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Hugh Alderwick @hughalderwick.bsky.social · 23/06/2026

Immigration makes a positive contribution to the NHS New review of the evidence www.health.org.uk/reports-and-...

health.org.uk

Reposted by Hugh Alderwick

The Health Foundation @healthfoundation.bsky.social · 28/05/2026

Our Director of Policy and Research @hughalderwick.bsky.social has joined the @bmj.com podcast to discuss the measures in the Health Bill, and what Wes Streeting’s departure from the Department for Health and Social Care will mean for the future of the bill. Listen now👇️

bit.ly

What does Wes Streeting's exit mean for the NHS modernisation bill? | Medicine and Science from The BMJ

Hugh Alderwick, Director of Policy and Research at the Health Foundation, joins the BMJ podcast to discuss Wes Streeting's recent resignation and what that means for the future of the Health Bill.

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Hugh Alderwick @hughalderwick.bsky.social · 15/05/2026

On the same day Streeting resigned, government published a new health bill reorganizing the NHS Ministers gain new powers, while patients and the public lose a voice Our take in @bmj.com www.bmj.com/content/393/... @healthfoundation.bsky.social

bmj.com

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Hugh Alderwick @hughalderwick.bsky.social · 13/03/2026

New qual research on the changing role of ICSs in England, based on interviews with local leaders Lots in there--including support for government's policy aims--but the ongoing mess of yet another NHS restructure is inescapable: www.health.org.uk/reports-and-...

health.org.uk

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Hugh Alderwick @hughalderwick.bsky.social · 15/01/2026

Big qual study on access to general practice Changes linked to 10 year plan offered some benefits, but also unintended effects—including undermining continuity and human connection, fragmentation of care, and widening inequities Careful design, implementation, and evaluation of new services needed

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Hugh Alderwick @hughalderwick.bsky.social · 26/09/2025

Our new assessment of Labour's first year Main story: - Labour has set out a broad vision on the NHS - But detail on how change will happen is lacking - And resources to deliver are limited - Standing back, it's hard to find a coherent policy agenda - More reorganization will make it all harder

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Hugh Alderwick @hughalderwick.bsky.social · 27/08/2025

Lessons from history for bringing NHS England back into the department

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Hugh Alderwick @hughalderwick.bsky.social · 28/07/2025

Dazed and confused? Policy ideas behind the NHS 10 year plan www.health.org.uk/reports-and-...

health.org.uk

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Hugh Alderwick @hughalderwick.bsky.social · 23/07/2025

You'd want to design some exemptions and various rules... But—luckily—government already has a fairer and more efficient way of raising revenue for the NHS… tax! We should focus on the real problems facing the NHS, not made up ones www.bmj.com/content/380/...

bmj.com

Rhetoric about NHS reform is misplaced

The NHS is in crisis, and talk of fundamental reform is little more than a distraction The NHS in England is in crisis. The health service entered the new year—as it did the last one—with several NH...

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Hugh Alderwick @hughalderwick.bsky.social · 23/07/2025

And on more user charges (eg £X to see your GP), evidence tells us they can reduce demand for health care, but that includes the care people need to stay healthy The poorest and sickest patients suffer as a result pmc.ncbi.nlm.nih.gov/articles/PMC...

pmc.ncbi.nlm.nih.gov

The RAND Health Insurance Experiment, Three Decades Later

We re-present and re-examine the analysis from the famous RAND Health Insurance Experiment from the 1970s on the impact of consumer cost sharing in health insurance on medical spending. We begin by su...

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Hugh Alderwick @hughalderwick.bsky.social · 23/07/2025

My colleagues summarised this and other evidence here: www.health.org.uk/sites/defaul...

health.org.uk

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Hugh Alderwick @hughalderwick.bsky.social · 23/07/2025

People want government to improve the NHS, not reform its funding model. This would waste years of time and money and would not address the NHS’s problems Evidence on health system characteristics and performance points us to this conclusion too www.oecd.org/en/publicati...

oecd.org

How Do Health System Features Influence Health System Performance?

International comparisons are an important tool for benchmarking health system performance, shedding light on health systems’ relative strengths and weaknesses. The present work examines how different...

