In the second of two special episodes, we speak to Alan Milburn about the future of the NHS and his thoughts on the government’s 10-Year Health Plan. Alan was Secretary of State for Health from 1999 to 2003, during the Blair governments, with his tenure seeing the development of the NHS Plan (2000) and record levels of investment. As Lead Non-Executive Director at the Department of Health and Social Care, Alan also had a hand in writing and developing the new plan. 

In conversation with our Chief Executive Jennifer Dixon, Alan reflects on the key challenges facing the NHS today and why he believes the new plan sets the right direction of travel. But is the plan clear enough about how change will be delivered? How will the plan ensure the health service pulls in one direction across varying objectives and programmes? And will the pace of change be sufficient by the time of the next election?   

The Health Foundation (2020). Glaziers and window breakers. Former health secretaries in their own words.

The Health Foundation (2025). Jeremy Hunt on the 10-Year Health Plan. 

The Health Foundation (2025). 10-year ‘Plan for Change’ or ‘plus ça change’?

The Health Foundation (2025). Neighbourhood health is the right ambition – but will the 10-year plan deliver?

The Health Foundation (2025). Dazed and confused? Policy ideas behind the 10-Year Health Plan. 

In the first of two special episodes, we speak to Jeremy Hunt about the state of the NHS and his reaction to the government’s 10-Year Health Plan. Jeremy was Secretary of State for Health and Social Care between 2012 and 2018, in the Cameron and May governments, making him the longest serving health secretary to date. He later served as foreign secretary (2018–2019) and Chancellor of the Exchequer (2022–2024).

In conversation with our Chief Executive Jennifer Dixon, Jeremy reflects on his time as health secretary and whether he believes the new plan presents a coherent blueprint for reform. Does the plan strike a positive balance between top-down targets and decentralisation? Will the decision to scrap NHS England and cut the numbers of ICBs help or hinder delivery? And what is the future role of regulation in improving patient safety and care quality?

The Health Foundation (2020). Glaziers and window breakers. Former health secretaries in their own words.

Nuffield Trust (2025). Exploring earnings of NHS doctors in England.  

The Health Foundation (2025). Taking a chainsaw to NHS England is not the sign of a healthy state.

HSJ (2025). Cuts to ICBs and NHSE slammed by ex-health secretary. 

HSJ (2025). Patient Safety Watch: Dash Review opens a crucial door. 

BMJ (2025). Government’s 10 year plan for the NHS in England.

Our surroundings play a big role in shaping our health. And some neighbourhoods – including so-called ‘left behind areas’ – can be tough places to live, with limited economic opportunity, low levels of social mobility and social capital, and poorer health. All this contributes to people in the most deprived areas on average living 19 fewer years in good health than people in the least deprived. 

The government is pursuing a range of initiatives to boost the fortunes of deprived neighbourhoods, including a national plan for neighbourhoods, extending devolution and directing more infrastructure investment towards struggling areas. But has government understood the value of social capital in rebuilding communities? What are the lessons of past government initiatives focused on neighbourhood renewal and left behind communities? And can the concept of ‘neighbourhood health’ help to improve health and reduce entrenched inequalities? 

To discuss, our Chief Executive Dr Jennifer Dixon is joined by:

Hilary Armstrong, Chair of the Independent Commission on Neighbourhoods (ICON), and former New Labour cabinet minister and MP for North West Durham.

Andrew O’Brien, Head of Secretariat at ICON.

ICON (2025). ICON’s Neighbourhood Policy Green Paper – Delivering Neighbourhood Renewal: Proposals for Change.

ICON (2025). Anatomy of mission critical neighbourhoods. 

Ministry of Housing, Communities and Local Government (2025). Plan for Neighbourhoods. 

Ministry of Housing, Communities and Local Government (2025). Trailblazer neighbourhoods. 

Collier P (2024). Left Behind: A New Economics for Neglected Places. 

Health Foundation (2024). Sure Start: a model for long-term policymaking? – with Naomi Eisenstadt and Donna Molloy. 

Health Foundation (2021). The government’s levelling up agenda: An opportunity to improve health in England. 

8.2 million working-age people report having a long-term health condition that limits their ability to work. 1.7 million say that work itself is making them ill or creating challenges. In addition to causing personal hardships, this decline in working-age health is causing concern among employers, politicians and policymakers. 

With the benefits bill rising, government has set its sights on wide-ranging welfare reforms, including significant changes to health and disability benefits. Are these reforms likely to incentivise and support people back into work? And how can the system intervene earlier and support employers to provide people with the flexibility they need to stay in work in the first place? 

