Starmer pledges major NHS reforms in wake of Darzi review
The prime minister has pledged the “biggest re-imagining of our NHS since its birth”, in response to a major report into the current state of the health service.
Sir Keir Starmer today promised major reforms to the NHS, including moving care from hospitals into the community, shifting services from analogue to digital and moving away from sickness to prevention.
“Only fundamental reform and a plan for the long term can turn around the NHS and build a healthy society”
Keir Starmer
The announcement from the prime minister follows the publication last night of the Independent Investigation of the National Health Service in England.
The review, undertaken by leading surgeon and former Labour minister, Lord Ara Darzi, concluded that the NHS was in a “critical condition”, after identifying widespread problems for those accessing services.
His report presented the realities of what many NHS staff and patients have known for some time, for example, that waiting lists have surged, A&E is in “an awful state” and that cancer and cardiovascular care is lagging on the global stage.
In addition, the report specifically highlighted that promises by successive governments to move care out of hospitals had been hampered by the lack of investment in community nursing.
Over nine weeks, Lord Darzi examined over 600 pieces of analysis from the Department of Health and Social Care, NHS England and external organisations during his investigation.
An expert reference group made up of more than 70 organisations, including the Royal College of Nursing and the Royal College of Midwives, also contributed to the review.
Lord Darzi identified “three major shocks” that he said had led the health service into the crisis that it was in today.
The first was austerity, with the report noting that the 2010s were “the most austere decade since the NHS was founded”.
The second was the fact that the NHS has been starved of capital, with low investment in buildings, scanners and other digital technology.
As part of this, the review argued that the NHS remained “in the foothills of digital transformation”.
Lord Darzi said the last decade was a “missed opportunity to prepare the NHS for the future” and to embrace digital technologies that could support prevention.
The third shock, the only one of which Lord Darzi argued was not a political choice, was the Covid-19 pandemic.
The report found that the combination of austerity and capital starvation “saw the NHS enter the pandemic with higher bed occupancy rates and fewer doctors, nurses, beds and capital assets than most other high-income health systems”.
On workforce, Lord Darzi found that “too many staff are disengaged” because of burnout from the pandemic.
He noted “distressingly high levels of sickness absence” in the NHS, with as much as one working month a year missed for each nurse and each midwife working in the NHS.
Despite the damning analysis, Lord Darzi insisted that the NHS’s vital signs “remain strong” and he praised staff for their “shared passion and determination to make the NHS better for our patients”.
While he noted that his task was to provide a diagnosis, rather than a cure, he set out several themes that should be taken forward by the new Labour government.
These were:
- Re-engage staff and re-empower patients
- Lock in the shift of care closer to home by hardwiring financial flows
- Simplify and innovate care delivery for a neighbourhood NHS
- Drive productivity in hospitals
- Tilt towards technology
- Contribute to the nation’s prosperity
- Reform to make the structure deliver
The Darzi review was commissioned by the new government, which said the findings will be used to inform a 10-year plan to reform the NHS.
Sir Keir pledged today that these reforms would be “the biggest re-imagining of our NHS since its birth”.
In his speech, delivered at the King’s Fund, he said: “If we get this right, people can look back and say this was the generation that took the NHS from the worst crisis in its history, got it back on its feet and made it fit for the future.”
The 10-year plan will see the NHS undergo three “big shifts” in how it delivers care, noted Sir Keir, addressing some of the key points in the Darzi report.
These include moving “from an analogue to a digital NHS”, shifting care “from hospitals to community” and “moving from sickness to prevention”.
Sir Keir promised that, instead of the top-down approach of the past, the 10-year plan was “going to have the fingerprints of NHS staff and patients all over it”.
He said: “Only fundamental reform and a plan for the long term can turn around the NHS and build a healthy society.
“It won’t be easy or quick – but I know we can do it.”
Responding to the speech, the general secretary and chief executive of the RCN, Nicola Ranger, said: “The best reform in the NHS looks beyond its own doors and at investment as well as the delivery and standard of each service.
“Only that holistic approach will achieve the aims being set out today by the prime minister.”
Professor Ranger argued that nurses would “stand up to their patients and continue to challenge care standards”.
“They can provide high quality care and believe ministers, with their advice, can make that happen,” she said.
“Today the government has begun its journey to turn around health and care after years of neglect,” she sadded.
“This must start with significant investment in the nursing workforce to make any reforms or shifts viable.”
