The independent think-tank 2020health has issued a report calling for "the restoration of a truly National Health Service which rewards positive behavioural choices".

The report demands "radical honesty" as part of a meaningful debate on the future of the NHS. It states that "the public are a willing audience" and while their experience of the NHS may be mixed, "they appreciate that we in the UK have pioneered one of the fairest health systems in the world. No one wants to return to times of uncertainty and fear".

The analysis, called Going with the flow, includes calls for a ‘payment by results’ tax benefit for people who make positive behavioural choices that reduce their risk of developing illness "and honesty from politicians and NHS leaders on what the NHS can provide in the 21st century". It also calls for a strategic review of hospitals, public consultation on services, and for greater public understanding of the appropriate use of the latter.

The report goes on to note that the issue "has been stifled by party political point-scoring and vested interests polarising the debate, not least confusing the public with claims of ‘privatisation’." It claims that the NHS "has always been a public-private partnership and there is no de-nationalisation party political agenda on the table. If anything, the opposite is true, with talk now more of GPs becoming NHS employees, rather than being self-employed as most are now".

2020health concludes by saying that "a mature, managed public debate" is needed, "with clarity on the financial pressures and the call for us all to be involved". The think-tank's chief executive Julia Manning, called for politicians to be honest with the public, adding that "we are facing a financial crisis and we all need to play our part to ensure we have an NHS for the next generation".

Gail Beer, co-author of the report, stressed the need to "look beyond ‘the NHS must change’ rhetoric to actually consider how the NHS can survive".