To discuss, our Chief Executive Jennifer Dixon is joined by:

Jon Ashworth, Chief Executive of Labour Together and former shadow Secretary of State for Health and Social Care and for Work and Pensions.

Sacha Romanovitch, Chair of the Commission for Healthier Working Lives, which is supported by the Health Foundation.

Commission for Healthier Working Lives (2025). Action for healthier working lives. 

UK government (2025). Pathways to Work: Reforming Benefits and Support to Get Britain Working Green Paper. 

Barnsley Metropolitan Borough Council (2024). Pathways to Work Commission. 

Health Foundation (2025). Will short-term fixes undermine building a healthier workforce in the long run?

Financial Times (2025). How to keep sick people in employment. 

Health Foundation (2025). Mental health trends among working-age people. 

‘Today we are abolishing the biggest quango in the world,’ – Wes Streeting, 13 March 2025 

Many people were surprised by the government’s decision to abolish NHS England and fold its functions into the Department of Health and Social Care. Not least Richard Meddings, Chair of NHS England since 2022. Having formally completed his term in March, Richard joins our Chief Executive Jennifer Dixon to discuss. 

In a wide-ranging conversation, Richard reflects on his time at NHS England and how the organisation has changed. With the NHS facing growing demand for care, and continuing to top the public’s list of priorities, where does the forthcoming 10-year health plan need to focus? How should ministers lead the service in the future? And what needs to happen to ensure the NHS reaches its 100th year?

The Health Foundation (2020). Glaziers and window breakers. Former health secretaries in their own words.

OECD (2025). How do health system features influence health system performance?

Department of Health and Social Care (2023). The Hewitt Review: an independent review of integrated care systems.

The Health Foundation (2025). Taking a chainsaw to NHS England is not the sign of a healthy state. 

The Health Foundation (2025). Labour’s 10-year plan for the NHS in England: what should it look like?

NHS England (2025). Review of NHS performance and delivery (27 March 2025). NHS England board meeting.

It’s 2 years since Keir Starmer first set out his five missions for government, including a health mission to build ‘an NHS fit for the future’ and ‘a fairer Britain, where everyone lives well for longer’. Missions were supposed to mean a new way of doing government – focused on ambitious, long-term objectives that provide a driving sense of purpose for the country.

So, with Labour now in office for 9 months, what have we learned about how mission-driven government works in practice? Are clues emerging about how government plans to improve the nation’s health beyond the confines of the NHS? And do missions show signs of bringing about durable changes in policy and how the state works? 

To discuss, our Chief Executive Jennifer Dixon is joined by:

Hannah White, Director at the Institute for Government. 

Jo Bibby, Director of Health at the Health Foundation. 

Institute for Government (2025). Inside Briefing. Keir Starmer rewires the state. 

Institute for Government (2024). What does a mission-driven approach to government mean and how can it be delivered?

Health Foundation (2024). Health at the heart of government. 

UK Government (2024). Plan for change: Milestones for mission-led government. 

Future Governance Forum (2024). Mission-critical: statecraft for the 21st century. 

There are around 350,000 synthetic chemicals in use today and only a small fraction have been robustly tested for their long-term effects on our health. Many of these are used in manufacturing plastics and microplastics – the production of which has doubled since 2008 and is projected to triple by 2060. 

Unknowns remain, but research is suggesting pervasive exposures to these manufactured substances is shaping human health. In particular, links are being identified with a range of non-communicable diseases, including some cancer types, metabolic disorders, neurological conditions and reproductive and developmental issues. 

So, what do we know about how the chemical environment is influencing our health? Could AI and other emerging technologies shed new light on the effects of synthetic substances? And what does it all mean for regulation and wider policy protecting public health? 

To discuss, our Chief Executive Jennifer Dixon is joined by:

Tracey Woodruff, Professor at University of California, San Francisco, and Director of the Program on Reproductive Health and the Environment (PRHE). 

Thomas Hartung, Professor at Johns Hopkins University, and Director of the Centre for Alternatives to Animal Testing (CAAT).  

Woodruff et al (2025). Manufactured chemicals and children’s health – the need for new law. 

Kleinstreuer & Hartung (2024). AI – it’s the end of tox as we know it (and I feel fine). 

Nihart et al (2025). Bioaccumulation of microplastics in decedent human brains. 

