Three horizons: shaping the future of the NHS

Spring 2015
David Peters


First Paragraph

The ways we think and imagine affect what we do, and what we do now will shape the future. In Bill Sharpe’s 3 Horizons model (which he introduces in this issue), Horizon 1 might represent the NHS now – a system in decline; managerial mindsets doing the same old things yet expecting different outcomes; keeping the lights on as budgets flatline but also keeping the brakes on Horizon 2 innovations which the system must create to meet the extra-ordinary challenges of our times. As the world changes, ways of thinking and doing have to adapt and evolve so a world can emerge that’s operating on a paradigm that fits. But which paradigm? For three decades neo-liberal economics have been reshaping our world and the NHS with it: innovations aplenty, but too often at a cost to human flourishing, sustainability and social justice. This free market orthodoxy may continue to mould Horizon 1, its unexamined assumptions and values all the while underpinning unwelcome Horizon 2 adaptations and dictating a transformation to its very own version of Horizon 3. But if we let this happen, would we enjoy the world we made?