The findings of the study by Lord Ara Darzi, commissioned by Labour when it came to power, will be cited by Prime Minister Keir Starmer. He will announce that the NHS must "reform or die".
In a detailed analysis of England's NHS woes and the road to recovery, Darzi warns the Prime Minister that it will take his government more than the 5 years Labour promised before the election to bring waiting times back to normal. He found out personally that the task would take "4 to 8 years".
"I have no doubt that significant progress will be possible, but it is unlikely that waiting lists can be cleared and other performance standards restored within one parliamentary term," Darzi said.
Starmer will use his major speech dedicated to the NHS to rule out tax rises as a way of finding the extra billions of pounds experts say the health system needs.
The 142-page report by Darzi, a cancer surgeon and health minister in Gordon Brown's cabinet, is a damning critique of how years of neglect of the NHS by previous governments have left it "in a critical state" and no longer able to give patients the continued care they need. This comes amid an explosion of demand caused by the UK's ageing, growing and increasingly sick population.
Darzi's scathing report on the Conservatives' 14-year stewardship of the NHS says A&E is in a terrible state. He refers to evidence he has received from the body representing A&E doctors that 'long waits are probably causing an extra 14,000 deaths a year. This is more than 2 times the number of all battle deaths in the British armed forces since the health service was established in 1948.
He details how the NHS has experienced 3 shocks in the 2010s: austerity funding under the Conservative and Liberal Democrat coalition governments; Andrew Lansley's disastrous reorganisation and the arrival of Kovid - the first 2 of which were "choices made at Westminster".
In his response, Starmer will accuse successive Conservative administrations from 2010 to July 2024 of causing "unforgivable" damage to the NHS, including avoidable deaths due to long waits for help in A&E. He will also seek to reassure constituents that the service will improve as a result of a 10-year plan to revitalise its condition. Labour is expected to unveil it early next year.
The Prime Minister will promise "long-term health reform - serious surgery, not easy band-aid solutions".
He will also outline a future in which much care will be moved from hospitals to community services and there will be a determined drive to tackle the rise in the number of people with long-term conditions, such as diabetes, heart and lung disease, through better prevention measures.
The Darzi report also states that:
- The number of people forced to wait more than a year for hospital treatment they should have received within 18 weeks has increased 15-fold since March 2010, from 20,000 to more than 300,000.
- Improvements in cancer survival "slowed significantly in 2010".
The quality of care in some key areas, such as maternity care, is now a real concern.
- Although it has more staff and a record budget, the NHS is less productive than before because many buildings are very old and the NHS is 'starved' of capital funding.
- Since Kovid, many staff have become 'disengaged' and now do much less additional work of their own accord.
- The state of the under-resourced social care sector is "dire" and poses "an increasing burden on families and the NHS, resulting in huge human loss and economic impact".
"This report shows that the NHS is on its knees after years of the Conservatives failing local health services," Liberal Democrat leader Ed Davey said. He added that fixing the health service was the biggest challenge facing this country.
Starmer has come under increasing pressure from his government, which is already facing tough decisions on public spending, to find extra funds to boost the NHS recovery. Thea Stein, chief executive of the Nuffield Trust think-tank, has called on Rachel Reeves to use her first Budget next month to plug a multi-billion pound hole in NHS England spending this year.
The Treasury is carrying out a multi-year spending review, due to report in spring 2025. But the level of overall public sector spending envisaged for the next Parliament would currently mean cuts similar to those seen under David Cameron's government.
Reeves has already announced a delay to the Conservatives' new hospital programme, which was a pledge to build or expand 40 NHS hospitals by 2030, citing the £22bn fiscal black hole left by the previous government.
In his speech, Starmer will explicitly rule out raising direct taxes to boost the NHS budget. The Health Foundation reports that the NHS in England alone will need an extra £46 billion by 2029.
The British Prime Minister will also say: the NHS is at a crossroads and we can choose how to meet these growing demands. Increase taxes on working people to meet the rising costs of an ageing population, or implement reforms to secure its future. We know that working people cannot afford to pay more, so it must reform or die." | BGNES
