No extra NHS funding without reform, says PM

There will be no extra NHS funding without reform, Sir Keir Starmer says, as he promised to draw up a new 10-year plan for the health service.

The pledge came after a damning report warned the NHS in England was in a “critical condition”.

The prime minister said the new plan, expected to be published in the spring, would be the “the biggest reimagining of the NHS” since it was formed.

However, the Conservatives said the government needed to turn “rhetoric to action” after scrapping its plans to reform social care and build new hospitals.

Sir Keir set out three key areas for reform – the transition to a digital NHS, moving more care from hospitals to communities, and focusing efforts on prevention over sickness.

The report was the result of a nine-week review by the independent peer and NHS surgeon Lord Darzi.

He was asked by Labour, shortly after the election, to identify the failings in the health service, but his remit did not stretch to coming up with solutions.

His findings present a stark picture of a service which he says is in “serious trouble” with declining productivity, “ballooning” waits and “awful” emergency services that put patients at risk.

Responding to the report during a speech in London, Sir Keir said the problems would not be solved by just more money.

“We can’t duck long-term change. This isn’t just going to be solved by more money, it’s solved by reform.”

Sir Keir said it would be “so different” from everything that has gone before as he talked about changing it into a “neighbourhood health service”.

This would mean “more tests, scans and healthcare offered on high streets and towns centres” alongside bringing back the family doctor and offering digital consultations to those who want them.

“Hear me when I say this – no more money without reform.”

Speaking in the House of Commons, Health Secretary Wes Streeting pledged to be “tough on ill-health” and its causes as he evoked the spirit of New Labour.

He gave a nod to Sir Tony Blair’s “tough on crime” mantra as he outlined a “national mission” to improve health opportunities across the country.

Mr Streeting said he wants to be “honest about the problems” facing the NHS and be “serious about fixing them”, as he updated MPs about the “raw, honest and breath-taking” Darzi report commissioned by the new Government.

The report from Lord Darzi, who served as health minister in the last Labour government, said the NHS was still struggling with the aftershocks of the pandemic and falling well short of its key targets for cancer, Accident & Emergency (A&E) and hospital treatment.

It said this was contributing to poor survival rates in cancer and heart disease, and falling rates of satisfaction with the service.

The report said the NHS had been left chronically weakened by the policy of austerity of the 2010s and, in particular, a lack of investment in buildings and technology.

The NHS has crumbling hospitals, fewer scanners than many other developed nations and is years behind the private sector in terms of digital innovation, it says.

This has contributed to falling levels of productivity in hospitals, with rises in staff outstripped by increasing numbers of patients needing care.

It has meant hospitals have been sucking up an ever-increasing amount of the budget, when more care should be shifted into the community.

Lord Darzi was also critical of the “disastrous” 2012 reforms introduced by the coalition government, which led to a shake-up of management structure in the NHS and acted as a distraction for the rest of the decade.

It said all this contributed to the NHS entering the pandemic in a depleted state, leading to the cancellation of more hospital treatments than any comparable country and the “ballooning” waiting list, which currently stands at 7.6 million.

Meanwhile, a surge in patients suffering several long-term illnesses, such as diabetes, high blood pressure and respiratory illness, is threatening to overwhelm the NHS, alongside soaring levels of mental health problems among young people.

Lord Darzi said: “Although I have worked in the NHS for more than 30 years, I have been shocked by what I have found during this investigation – not just in the health service, but in the state of the nation’s health.”

Shadow health secretary Victoria Atkins said the government had yet to come up with meaningful plans for reform.

“The Labour government will be judged on its actions. It has stopped new hospitals from being built, scrapped our social care reforms and taken money from pensioners to fund unsustainable pay rises with no gains in productivity.”

She also defended the Conservative government’s record, saying the NHS budget had been increased during the last Parliament.

But Lib Dem leader Ed Davey said the Tories had driven health services “into the ground”.

“Fixing the NHS is this country’s greatest challenge and the new government must make it their top priority.”

Rachel Power, of the Patients Association, said the findings were “deeply concerning” but “sadly not surprising”.

“This diagnosis report provides a stark and necessary assessment of the challenges facing our NHS. We now must stop normalising the abnormal.”