Financial Times (2023). ‘Global sperm counts are falling. This scientist believes she knows why.’ 

Programme on Reproductive Health and the Environment (PRHE). Scientific principles to protect public health. 

Programme on Reproductive Health and the Environment (PRHE). Toxic matters. 

Health and care services are facing acute pressures and the NHS tops the public’s list of priorities. The government has pledged to ‘reimagine’ the NHS via a 10-year plan, expected in the spring. 

The pressure is now on to develop a credible reform plan. It will need to address the huge challenges of changing health care needs and capitalise on the opportunities ahead, including those stemming from new technologies. All within a challenging fiscal context. 

So what needs to be in the plan on key priorities – primary care, community services, and improving hospital services? What are the lessons from past NHS plans? And how can policymakers bring front-line staff with them and provide hope their working lives will improve?  

To discuss, our Chief Executive Jennifer Dixon is joined by:

Nigel Edwards, former Chief Executive of the Nuffield Trust.

Hugh Alderwick, Director of Policy at the Health Foundation.  

The Health Foundation (2024). Public perceptions of health and social care: five findings the new government should know. 

The Health Foundation (2024). The public’s views on the future of the NHS in England. 

Nigel Edwards. The Nuffield Trust (2018). Avoiding groundhog day: learning the lessons of NHS reforms.

The Health Foundation (2025). Health Foundation response to consultation on 10-year health plan.

The Health Foundation. Policy Navigator – NHS reform.

We look back at our pick of the pod from 2024. 

As 2024 draws to a close, what to make of the year’s developments in health and care?  

As yet, a murky picture on NHS reform and on how the new Labour government’s five missions will work in practice; a pressing need to improve the health of the working-age population; and some promising ways forward for technology to improve care, quality and productivity in the NHS.

In this episode, we also revisit how to drive the economic growth we need to fund high-quality public services, search for clues about what might be behind the worrying rise in cancer rates among younger adults, and explore what the latest evidence tells us about inequalities in health across ethnic groups in the UK.

This episode also marks our 50th – meaning there’s a great back catalogue for you to enjoy. Join our Chief Executive Dr Jennifer Dixon as we reflect with guests who appeared on the podcast in 2024.

Health Foundation (2020). Low life expectancy in Glasgow, and what to do about it. 

Health Foundation (2021). Inside the teen mind: what’s happening to mental health?

Health Foundation (2020). What should nanny do next? The government and obesity.

Health Foundation (2023). AI in health care: hope or hype?

Health Foundation (2021). We are what we eat: food, health and inequality.

John Burn-Murdoch (2024). What if the UK isn’t actually the sick man of Europe? Financial Times. 

Barnsley MBC (2024). Pathways to Work: Commission Report. 

Edwards & Dayan (2024). Leagues tables for the NHS.

Health secretary Wes Streeting has set out three big shifts the NHS must deliver – including moving from analogue to digital. National strategy on health technology and digital is developing at pace, with a 10-Year Plan for the NHS expected to set out new priorities in the spring.

We’ve seen no shortage of initiatives, roadmaps and plans for tech and innovation in recent years – yet delivery has often lagged behind. Today, acute pressures on health and care services, demographic headwinds and trends in disease burden mean there’s an imperative to deliver at pace. Much recent attention has focused on AI and its revolutionary potential, but leveraging this depends on a range of other digital capabilities that not all NHS trusts and services have. 

So, where is the NHS on its journey to digitisation? And, given all of this, what will it take for the NHS to become a truly digital health system?   

To discuss, our Chief Executive Jennifer Dixon is joined by:

Holly Krelle, Assistant Director at the Center for Healthcare Innovation & Delivery Science at New York University's Langone Medical Center.

Erik Mayer, Consultant Surgeon at Imperial College Healthcare and the Royal Marsden NHS trusts, and Director of Imperial's clinical analytics unit. 

Darzi et al (2024). Independent investigation of the NHS in England.  

The Health Foundation (2025). Briefing on digital maturity in the NHS [forthcoming].  

The Health Foundation (2023). What do technology and AI mean for the future of work in health care?

Horwitz & Krelle (2023). Using rapid randomised trials to improve health care systems. Annual Review of Public Health. 

Honeyford et al (2022). Challenges and recommendations for high quality research using EHRs. Frontiers in Digital Health.

NHS Confederation (2024). Frontline digitisation: creating the conditions for a digital NHS. 

Dearing & Cox (2018). Diffusion of innovations theory, principles and practice. Health Affairs.