Three horizons: shaping the future of the NHS
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?