The spectre of how to fill the NHS’ £30bn funding gap raised its head again over the weekend, with the news that Frank Field is to discuss his proposals for raising National Insurance with the health secretary.

We have been here before of course. Field’s inspiration for his plan is the similar rise introduced by the previous Labour government in 2002. This NI increase is often cited as a popular way to raise taxes. Those that do cite it, however, generally fail to mention that it went hand in hand with a serious programme of reform. Without this commitment to dramatically improve the NHS it is unlikely the public would have consented to paying more tax.

So while it is welcome that politicians are finally starting to grapple with the challenge of funding the NHS and reducing the deficit, Labour should be hesitant about asking taxpayers for more money without first offering them a clear plan for improving and safeguarding the NHS over the coming decade. Such a comprehensive plan is clearly needed. After all the NHS is not just facing a financial challenge, but a structural one too.

Thanks to the success of modern medicine we now have an ageing population and millions more living with chronic conditions than was the case two decades ago. These are causes for celebration and a measure of success not failure; however, in its current form, they are going to prove extremely problematic for our health service.

The current one-size-fits-all NHS model is no longer the most effective, or efficient way of treating either the elderly, or those with chronic, physical or mental health conditions. What we need instead is an NHS that offers far more diverse settings for treatment and a more personalised service.

Fortunately it appears that Labour is alive to this challenge. Andy Burnham’s ‘whole person care‘ agenda and Ed Miliband’s Hugo Young lecture, are strong starting points in the search for a new type of NHS.

The Tories on the other hand simply do not get this agenda. Their Health and Social Care Act only really amounted to a rearranging of the deck chairs – largely retaining the existing NHS model, yet leaving it fragmented and underfunded.

Labour must reject the Conservatives’ limited vision of a managed decline for the NHS and instead work to build a service fit for the future. To do this we must start with the modern patient’s needs and build a system capable of meeting them. The question is what this new system will look like.

First there will be a greater focus on community and primary care. No longer is a trip to hospital necessary to tackle our most common problems. More and more people with chronic conditions can now be treated at home and given better support for self-management. This improves their experience and reduces the chances of contracting a hospital-acquired infection. This approach will not only reduce demands on A&E departments and GP surgeries but, it could save as much as £4bn a year.

This money can be better spent integrating health and social care, increasing community care and improving the shockingly poor pay and working conditions of many in the care workforce.

In addition, hip and knee replacements can also be treated more effectively in planned care centres, while major trauma units have shown they can drive up quality for heart and stroke patients.

Secondly, we must give more power to patients. The era of ‘doctor knows best’ is over and the time for shared decisions between patient and clinician has arrived. Personal health budgets and individual care plans mean people can now choose the best treatment option for them, one that fits in with their lives and what is important to them. By empowering patients and giving them greater confidence to manage their own conditions we can save money and more importantly improve outcomes.

Finally, we need greater transparency. It is time to throw open the books and let the public know if their local services are measuring up. Before we consider if the NHS needs more money, it is vital that we know if what we already spend is used efficiently. If it is not, public pressure should be used to drive improvement and ensure that full value is wrung out of every penny.

To successfully deliver change on this scale will require an honest dialogue between politicians and the public. Over a decade ago Labour did just that and presented voters with a roadmap for dramatically improved health care – part of which involved them paying more tax.

If we are to safeguard the NHS for the future, similar boldness, with a commitment to drive up standards at its heart, is required once again. This is a challenge that Labour has successfully met in the past and one that we should be confident in embracing again. Your move Frank …

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Rich Durber is a member of Progress. He tweets @richdurber and blogs here.

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Photo: Visa Kopu