Towards resilient health systems: New institutions, an invigorated civil society, and global cooperation

A new health-sector institution is necessary at the national level. The UK needs a Health Resilience Commission whose purpose would be to monitor the UK health system and provide policy advice about its ongoing reform. This would be a statutory body holding public enquiries, making use of research skills and quantitative modelling abilities, and delivering reports to Parliament. The Australian Productivity Commission provides an indication of how to build such a body and how it might operate. New health-sector institutions are necessary at the global level. The world needs a reformed WHO, a body with delivery capabilities including crisis management skills, money to spend where necessary, and the ability to train and support national officials. It also needs a Global Health Board which can monitor the global health system and make recommendations about its ongoing reform. This body would have a similar role, at the global level, to the role of the Health Resilience Commission within the UK. The IMF provides a guide as to how a reformed WHO might operate and how it might be governed. The OECD provides a model for a Global Health Board, as does the Financial Stability Board, a body set up to help reform the global financial system after the Global Financial Crisis. All heath systems – both national and global – require greater cooperation between three "poles of delivery": namely markets, government, and civil society. The private sector is flexible, and is where innovation in production happens. Government can respond to crises, spend big money, manage society-wide systems, and enforce system change. Mechanisms involving civil society will come to the fore when markets and government alone cannot solve pressing problems. Civil Society can activate generosity and mobilise group support, and some things are best achieved with the kind of knowledge, skills and capabilities possessed by people who do not work for either the corporate sector or the government sector. Cooperation between these three poles of delivery is essential for health-system reform. Greater international cooperation on health policy is necessary between nation states, and between health-policy makers and the national treasuries and central banks who deliver economic policy.