He's also patron of two mental health charities in his constituency.Show notesThe Health Foundation (2022) Response to the Spring StatementResolution Foundation (2022) Inflation Nation: Putting Spring Statement 2022 in contextInstitute for Fiscal Studies (2022) Analysis of the Spring StatementThe Health Foundation (2022) DebtThe Health Foundation (2022) Debt and healthThe Health Foundation (2020) Living in poverty was bad for your health long before COVID-19Financial Times (2022) Chancellor provides minimal help to households on cost of living crisisThe Trussell Trust (2022) Debt to government, deductions and destitution

  • For the last decade, gains in life expectancy have been stalling. We’re living more years in poor health too, with a 20 year gap in healthy life expectancy between women living in the richest and poorest areas.

    The biggest risk factors driving the UK‘s high burden of ill health are smoking, poor diet, physical inactivity and harmful alcohol use. All are socioeconomically patterned and contribute significantly to widening health inequalities.

    There have been many policies proposed to help over the years, and the government has already set a target to increase healthy life expectancy by five years by 2035 and reduce inequality. But at the current rate of progress this will take nearly 200 years, not 12, to reach.

    Is it time to get much tougher on the risk factors? And if so, how? A recent Health Foundation report showed that the government could do a lot more to be effective, but will politics allow national government to do what it takes?

    Our Chief Executive Dr Jennifer Dixon is joined by:

    Professor Kevin Fenton is regional director for London at the Office for Health Improvement and Disparities, having previously held the same position at Public Health England. He has also been elected to be the next President of the UK Faculty of Public Health and is due to take up the position in June 2022. Richard Sloggett is the founder and director of Future Health. Between 2018 and 2019 he was Special Advisor to the then Secretary of State for Health and Social Care, working on the prevention green paper. Show notesAnderson P, O'Donnell A, Kaner E, Llopis E, Manthey J, Rehm J. Impact of minimum unit pricing on alcohol purchases in Scotland and Wales: controlled interrupted time series analyses. Lancet, Volume 6, Issue 8, E557-E565; 2021Everest G, Marshall L, Fraser C, Briggs A. Addressing the leading risk factors for ill health: A review of government policies tackling smoking, poor diet, physical inactivity and harmful alcohol use in England. The Health Foundation; 2022Lewis T, Buck D, Wenzel L. Equity and endurance: how can we tackle health inequalities this time? The King’s Fund; 2022Theis, D R and White M. Is Obesity Policy in England Fit for Purpose? Analysis of Government Strategies and Policies,1992–2020. The Milbank Quarterly, 99: 126-170; 2021Javid S. Health and Social Care Secretary speech on Health Reform, 8 March 2022

  • Like many other countries, the UK has a growing drug problem.

    In England around 3 million people take drugs and drug deaths are the highest on record at nearly 3,000 a year. In the last decade, heroin-related deaths have more than doubled and cocaine-related deaths have grown fivefold. The situation in Scotland is even worse – now the drug death capital of Europe.

    The UK government tackles drugs as a criminal justice matter focused on punishment, rather than a public health matter focused on support. But many countries are taking a different approach, most famously Portugal which in 2000 decriminalised all drugs and concentrated instead on public health and harm reduction. The result? From one of the highest drug death rates in Europe to one of the lowest.
    How did they do it and what can we learn?

    Our Chief Executive Dr Jennifer Dixon is joined by:

    Dame Carol Black, who was commissioned by the Home Office and the Department of Health and Social Care to undertake a two part independent review of drugs, to inform the government’s thinking on what more can be done to tackle the harm that drugs cause.Dr João Castel-Branco Goulão, a Portuguese physician and the current national drug coordinator for Portugal. He is credited as being the main architect of Portugal’s drugs policy established in 2000 and since then has advised on drug policy for successive governments.Show notesIndependent review of drugs by Professor Dame Carol BlackFrom harm to hope: A 10-year drugs plan to cut crime and save lives (December 2021)Ferreira, S. Portugal’s radical drugs policy is working. Why hasn’t the world copied it? (December 2017)National Records of Scotland, Drug-related deaths in Scotland in 2020 (July 2021)Nutt, D. UK drugs strategy promises to be tough on criminals, but evidence shows this doesn't work. BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n3066 The House of Commons Scottish Affairs Committee report on Problem drug use in Scotland (October 2019) includes an outline of some international case studies.

  • Those of us working in health often focus on the government as the main agent to get things done, especially when it comes to public health. But think of all the others out there with power, particularly commercial and investment power.

    There are signs that businesses and institutional investors do seem to be getting more interested in health, with some businesses starting to consider their impact on health in their environmental, social and governance (ESG) reporting.

    Are we now at a turning point? Or is interest in health temporary? If businesses and investors really want to improve health, how do they best move forward? And can government do more to support them?

    Our Chief Executive Dr Jennifer Dixon discusses this with expert guests:

    Catherine Howarth joined ShareAction as Chief Executive in 2008. ShareAction coordinates civil society activism to promote responsible investment across Europe. Catherine also serves on HM Treasury's Asset Management Taskforce. John Godfrey joined Legal & General in 2006 and is now Director of Corporate Affairs. John has worked in the City of London for over 30 years and from 2016-17 worked at Number Ten Downing Street as Head of Policy for Prime Minister Theresa May. Show notesAPPG on Longevity, Levelling up health, (April 2021)British Academy: The Future of the Corporation programme and reports Policy & Practice for Purposeful Business (2021), Principles for Purposeful Business (2019) and Reforming business for the 21st century (2018)Business for Health, Business Framework for Health: Supporting businesses and employers in their role to enhance and level up the health of the nation (October 2021)Health Foundation, Using economic development to improve health and reduce health inequalities (2020)Institute of Health Equity, Health Equity in England: The Marmot Review 10 Years On (2020)ShareAction, Health: An Untapped Asset – How investors can strengthen returns by improving health outcomes (September 2021)

  • 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 linksRead 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 linksRebecca Fisher (2021) 'Levelling up' general practice in England Rebecca Fisher, Ruth Thorlby and Hugh Alderwick (2019) Understanding primary care networksMartin Roland, HEE Primary Care Workforce Commission (2015) The future of primary careNHS 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 2021Academy of Medical Sciences and the Royal Society (2021) Climate change and healthHM Government (2021) Net Zero Strategy: Build Back Greener HM Government (2020) The Ten Point Plan for a Green Industrial RevolutionCouncil 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 contentListen to our podcast episode on the Wanless Review and read the related publication, The most expensive breakfast in historyListen to our podcast episode with Rt Hon Jeremy Hunt MPRead more about the role of health secretary in Glaziers and window breakersExplore NHS policy developments in the Thatcher years, Major years and Blair years in our Policy NavigatorRead 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 contentFind out more about the National Food StrategyFind out more about the government's obesity strategyListen to our podcast episode on the government's approach to tackling obesityFind 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 CentreFind out more about our podcastA note on audio quality in this episodeUnfortunately, 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 inquiryWatch our Surviving COVID film about the impact of the pandemic on young peopleFind 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 strategySir 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.