NHS to receive ‘no more money without reform’, says Starmer

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Sir Keir Starmer vowed the NHS would receive “no more money without reform” as he warned it would take a decade to fix England’s health service in the wake of a damning report.

Britain “can’t go on” with continued falls in NHS productivity and climbing waiting lists, the prime minister said, as he called the findings of Lord Ara Darzi’s government-commissioned report “really profound”.

The report published on Thursday said that the health service was in a “critical condition” after suffering a £37bn shortfall in capital spending compared with peer nations.

It attributed the state of the health system in large part to the austerity policies of the 2010s, which slashed public spending in a bid to cut the budget deficit, as well as the pandemic and declining health of the nation.

In a speech on Thursday morning addressing the findings, Starmer pledged to carry out the “biggest reimagining of our NHS since its birth”. He said: “We know working people can’t afford to pay more, so it’s reform or die.”

The prime minister warned that reform will “take a decade to do it properly, it will take more than one parliamentary term”. Asked why his government would be able to deliver sweeping reforms that successive governments had promised but failed to deliver in full, he pointed to his past roles overhauling the Crown Prosecution Service and the Labour party, saying: “I’ve reformed before.”

Setting out the government’s top three priorities for reform, Starmer vowed to move the NHS away “from an analogue to a digital” service, shift more care from hospitals to communities and “be much bolder in moving from sickness to prevention”.

He said: “We have to go to a preventative model, I’m absolutely convinced about that”, adding that the government would be more ambitious on early interventions in areas such as children’s mental health and dentistry.

“I know some prevention measures will be controversial but I’m prepared to be bold, even in the face of loud opposition,” he said, pointing to a range of preventative fields, including diet and lifestyle. “I know some of [the measures] will be welcome and I know some of them will be controversial. They always are, but unless we shift the model, I don’t think we can bring about the change that we need.”

The government is due to publish a 10-year plan for the health service next year, which he said will include additional investment in infrastructure and equipment.

Starmer also said the government was committed to building the 40 new hospitals set out in the former government’s New Hospitals Programme.

“We will deliver against it but I want a realistic timetable for delivery,” he said, adding that the last government had made promises that were not deliverable and some of the hospitals were not new projects and some were not even hospitals.

Earlier on Thursday Wes Streeting, health secretary, promised to reduce NHS waiting lists by “millions” over the coming five years as he pledged to go “hell for leather” to reform England’s health service.

Streeting told BBC Breakfast on Thursday morning: “I’m going hell for leather to get the NHS back to what’s known as the constitutional standards, the targets it sets for itself, over the five-year period that we committed to, and to make sure that by the end of this parliament we see waiting lists millions lower than they are today.”

Streeting also called on Thursday for the British Medical Association, the doctors’ union, to stop “sabre-rattling” over a dispute over government funding for general practice.

Some GP surgeries across England are capping the number of patients they see each day, as family doctors stage industrial action.

“I do not find resistance in the NHS, people are crying out for change, and I have some good conversations with the BMA, actually, on reform,” Streeting told BBC Radio 4’s Today programme on Thursday.

“I think GPs want to work with this government,” he added. “They can see the seriousness of our intent and GPs really care about their patients. They want, as we do, to rebuild the family-doctor relationship.”