A Christian response to the government's ten-year NHS plan for England

The government have released their long-awaited Ten-Year Health Plan for England: fit for the future. Are these the planned changes that the country has been crying out for or have they bitten off more than they can chew?

Our report Thinking faithfully about politics was released in the lead up to the 2024 general election and reveals how evangelicals feel about different policy issues. Health was cited as the eighth most important issue facing the UK today. The desire for the ​‘reorganisation of the NHS’ was also a repeated theme in relation to outcomes that evangelical respondents wanted to see in the next parliamentary session. The healthcare system impacts us all, and many of us will have personal experiences of the ways it cares for people with respect and compassion. 

More than us caring about our own healthcare and health, this is something that matters to God. At its heart, the NHS is built upon treating people with care and healing sickness, often seeing people through their most difficult days. Jesus did this. He valued every individual who came to Him for help. We too should care about the ways our healthcare system is failing to meet the needs of the suffering. 

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However, we know that it is stretched and unable to serve the needs of all, which disproportionately affects the most vulnerable in our society. Currently, public satisfaction with the NHS is at its lowest ever level. The report acknowledges this. There is also a recognition of the way that certain groups of people have slipped through the cracks and received worse care. The plan mentions that Blackpool has the lowest healthy life expectancy in England (pay is 16% lower than the national average). In addition, it exposes the disparities between the treatment received by the working class, ethnic minorities, those in rural or coastal areas, victims of domestic abuse and the homeless. These realities urgently need addressing as people with specific medical needs are not receiving the best care. 

The plan is focused on three major changes that seek to transform the healthcare service and shift the burden from overstretched hospitals. They are: 

• From hospital to community 

• From analogue to digital 

• From sickness to prevention

In taking a more localised approach to care, the government is seeking to create a model where ​“care comes to you”, therefore improving patient access. The vision is to establish Neighbourhood Health Centres (NHC), complete with multi-disciplinary teams, within walking distance of patients’ homes. Provisional plans are for health centres to be open 12 hours a day, six days a week, and to be located within communities. By 2035, the aim is that most outpatient and non-emergency care will transfer to NHCs, prioritising areas where life expectancy is the lowest. As stated on page 61, their overall goal is to halve the gap in healthy life expectancy between the richest and poorest regions.

The thinking behind ​“from analogue to digital” is the prime minister’s commitment to digitalise public services to improve efficiency. This will involve developing the NHS app further so that it is the first port of call, and to incorporate AI tools more effectively for use in diagnostics and admin.

Finally, the third shift is to give patients ​“power to make the healthy choice”. Page 59 in the plan talks about tackling child obesity through advertising restrictions and improving school meals. It also mentions creating a smoke-free generation, a campaign to make the population more active, improving air quality and providing information on making healthier choices around alcohol consumption. 

Many of these plans are timely and necessary. There needs to be an overhaul to healthcare in each of the four nations and hopefully this plan for England will inspire devolved administrations to tackle health inequality and disparity. 

In some sections of the plan there is a lack of clarity about concrete milestones. The plan fails to include a year-by-year roadmap to ensure targets are delivered. 

Disappointingly, there is only one mention of palliative care (in 168 pages). This is both surprising and disappointing when parliamentarians have been debating the assisted suicide bill for the past eight months, which has exposed poor provision and under-investment in palliative care. Similarly, the strategy fails to incorporate clear ideas for social care reform, another area that is struggling to meet people’s needs. 

As Christians, we want to see these plans succeed, not because we put all our trust in the NHS as an institution but because at the heart of these conversations – long waiting lists, late diagnoses and disparities – are people. 

Local councils will be crucial in the rollout of these reforms, so I encourage you to share your views and experiences with them. There will be times of transition and teething problems, so do keep communicating what is working and what isn’t with your local representatives. 

More importantly, this is something we can be praying about. It is crucial the church continues to pray for the state of health and social care in this country, asking God to help those making decisions keep the most vulnerable at the centre of their strategic priorities; equipping Christian medical practitioners to be the hands and feet of Jesus on medical wards. If you work in health and social care, we encourage you to connect with member organisation Christan Medical Fellowship to access seminars and network with other Christians in the profession. 

It can be tempting to get distracted by statistics and pound signs. However, what we really need is for these changes to protect the needy. We can pray that this document will not be left as an overambitious ideal but will result in real, beneficial reform.