Where now for the NHS? The 60 year landmark has provided an opportunity for some valuable analysis, not least from Nicholas Timmins’ series in the FT, about the future of healthcare in the UK. How will a commitment to localism be squared with a centrally-run (whether by Ministers or an independent board) national service? How will we pay for increasingly expensive long term care for a complex array of conditions?

In his book ‘We-Think’, Charles Leadbeater draws some interesting lessons for the future of health policy from the rise of Web 2.0 and the principles of collaboration, mass innovation and open networks. With around half the population having at least one long-standing medical condition, Leadbeater argues that “The hospital-based health system, with its heavy fixed costs for buildings and professional staff, is being clogged up by people with conditions that need to be prevented, managed and treated at home or in the community. Our hospital systems will become unclogged and health will improve in the long term only if patients become participants, producers of their own health, looking after themselves more effectively and relying on doctors less.”

Leadbeater cites new technology in use in Germany which allows greater self-assessment and self-diagnosis in preventing thrombosis and makes the point that “We have been schooled to regard health as a service delivered to us, when it should primarily be a responsibility we all exercise.”

One thing that was clear from last week’s historical reflections is that Bevan’s original idea that a national health service would in the long run reduce demand for healthcare is the opposite of what has happened.  A greater emphasis on personal responsibility in healthcare – and with it, greater purchasing power for the patient, need to be at the heart of health reform in the next phase of the NHS’ life.