The Prime Minister is set to announce the biggest changes to the NHS in its eight-decade history when she makes her speech today.
Sir Keir Starmer will say the NHS must ‘reform or die’ as a major report into the health service is to be published.
The Prime Minister will set out plans to tackle long waiting lists, improve the nation’s health, and shift focus to community services after a scathing report from Lord Darzi found the NHS ‘suffering from serious problems’.
The rapid review, completed in nine weeks, diagnosed problems in the NHS and set themes for the Government to incorporate into a 10-year plan to reform the health service.
The study highlighted that the NHS is facing increased demand for care as people live longer in pain, coupled with low productivity in hospitals and low staff morale.
Speaking at an event in London on Thursday, the Prime Minister will say: ‘The NHS is at a crossroads, and we have choices about how we must meet these demands.
‘Raise taxes on working people to meet the higher costs of an aging population – or reform to secure the future.
‘We know working people can’t afford to pay more, reform or die.’
Sir Keir will pledge to work on three fundamental areas of reform to make the NHS fit for the future.
Key findings from the Darzi Report
The report also explains how:
• The health of the nation is deteriorating, with years of sickness.
Factors affecting health, such as poor housing, low incomes and insecure employment, ‘have moved in the wrong direction over the past 15 years, with the result that the NHS has suffered from the demand for health care from a distressed public’ .
• There has been a ‘rise’ in some long-term conditions, including a rise in poor mental health among children and young people. Fewer children are getting vaccines and fewer adults are participating in things like breast cancer screening.
• Targeted waiting times are being missed across the board, including for surgery, cancer care, A&E and mental health services. The report said ‘long waits are normal’ and ‘A&E is in a bad state’. In April 2024, around one million people are waiting for mental health services. The overall NHS waiting list is 7.6 million.
• People struggle to see a GP. ‘GPs are seeing more patients than ever before, but with the number of qualified GPs relative to the population falling, waiting times are increasing and patient satisfaction is at an all-time low.’
• Cancer treatment still lags behind other countries and the cancer death rate is higher than in other countries. There was ‘no progress’ in diagnosing stage I and II cancers between 2013 and 2021. However, more recent figures show some improvement.
• Progress in reducing death rates from heart disease has stalled while rapid access to treatment has broken down. For example, the time for heart attack patients at highest risk for rapid intervention to unblock an artery has increased by 28% from an average of 114 minutes in 2013-14 to 146 minutes in 2022-23.
• The NHS budget is ‘not being spent anywhere’ and too large a proportion is being ‘spent in hospitals, too little in the community, and too little productivity’. Too many hospital beds are taken up with people who need social care.
• Between 2009 and 2023 the number of nurses working in the community will decrease by 5%, while the number of health visitors will decrease by almost 20%.
• By the beginning of 2024, 2.8 million people are economically inactive due to long-term illnesses, with most of the increase ranging from pandemics to mental health conditions. The report says that ‘being in work is good for well-being’ and that more people in work boost the economy. ‘Therefore there is a virtuous circle where the NHS can help more people return to work.’
• Raids on the capital budget have left the NHS with crumbling buildings and too many outdated scanners, and ‘parts of the NHS have not entered the digital age’. The report says that ‘the NHS is on the cusp of digital transformation’.
• The resilience of the NHS was ‘underwhelming’ going into the pandemic due to a ‘decade of austerity’, high bed occupancy rates and fewer doctors, nurses, beds and capital assets than other high-income health systems.
• The NHS delays, cancels or postpones care more regularly during a pandemic than similar health systems.
• Too many NHS staff are ‘disengaged’ and there are ‘distressingly high-levels of sickness absence’. The pandemic is ‘exhausting’ for many and the result is a ‘marked reduction in discretionary effort across all staff groups’.
• Regulatory type organizations now employ some 7,000 staff, or 35 per NHS provider trust, having doubled in the last 20 years.
He will say: ‘This government is working fast to come up with a 10-year plan. Something completely different from anything that has come before.
“Rather than the top-down approach of the past, this plan will have the fingerprints of NHS staff and patients all over it.
“And as we build together, I want to build this plan around three big changes – firstly, moving from an analogue to a digital NHS. Tomorrow’s service, not just today’s service.
‘Secondly, we need to shift more care from hospitals to the community… And thirdly, we need to be bolder in moving from disease to prevention.’
Lord Darzi, a respected surgeon and former health minister, said in the report that the NHS could be fixed.
He said: ‘There is nothing I want to question the principle of a health service funded by the taxpayer, free at the point of use, and based on no need to pay.’
Lord Darzi said the country ‘can’t afford to have an NHS, so we have to change the situation’, adding that the health service is ‘critical, but the signs of its importance are strong’.
He criticized political decision-making in the Conservative and coalition governments, including the impact of austerity and the reorganization of the NHS under Andrew Lansley in 2012.
In his report, Lord Darzi said that ‘the Health and Social Care Act 2012 is a disaster without international precedent. It proved disastrous’.
He continued: ‘Over the past 15 years, the NHS has been hit by three shocks – austerity and investment starvation, the confusion caused by top-down reorganisation, and then the pandemic which has arrived with resilience at all times.
‘Two out of three of those surprises were choices made at Westminster.’
As part of the prescription for reform, Lord Darzi said the Government must ‘re-engage staff and re-empower patients’ and must ‘lock care shifts closer to home’.
Furthermore, it is necessary to drive productivity in the hospital through re-staffing, taking people out of the hospital when they are no longer needed and investing in buildings and equipment.
In a speech on Thursday, Sir Keir will point the finger of blame for the current state of the NHS on the Tories, saying it is ‘unforgivable’.
He would say, ‘People have the right to be angry. Not just because the NHS is so personal to us all – because some of these failures are life and death.’
‘Get the waiting time in A&E. This is not only a source of fear and anxiety – it leads to avoidable death.
‘Loved ones that can be saved. Doctors and nurses who all called to save him – could not do it. It’s devastating.’
Addressing the number of people out of work, Sir Keir will add: ‘There are 2.8 million people who are economically inactive due to long-term illness, and more than half of the current waiting list for inpatient care are working-age adults.
‘Getting people back to health and work will not only reduce costs in the NHS, it will drive economic growth – in turn creating more tax receipts to fund public services.’
Contact the news team by emailing webnews@metro.co.uk.
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