The three changes that need to happen to save the NHS

The Prime Minister has laid out the vital need for radical reform in the NHS following a report into the ‘critical condition’ of the health service.

Sir Keir Starmer said the government could not afford to try and fix the wide array of issues by simply pumping in cash, and a series of dramatic changes must be made.

He set out his plans for tackling long waiting lists, improving the nation’s health, and shifting the focus towards community services after a scathing report from Lord Darzi found the NHS in England is ‘in serious trouble’.

Wes Streeting, the health secretary, has said the report – which was released this morning – highlighted the three major changes the institution should urgently make to save it.

He has said they are:

• Shifting from hospital to community care
• Changing from analogue to digital
• Moving from treating sickness to preventing it

Streeting said work to resolve the challenges facing the NHS must start immediately, though a 10 year plan outlining the government’s approach to the reforms will not be published until spring next year.

He also warned the health service could ‘go bust’ if the government doesn’t ‘grasp both the immediate challenge in front of us and deal with the crisis today but also prepare the NHS for the challenges of the future’.

He told BBC Breakfast it is also in terms of ‘an ageing society and disease and rising costs, rather than a country with an NHS’.

He added: ‘We’re going to have an NHS with a country attached to it if we’re not careful, and more likely an NHS that goes bust.

‘That’s not the future we want to see, which is why we’re going to deal with the immediate crisis today, but get the NHS back on its feet and make it fit for the future.’

The rapid review, completed in nine weeks, diagnoses the problems in the NHS and sets out themes for the government to incorporate into a 10-year plan for reforming the health service.

It argues the NHS is facing rising demand for care as people live longer in ill health, coupled with low productivity in hospitals and poor staff morale.

Speaking at an event in London this morning, the Prime Minister said: ‘The NHS is at a fork in the road, and we have a choice about how it should meet these rising demands.

‘Raise taxes on working people to meet the ever-higher costs of an ageing population – or reform to secure its future.

‘We know working people can’t afford to pay more, so it’s reform or die.’

Sir Keir pledges to work on three fundamental areas of reform to make the NHS fit for the future.

He said: ‘This government is working at pace to build a 10-year plan. Something so different from anything that has come before.

‘Instead of the top-down approach of the past, this plan is going to have the fingerprints of NHS staff and patients all over it.

‘And as we build it together, I want to frame this plan around three big shifts – first, moving from an analogue to a digital NHS. A tomorrow service, not just a today service.

‘Second, we’ve got to shift more care from hospitals to communities… And third, we’ve got to be much bolder in moving from sickness to prevention.’

Report highlights the ‘appaling state of the NHS’

The Health Secretary has also vowed to ‘turn the NHS around’ after the damning report into one of the nation’s most-loved institutions.

Wes Streeting said the review highlights the ‘appalling state’ of the health service in England.

He said the findings will inform a 10-year-plan to ‘radically reform’ the NHS.

NHS England chief executive Amanda Pritchard acknowledged that waiting times across many services are ‘unacceptable’ but said teams were working hard to get services back on track.

Streeting said: ‘I asked Lord Darzi to tell hard truths about the state of the NHS. He has produced an honest, expert, comprehensive report on the appalling state our health service is in.

‘Today’s findings will inform our 10-year plan to radically reform the NHS and get patients treated on time again.

‘The damage done to the NHS has been more than a decade in the making. We clearly have a long road ahead.

‘But while the NHS is broken, it’s not beaten. We will turn the NHS around so it is there for you when you need it, once again.’

Ms Pritchard said that NHS staff are facing ‘unprecedented challenges’, adding: ‘Our staff are treating record numbers of patients every day despite ageing equipment and crumbling buildings, a surge in multiple long-term illnesses, and managing the long-lasting effects of the pandemic.

‘While teams are working hard to get services back on track, it is clear waiting times across many services are unacceptable and we need to address the underlying issues outlined in Lord Darzi’s report so we can deliver the care we all want for patients.

‘We are fully committed to working with Government to create a 10-year plan for healthcare to ensure the NHS recovers from Covid, strengthens its foundations and continues to reform so it is fit for future generations.’

The report details a number of concerns about various elements of the health service including:

What is the Lord Darzi report and what are the changes?

Lord Darzi, a widely respected surgeon and former health minister, argues in his report that the NHS can be fixed.

He says: ‘Nothing that I have found draws into question the principles of a health service that is taxpayer-funded, free at the point of use, and based on need not ability to pay.’

Lord Darzi says the country ‘cannot afford not to have the NHS, so it is imperative that we turn the situation around’, adding that the health service ‘is in critical condition, but its vital signs are strong’.

He criticises political decision-making under the Conservatives and the coalition government, including the impact of austerity and the reorganisation of the NHS under Andrew Lansley in 2012.

In his report, Lord Darzi says the ‘Health and Social Care Act of 2012 was a calamity without international precedent. It proved disastrous’.

He continues: ‘In the last 15 years, the NHS was hit by three shocks – austerity and starvation of investment, confusion caused by top-down reorganisation, and then the pandemic which came with resilience at an all-time low.

‘Two out of three of those shocks were choices made in Westminster.’

As part of his recipe for reform, Lord Darzi says the Government must ‘re-engage staff and re-empower patients’ and must ‘lock in the shift of care closer to home’.

Furthermore, there is a need to drive productivity in hospitals through re-engaging staff, getting people out of hospital when they no longer need to be there and investing in buildings and equipment. 

Thomas Brown