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Hugh Alderwick @hughalderwick.bsky.social · 23/07/2025

When presented with detail on how other models work—including social insurance, like in some European countries, or some version of our current model with additional user charges—they overwhelmingly favour sticking with our current tax-funded system www.health.org.uk/reports-and-...

health.org.uk

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Hugh Alderwick @hughalderwick.bsky.social · 23/07/2025

The way the NHS is funded—largely through general taxation—is an efficient and equitable way of raising revenue, with comparatively low admin costs

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Hugh Alderwick @hughalderwick.bsky.social · 23/07/2025

In either case, there’s no clear evidence that one model performs better than the other (and recent work suggests that, if you were starting from scratch, you would not choose SHI) core.ac.uk/download/pdf... onlinelibrary.wiley.com/doi/10.1002/...

core.ac.uk

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Hugh Alderwick @hughalderwick.bsky.social · 23/07/2025

Both systems basically rely on the same thing: risk pooling across the population, funded by compulsory payments (whether you call these a tax or not) www.ft.com/content/602f...

ft.com

The dangers of magical thinking on health policy

We must carefully consider how changes in the funding model might affect the healthcare system

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Hugh Alderwick @hughalderwick.bsky.social · 23/07/2025

How countries fund health care is shaped by history, culture, politics, values, more The distinction between Beveridge (tax funded) and Bismarck (social insurance) systems has blurred over time, as countries with social insurance increasingly rely on extra government £ www.who.int/europe/publi...

who.int

Spending on health in Europe: entering a new era

Publicaciones de la Organización Mundial de la Salud

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Hugh Alderwick @hughalderwick.bsky.social · 23/07/2025

Policy exchange, backed by Sajid Javid, think we need to switch the NHS funding model to social insurance, and introduce new charges for NHS services, like to see a GP policyexchange.org.uk/publication/... These are not new ideas, but they are bad ideas A thread with some evidence

policyexchange.org.uk

The NHS – a Suitable Case for Treatment? - Policy Exchange

Download Publication Online Reader ‘The NHS – a Suitable Case for Treatment?’ makes the case that the NHS is not fit for purpose and is in urgent need of reform.The report finds that NHS performance r...

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Hugh Alderwick @hughalderwick.bsky.social · 17/07/2025

1 in 5 care workers live in poverty—much higher than the average UK worker. Poverty is even worse for migrant workers in social care New analysis @healthfoundation.bsky.social www.health.org.uk/reports-and-...

health.org.uk

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Reposted by Hugh Alderwick

BJGP Open @bjgpopen.bsky.social · 19/06/2025

What’s been tried? A curated catalogue of efforts to improve access to general practice ➡️ doi.org/10.3399/BJGP... ‬Using 449 different sources, this review offers a comprehensive, thematically curated catalogue of attempts to improve access to general practice.

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Reposted by Hugh Alderwick

The Health Foundation @healthfoundation.bsky.social · 12/05/2025

🎧 @hughalderwick.bsky.social joins @thelancet.bsky.social podcast to explore the impact of Labour's health policies since coming to power last July. Also hear Hugh's analysis on the balance between funding and reform, the role of AI, and improving access to primary care. Listen now ⬇️

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Hugh Alderwick @hughalderwick.bsky.social · 28/03/2025

Rejigging NHS structures while the health service is in crisis is a distraction that NHS staff and patients could do without. See more @healthfoundation.bsky.social

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Hugh Alderwick @hughalderwick.bsky.social · 28/03/2025

Government could achieve the same objectives with far less disruption—for instance, by bringing some functions into the department over time, leaving others at arms length from ministers, and avoiding distracting legislative changes needed to scrap NHS England entirely

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Hugh Alderwick @hughalderwick.bsky.social · 28/03/2025

But scrapping NHS England altogether will be a massive distraction. Evidence tells us that NHS reorganisations cause disruption and rarely deliver the benefits politicians expect. They also waste time and effort that could be spent on work to improve services

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Hugh Alderwick @hughalderwick.bsky.social · 28/03/2025

There is some logic in bringing NHS England and the department closer together—for instance, to reduce fragmentation and improve clarity for the health service

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Hugh Alderwick @hughalderwick.bsky.social · 25/02/2025

New data suggest the public's top priority for the NHS is improving GP access But government's headline NHS pledge is reducing elective waiting times Hospitals risk crowding out other priorities Polling @healthfoundation.bsky.social @ipsosintheuk.bsky.social: www.health.org.uk/reports-and-...

health.org.uk

Things can only get better?

What does the public make of the new government’s early agenda for the NHS and social care? Have perceptions and expectations of NHS and care services changed? This analysis presents findings from the...

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