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Those who know me well would probably rush to tell you that I’m a cynical, glass half empty kind of person. Someone who doesn’t like to get too hopeful so I can avoid disappointment, but not fatalistic. 

But you know something, I’m hopeful about what we can achieve in health and care over the next 10 years, including growing further opportunities for counsellors and psychotherapists. 

Admittedly the current situation looks bleak, NHS productivity is still below pre-pandemic levels, too many years of low investment in capital and technology means we’ve failed to even stand still – we’ve gone backwards, we’ve got 10 million people in England on a NHS waiting list, and around 10% or over 120,000 vacancies in the NHS workforce. This is despite around £200 billion a year now being spent on health. That’s around 20% of everything the Government spends.

We need to reform. We need to be brave. We need to be ambitious. We literally cannot go on putting more money into the NHS to deliver services in the same way we have been doing in recent years. As a nation we’ve been there, done that and got the t-shirt. That approach hasn’t fixed underlying systemic problems, it’s simply kept the system on enough life support to limp into each new year.

So, where's the hope in all of that? 

In part it comes to me because it feels like we’re at a do or die time for many public services. Even if we wanted to continue to pump increasing billions into those systems – we can’t. The country doesn’t have the money.

No longer able to do the same thing year after year, all the while hoping for a different result, we’re going to have to do something different. That gives me hope. It gives me hope that voices for wide-ranging reforms can cut through.

Maybe the Labour Party is more likely to be trusted by the public with reform of the NHS than the Conservative Party. Not fearing a Government that is seeking to compromise on the fundamental principle of care free at the point of need, the public might be more open to some more radical change.

A big opportunity for us all to influence positive change are the NHS Change consultations. Launched in October, and focused on the ‘Three Shifts’ of;

• moving more care from hospitals to communities
• making better use of technology in health and care
• focusing on preventing sickness, not just treating it

It’s an open invitation for us as individuals and for organisations to propose radical change to health and care. Reforms for how we can meet need earlier or how we as users of NHS services interact with the system, how information is shared across services and clinicians to enhance our care, and how we can build a more psychologically astute NHS, which better ultilises the expertise of the counselling professions. Just some starters for 10.

For counselling and psychotherapy this isn’t simply an opportunity to reinforce the case for the NHS to continue to accelerate funding for mental health services to be somewhere closer to matching the financial burden of mental ill health. This is an important opportunity for counselling and psychotherapy to make the case for how it can help the NHS to fundamentally improve.

I’m hopeful that as a country we’ll rise to the challenge in front of us. I’m hopeful that counselling and psychotherapy can succeed in the case for playing a bigger role in the NHS on its 100 birthday than the role it plays today. I’m hopeful we’ll look back in a decade and be able to pinpoint these moments as the point at which we restored the NHS to a solid footing and helped it modernise to continue looking after us all.

We’d encourage all our members to engage with the NHS Change process. Whether responding as an individual or on behalf of an organisation, the powerful voice of our profession can make a real impact on the upcoming 10 Year Health Plan for England.

Individuals can engage with , the deadline for individual submissions is the end of January 2025.