How can we create a health system that serves the needs of everyone equally? Our vision of sustainable healthcare responds to the challenge laid down to governments by the World Health Organization.

Currently – in the UK and elsewhere – the higher up the social hierarchy an individual is (in essence, the richer they are), the lower their risk of sickness, mental illness and premature death, and vice versa.

This is because the ‘social determinants of health’ – things such as food, housing, physical activity of lifestyle, education and access to the natural environment – have such a huge effect on people’s health and well-being. 

The final report of the WHO's Commission on the Social Determinants of Health, called Closing the Gap, called on governments everywhere to take action on these avoidable health inequalities, asserting that ‘achieving health equity within a generation is achievable, it is the right thing to do, and now is the right time to do it’. 

The UK government's Strategic Review of Health Inequalities in England Post 2010 (The Marmot Review), was commissioned in 2009 to do just that. As part of the Review, Forum for the Future contributed a vision of what our health system could look like in 2025, fifteen years from now, when we want to be well on the way to bridging the health inequality gap. 

Forum’s vision is not intended to be ‘the answer’ – we’re not suggesting that 15 years is long enough to solve all the challenges of health and healthcare we face, but it’s a snapshot of the journey, a plausible yet aspirational future. As with all visions, it’s a great starting point for debate, a way of stimulating people to look at things differently, and ask those vital ‘big picture’ questions.

The vision describes how shorter working hours, more contact with the environment, growing localisation of production and consumption, redistribution of wealth towards the poor, and greater service accessibility are all accepted as key drivers of health and wellbeing.  

By 2025, systems of governance reflect this shift in emphasis. Policy development is at last joined up – with the key test of any new initiative being its contribution to sustainable development and improved health. Cross-budgeting between government departments enables interventions to be planned and paid for holistically.   
 
Local Service Hubs, where citizens can access advice and assistance on health, security, work, money and family matters, are also co-creation centres where those same citizens can volunteer, advise others, socialise, exercise, and participate in decision-making. And all of this is happening in a world where the UK has radically decarbonised its economy, and is on track for an emissions reduction of 90% by 2050.

Download the report to read the full vision, including four stories of fictional characters living and working in 2025. Is it a vision that you share? 

Click here for more information about the Marmot Review. The Review is due to report to the Secretary of State by the end of 2009 and the final report will be published early in 2010. 

Contact: Helen Clarkson