12th June 2023
All government policies should consider what the second-order effect on health will be, says Civica’s Tracey Cotterill
How do we change planning within government departments to put health at the centre of all decision making? The primary function of governments across the globe is the health, wellbeing and happiness of the populations they serve.
Every policy decision impacts our health and wellbeing, from financial and socio-economic to educational and welfare policy. So, every decision made at a national level should be considered in the context of how it will impact health.
This matters more now than ever before. There is an ageing global population. People are living for longer but often with multiple long-term health conditions.
We’re able to do so much more in healthcare than we were even a generation ago, and in greater volumes. When I think back to my early years in the NHS the stark comparison is in examples such as the hip replacement pathway. Patients would be in community hospitals for weeks post-op. Now the surgeries have improved and the recovery times are shorter, increasing capacity to meet the uptick in demand driven by demographics. Demand has also grown due to changes in criteria for patient eligibility, enabled by the latest clinical practices. But these changes are not enough, demand continues to outstrip capacity – we are all too familiar with the pressures on the system and healthcare staff.
The workforce dilemma
So, demand is growing both due to demographics and the capability of our health and care systems to do increasingly more. But all this added activity needs more people. We have more health workers than ever before but we still don’t have enough. The latest NHWA (National Health Workforce Accounts) data references 65 million health workers globally in 2020, a 14 million increase over 2013. Furthermore, there is a reported potential increase of another 19 million by 2030 - an increase of 29%. With global population growth during the same period forecast to be c. 9%, the question is where is this increased workforce coming from?
This sentiment was echoed at the recent Healthcare Information and Management Systems Society (HIMMS) Conference in Chicago where I listened to the keynote from the WHO’s Hans Kluge stating that while one in six people in the workforce is employed in the health sector, this is already moving towards one in five. It’s hard to see how we will be able to manage the workforce requirements in a way that economies can sustain and will other sectors and industries face shortages as a result? Perhaps the leap in AI technologies will release resources from other industries and enable the transition to an ever-growing health workforce?
Furthermore, this is a global issue which can’t be dealt with at a local level. The clinical workforce is now a global, transitory and competitive one – so it’s more important than ever that we look hard at the decisions we’re making. For example, according to a recent article in the Financial Times, approx. 18,000 doctors trained in the UK are now practising abroad, up 50% since 2008 (equating to one in seven). Similarly, according to the House of Commons Library statistics, 16.5% of the UK health workforce report a non-British nationality.
A joined up GovTech approach
To help mitigate the impact on resourcing needs, let’s go back to the opening sentiment of putting health at the centre of every government decision. Even within the health sector, this often isn’t the primary driving factor – organisations make decisions to help them achieve financial balance, often at greater cost, now or in the future, to another organisation. How can we get traction to change the metrics that organisational success is measured against? We need to change business case models to include impact assessments on wider government – and we need to be able to model data to measure that.
Civica works across all major GovTech sectors from central and local government to health, housing and education. We’re helping to digitally transform these sectors, putting us in a prime position to see the bigger picture and support digitisation which provides the insights and analysis necessary to benefit population health and wellbeing.
Our role is changing to help with impact assessments on how technology can enable all government departments to look at their policies and see what can be improved. Civica can then support this transformation with the best digital tools for the job; and with improved reporting tools through the use of AI and analytics, we can help our customers identify and measure the necessary data to support the goal of putting health and wellbeing at the centre of policy.
Back at HIMMS, a final thought from Päivi Sillanaukee, Ambassador for Health and Wellbeing at the Ministry for Foreign Affairs of Finland, who spoke passionately about how the country is already putting health at the centre of all government department policy to significant effect. It was inspiring to hear. If we are to solve the issues of increased demand, the need for a growing number of health and care staff and global competition for talent, we must work together to push health and wellbeing as the core purpose of government both now and into the future.
Tracey Cotterill is President, Civica Solutions Canada