About the Book
This book is for everyone who is concerned about the successful future of a very special institution – the National Health Service (NHS). It provides the reader with an overview of the complexity of healthcare delivery, and the crucial influence that fairness should have on healthcare planning. The National Health Service Act was approved by Clement Attlee’s Labour Government on 5 July 1948. It was created in a great post-war spirit of community with the aim of providing free care at the point of need for everyone, rich or poor. However, right from the start the NHS has faced issues in tackling the challenges that arise in trying to be fair, and of how greater equity in healthcare can be achieved.
The focus is on issues of fairness and equity in healthcare in the NHS, what fairness and equity mean both generally and in the organisational context. It begins with chapters on the inequalities that exist in UK healthcare delivery today. Then a series of chapters focuses on different elements of fairness in healthcare: governance, policy, and leadership; finance and financing; healthcare delivery; the key behaviours required of those working in the NHS and importantly, the patient perspectives.
The conclusions and recommendations will be of great interest to health and social care practice staff, health and social care managers and leaders, politicians and policy makers, health and social care specialists, operational managers within the system, NHS boards and healthcare governors, integrated care providers, primary, continuity and specialist providers, and charities in the healthcare sector. It will also be of interest to academics and others involved in training, research and development, students studying health, social care, and management and to the wider public: to everyone who is concerned about the successful future of a very special institution – the National Health Service.
Table of Contents:
Preface. The History of the NHS: A Chronology of UK Health, Social Care and Equity Policies, Statutory Legislation, and Regulatory Requirements – 1940–2024, PART ONE: Health Care for All? 1. Our Unequal Health, What Now, and Where Next? 2. Fairness in the NHS: Some Ethical Pointers, PART TWO: Governance and Leadership, 3. Fairness in Boards and Governance, 4. Fairness in Governance in the NHS, 5. Fairness and Finance in the NHS, 6. Fairness and Organisational Leadership in the NHS, PART THREE: Policy and Skills, 7. Questions of Fairness in Health and Social Care Policy Decisions – A Socratic Approach, 8. Faith, Spirituality, and the Concept of Fairness, PART FOUR: Access, Equity and Fairness of Delivery, 9. Contemporary Specialist Provision: Access, Equity, and Fairness of Delivery in the NHS, 10. Fairness in the NHS: Patient and Employee Perspectives: April 2023, PART FIVE: Conclusion, 11. Fairness in the NHS, Appendix A: Fairness in Health and Social Care Policy Decisions: Socratic Questions – Designed by Tony Culyer
About the Author :
Mike Thomas is Chair of University Hospitals of Morecambe Bay NHS Foundation Trust, Chair of the Lancashire and South Cumbria Provider Collaborative Board, and Chair of the mental health and learning disability charity, Making Space.
Gay Haskins is former Dean of Executive Education of London Business School and Saïd Business School, University of Oxford, and co-author, with Mike Thomas and Lalit Johri of Kindness in Leadership, Routledge, 2018.
Review :
"Fairness in the NHS should be at the top of the reading list of anyone interested in how we can transform the NHS to meet society's changing needs while still staying true to its founding principles. It makes the case that tackling inequalities makes sense...not only ethically, but practically and financially too. It reminds us that 'the values of fairness and kindness are the bedrock of caring.' If we want our communities to be good places to live, work and grow old in then we need an NHS that embodies these values. The contributors to Fairness in the NHS have provided a timely guide as to how we can make sure that's the case." David Fillingham CBE, Chair of the NHS National Improvement Board
“This book is an important and very timely, incisive review of the future direction of the NHS and discusses the critical debate around the current situation relating to health inequalities, conclusions, and future recommendations. The tone of this book is excellent as it cuts through the jargon and is uncomplicated. Indeed, one of the key areas debated is the thorny issue relating to the fairness of a tax-based NHS provision and the use of public taxation in the UK. It debates the consideration of sustainable approaches with the emphasis on the greatest societal good rather than political principles or personal wealth. Refreshingly, the final chapter offers concise conclusions and makes recommendations regarding the future of the NHS. This is essential reading for policymakers, health workers, and millions of individuals who rely on NHS for their care from our very precious NHS, which is our jewel of the British Institution.” Emeritus Professor Ruth Ashford, Co-founder and Director, Institute of Professional Development; Chief Examiner, Chartered Institute of Marketing; former Pro Vice Chancellor, Manchester Metropolitan University.
“This is a timely contribution to the increasing discourse on ‘fairness’ and ‘equity’ in the NHS and its future. A wide range of academic and clinical practitioner research outlines influences that fairness and equity do, and should, have planning and delivering healthcare and suggests how greater fairness and equity can be achieved. This book will appeal to individuals working in the public and third sectors, as well as the health and social care sectors. That the book’s publication closely follows the election of the new Labour Government may offer a further contribution: a benchmark/framework for assessing the achievement of the Prime Minister’s comment that ‘government is public service.’” Eileen Fairhurst MBE, Chair, Northern Care Alliance NHS Foundation Trust and Co-Chair, North-West NHS Chairs Forum
“This is an important contribution to the debate about the future direction of the UK National Health Service. In particular, how it might go about addressing the systematic and structural challenges that have created unprecedented internal pressure points. As such, it will be essential reading for those wishing to seek radical and patient-centred solutions to issues that have become so fundamental they are now an embedded part of the national conversation. It will also be essential reading for those charged with implementing the consequent public policy initiatives from the newly elected Labour government.” Dr David Perrin, Co-founder and Director, the Institute of Professional Development; Deputy Head of Division, Chester Business School.
“How can fairness be promoted in the leadership of our NHS, as well as in other public services? This includes services provided by government agencies, Charities, and other public benefit organisations. The authors present a balanced and thought-provoking discussion of the strengths and weaknesses of modern leadership approaches. They advocate for embedding fairness in public services to align with societal values. This publication serves as a guide for re-evaluating traditional management theories and considering a more compassionate approach that can lead to positive improvements in our well-being. I believe that this publication should be included in all leadership reading lists to explore and advance the theory of fairness and compassion in leadership.” Rachel Peacock, CEO of Making Space and Trustee of The Association of Mental Health Providers.
"This book offers an evidence-based critique of the NHS and outlines recommendations on how it must adapt to meet changing population needs. Its strength lies in the diversity of the contributions, the role of the editors in distilling key themes and findings, and the practical suggestions for improvement that emerge. It is grounded in real understanding of how the NHS works and what must be done to ensure its renewal." Professor Sir Chris Ham CBE, Co-Chair, NHS Assembly, Emeritus Professor of Health Policy and Management, University of Birmingham
