The latest podcast from Niall and Roy sees a somewhat different take on the current state of the NHS from Dame Jennifer Dixon, the longstanding and respected Chief Executive of the Health Foundation. Jennifer, who once practised in paediatrics before moving into public health, accuses the government of being disrespectful and menacing in its approach as it seeks to reform the service and argues that the system needs to use its principal asset which is human capital. She also questions whether it will be possible to deliver all that is being promised, arguing that while technology will help it is possible to be unrealistic about what it will achieve.

Dame Jennifer also questions whether the current approach to prevention will work suggesting that there is a limit to how much the NHS can do given its funding constraints and she warns that if autonomous Integrated Care Boards could go upstream and spend funds in that way it could be at the expense of basic services. She says that while we are not there yet, if improvements don’t come fast enough, we may get into a situation where we need to look at getting much more money into the system from some other routes.

On her own profession, she says she understands why young doctors are angry but reveals how she saw at one hospital how disrespectful they were to their chief medical officer, switching off their online cameras and putting barbed comments in the chat box. Jennifer calls for much more practical support for resident doctors but predicts that technology will mean more tasks will be protocolised and that as a result in the future there may be a need for fewer physicians, with those who are there working at the top of their licences. The next five years she says will be the most critical in the NHS’s existence.