This website  was designed and created in February 2018 when I was an Academic Resident at the Rockefeller Foundation Bellagio Centre on the side of Lake Como in Italy. Its intention is to summarise and make sense of six years of research undertaken by the Social Values Group of  King's College London and University College London on creating  equitable, clinically effective and cost effective health services. It seeks to do so in a way that is accessible and hopefully interesting to the general public.  It describes a journey through the challenging and often tragic events  that are inherent in ensuring that the most important attribute that we have - our health - is looked after in as caring and effective manner as possible but also in a way that ensures there is maximum benefit for society and the public as a whole.

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It acknowledges that difficult decisions have to made if we are to have the best quality care available. Whether you call  this process prioritising care or rationing is irrelevant if you are the one that cannot get the treatment that you require. It also emphasises that more treatment is not necessary best treatment  but that the decisions should be open and transparent and done as a collaboration between doctor and patient, politician and the public. It provides the tools to assist people to check that those responsible for planning and delivering health services are doing it well.  I also hope that this website will act as a means of people sharing how they have fared in trying to influence the health services in their locality.

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The format emphasises the meetings that  many energetic and committed people have had over the years and the ideas that have emerged. While all the key academic references emanating from the research are here for those who want them the real audience are the  general public as I hope that this will encourage them to participate at a local and national level  in consultations and advisory groups to ensure that they get the health services that they deserve

 

 As Vicki Santi, President of the Lown Institute said at the launch of the Lancet Series on "Right Care" at Kings College London  in January 2017 

 

"although many steps [to right care] will involve technical innovations, and expertise, the broader goal of getting to the right care will not be possible without strong democratic participation by the people […]. The deepest drivers of poor care arise out of fundamental inequalities of information, wealth and power. In addition to more and better knowledge, the path to right care for health systems will therefore require an activated, informed and mobilised citizenry".

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I would like to thank all the residents  (including their partners) attending Bellagio in February 2018 for their stimulating conversations and their insights and comments that made this time for me one of the most fulfilling months of my career

 

These residents together with visiting conference delegates who came from all over the world with such varied backgrounds ( probably no where else could you meet such a disparate group but all sharing the same common goal of improving the lot of   humanity and the environment) had an enormous impact on my thinking and the final product.  However as a public health physician I am well aware that health and wellbeing is dependent on the environment both physical and socio-economic in which we work and live. The location of the Villa Serbelloni is special. Its position and vistas demonstrates that man made structures and the  natural environment can co-exist in harmony. The physical environment was constantly discussed during our shared time there because the February residents included Peruvian environmental film makers whose art highlighted the human and physical damage of uncontrolled pollution and a climate change expert from the USA. I therefore felt that the other influence on me - the Northern Italian landscape should feature on the website. Bellagio makes you feel optimistic. So instead of showing the traumatised physical environment or pictures of people suffering from poor health prioritisation decisions (although they are included in the relevant pages) instead I have populated the home page  of this website with examples of what can be done when the man made environment complements nature and is seen as one

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 Peter Littlejohns

 Professor of public Health

 King's College London

 Bellagio

 8th February to 8th March 2018

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