Starmer to deliver damning verdict on how Tories left NHS and set out reform vision – UK politics live

Wes Streeting says he wants to reduce the NHS waiting list by “millions” by the time of the next election. (See 9.21am.) Statistics out today show the figure for NHS England is 7.62m, PA Media reports. PA says:

The size of the waiting list for routine hospital treatment in England was unchanged in July, following three consecutive monthly increases, figures show.

An estimated 7.62 million treatments were waiting to be carried out at the end of July, relating to 6.39 million patients, NHS England said.

The list hit a record high in September 2023 with 7.77 million treatments and 6.50 million patients, after which the figures fell for several months before rising in April, May and June of this year.

The Conservatives have accused Labour of not having a “meaningful” plan for NHS reform.

In a statement released overnight in response to the Darzi report, Victoria Akins, the shadow health secretary, said:

We will review this report carefully but it appears that Labour have missed an opportunity to put together meaningful plans for reform.

We Conservatives recognise that investment has to be married with reform. This is why we brought forward long-term plans for productivity, tech, Pharmacy First, virtual wards, attracting pharmaceutical research and training and retaining staff. We did this whilst boosting investment in the NHS in real terms every single year.

The Labour government will be judged on its actions. It has stopped new hospitals from being built, scrapped our social care reforms and taken money from pensioners to fund unsustainable pay rises with no gains in productivity. They need to move from rhetoric to action.

The Darzi report describes the Health and Social Care Act 2012, passed by the coalition government but championed by Andrew Lansley, the Tory health secretary, as a “calamity”. It says:

The Health and Social Care Act of 2012 was a calamity without international precedent. It proved disastrous. By dissolving the NHS management line, it took a “scorched earth” approach to health reform, the effects of which are still felt to this day. It has taken more than 10 years to get back to a sensible structure. And management capability is still behind where it was in 2011.

Some sanity has been restored by the 2022 Act which put integrated care systems on a statutory basis. This has the makings of a sensible management structure, consisting of a headquarters, seven regions and 42 integrated care boards (ICBs) whose strategy to tackle inequalities, and to improve population health, is set by an Integrated Care Partnership (ICP) that includes local government and the third sector alongside the NHS itself.

In an interview with Sky News this morning Atkins said she was surprised by this because she thought Darzi had been in favour of the Lansley reforms at the time. She said:

The puzzlement of that is that I’m told – I wasn’t in parliament at the time – but I’m told that Lord Darzi supported those reforms at the time.

In interviews this morning Wes Streeting, the health secretary, also said that new money for the NHS would be focused on primary care (GP and community services), rather than on hospitals. He was speaking in an interview on BBC Breakfast, and here are the key points.

We’ll be setting out our plans in the budget and the spending review, but effectively it means that when it comes to more resources for the NHS, additional resources going in, the first port of call will be primary care and community services, and social care too, because we’ve got to deal with the systemic problems in our health and care services.

In terms of the schemes that were on what the last government called the New Hospitals Programme, I am determined to deliver those schemes.

But I might have to do it over a longer period of time because I’ve got to make sure, firstly, the money is there, secondly that the timetables are realistic and we’ve got the supply chain, the labour and the resources that we will need, and thirdly I’ve got to balance the need for new bricks and mortar alongside the need for new technology.

If we don’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 in terms of an ageing society and disease and rising costs, rather than a country with an NHS, 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.

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.

In June the NHS waiting list figure was 7.62m, up from 7.6m in May. The figure for July is due out later this morning.

The Darzi report says the NHS has a £37bn shortfall in capital investment. It says:

On top of that, there is a shortfall of £37 billion of capital investment.

These missing billions are what would have been invested if the NHS had matched peer countries’ levels of capital investment in the 2010s. That sum could have prevented the backlog maintenance, modernised technology and equipment, and paid for the 40 new hospitals that were promised but which have yet to materialise. It could have rebuilt or refurbished every GP practice in the country.

Instead, we have crumbling buildings, mental health patients being accommodated in Victoria-era cells infested with vermin with 17 men sharing two showers, and parts of the NHS operating in decrepit portacabins. Twenty per cent of the primary care estate predates the founding of the health service in 1948.

In interviews this morning, Wes Streeting, the health secretary stressed that the new government would not be able to make up for this shortfall quickly. In an interview on Times Radio, asked if the government would be finding an extra £37bn for the NHS, Streeting replied:

No, not in a big bang, and it’s important I say that up front for two reasons.

One is so the chancellor doesn’t have a heart attack over her breakfast this morning with me writing her spending review for her.

But secondly, and very seriously, I think people know that it’s taken more than a decade to break the NHS and it’s going to take time to get the NHS back on its feet, and to make sure it’s fit for the future …

Because we don’t invest in the capital and the tech, day-to-day spending balloons out of control, and then capital and tech budgets are raided to plug the gaps in day-to-day spending, and so the cycle repeats.

In the spending review, the chancellor and I are determined to break that cycle by really focusing on the capital investment and the tech investment that will help us to bring down ballooning costs on the day-to-day spending and improve the productivity of the system.

Good morning. Keir Starmer has been in office for just over two months, and for much of that time the government has focused on trying to explain to the public just how bad was the legacy the left by the Tories. There has been extensive focus on the economy, and on prisons. Today Starmer is focusing on the NHS.

And, arguably, this is the most important issue at all. According to polling by More in Common, at the next election the single issue most likely to determine whether Labour has succeeded or not is whether NHS waiting lists have fallen.

Today the government has published a 163-page report by Lord Darzi, a senior surgeon and member of the House of Lords who served as a health minister under Gordon Brown, about the state of the NHS. Summing up his findings in an article for the Daily Mirror, Darzi says:

The state of the NHS isn’t an accident. The health service was hit by three big shocks. The 2010s saw the biggest slowdown in funding since it was founded in 1948. The next big shock was the top-down reorganisation of the NHS, which threw it into chaos for years. Then came the shock of the Covid pandemic, which hit the NHS harder than other similar countries – largely because of the other two shocks.

Two of the three shocks identified by Darzi are Tory-linked and, in a speech later this morning, Starmer will describe the damage done to the NHS as “unforgiveable”. According to the advance briefing of the speech, “the PM will say that the scale of the damage done to the NHS revealed by the report is ‘unforgivable’, recognising the tragic consequences for too many patients and their families”.

Starmer will say:

People have every right to be angry. It’s not just because the NHS is so personal to all of us – it’s because some of these failings are life and death.

Take the waiting times in A&E. That’s not just a source of fear and anxiety – it’s leading to avoidable deaths.

People’s loved ones who could have been saved. Doctors and nurses whose whole vocation is to save them – hampered from doing so. It’s devastating.

The report goes into considerable detail about what is wrong with the NHS. Today we might hear a bit less about how the government intends to fix these problems, but Starmer will set out the outlines of his approach. He will say:

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.

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.

The challenge is clear before us; the change could amount to the biggest reimagining of our NHS since its birth.

Here is Denis Campbell and Jessica Elgot’s overnight story.

And here is an analysis by Denis, the Guardian’s health policy editor.

Here is the agenda for the day.

9.30am: NHS England publishes its monthly peformance figures.

9.30am: The Office for Budget Responsibility publishes its fiscal risks and sustainability report, which looks at long-term risks to the economy.

10am: Keir Starmer delivers his speech on the NHS, and takes questions from reporters.

Afternoon: Starmer flies to Washington, where tomorrow he is meeting President Biden in the White House.

3pm: Nick Clegg, the former deputy PM who is now a senior Facebook executive, takes part in a Q&A at Chatham House on democracy and technology.

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