The Policy Ask: 'Put down the reports and listen to people on the front line'
Photo by IPPR / Sebastian Rees.
Sebastian Rees leads the Institute for Public Policy Research (IPPR) think tank's work on health. Here he talks devolution, community healthcare, and London's best commute.
How do you start your working day?
With a bike ride along the stretch of the Thames between St Paul's Cathedral and parliament – easily the best commute in the city!
What has been your career high?
Joining the IPPR at what feels like the most important time for health policy in decades. It's make or break time for the NHS and having the chance to inject ambitious, progressive thinking into debates on its future is a huge privilege.
What has been the most challenging moment of your career?
Every day has its challenges, but a constant has been trying to address the acute, short-term problems facing the NHS while carving out time and space to think about the bolder, long-term reform necessary to build a healthier nation.
If you could give your younger self career advice, what would it be?
Put down the reports a bit more often and spend time listening to people working in and using the NHS. A few hours in an A&E, a GP waiting room or a hospital discharge lounge can teach you more than an (ever-growing) stack of think tank publications.
Which political figure inspires you?
Julia Gillard. As Australia's first female prime minister – and now chair of the Wellcome Trust – she brought bold thinking and real political courage to health and care reform. The creation of Australia's pioneering National Disability Insurance Scheme under her leadership was a landmark. Even after leaving frontline politics, she's continued to champion health equity and mental health in particular.
What UK mental health policy or fund is the government getting right?
Reforming the Mental Health Act has been a long time coming, but when it finally passes, it will be a major step forward. Modernising this outdated legislation is essential if we want a mental health system that's fairer and genuinely puts people first.
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And what policy should the UK government scrap?
There is still further to go for government to end its culture of micromanagement of the health system. Loading up NHS providers and systems with more and more targets is a dead-end when it comes to improving services for patients. But when things aren't going well there is always a temptation to add in more. Let's hope that the ten-year plan moves us in a different direction!
What upcoming UK policy or law are you most looking forward to?
I'm really interested in the potential of the upcoming English Devolution Bill. Most people I speak to in policy – especially in health – agree that hoarding control in Westminster and Whitehall is holding public services back. But shifting that culture will mean some very tricky conversations about accountability and funding. And it raises big questions about where the NHS – arguably our most centralised and most cherished institution – fits into that picture.
What international government policy could the UK learn from?
We've made real strides in the UK in recent decades when it comes to mental health, but there's still so much more to do to put people truly at the centre of their care. There's still a lot to learn from community-based approaches like those in Geel, Belgium, and Trieste, Italy – where support is deeply embedded in local life and relationships, not just services.
If you could pass one law this year, what would it be?
It's great to see the government legislating on issues like smoking, employment rights and housing, where law really can improve public health. It's not just about health legislation – it's about a whole agenda. But some of the biggest health gains don't need new legislation at all. They just need us to do the basics well – consistently, and for everyone.
This article first appeared in the 15 May Spotlight policy report on Healthcare. To read the full report click here.
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