Starmer says no extra NHS funding without big reforms

UK Prime Minister Keir Starmer has promised the biggest 'reimagining' of the NHS in its history but stressed there would be no more funding without sweeping reforms.

The comments – made in the wake of the publication of the much-anticipated Darzi report on the NHS this morning – came as the government said it would publish a 10-year plan next year built around three key themes – moving care from hospitals to communities, transitioning to a digital service, and a focus on prevention rather than treatment.

Taking the previous Conservative government to task, Starmer highlighted the long-term impact of the 2012 Health and Social Care Act – described by Darzi as "a calamity without international precedent" and "disastrous," as well as the consequences of underinvestment throughout the 2010s under the then government's austerity policies.

"It is unforgivable, and people have every right to be angry – not just because the NHS is so personal to all of us, or because when people can't get the care they need and are off sick, it is a huge cost to our economy, but because some of these failings are literally life and death," he said.

"Crumbling buildings, decrepit portacabins, mental health patients accommodated in Victorian-era cells infested with vermin," continued the PM. "The 2010s were a lost decade for our NHS… which left the NHS unable to be there for patients today, and totally unprepared for the challenges and opportunities of tomorrow."

Hitting back, the Conservatives have accused the government of "political posturing" and said it must turn its rhetoric into action after abandoning policies introduced under the previous administration, including social care reform and plans to build new hospitals.

The solution is "major surgery, not sticking plaster solutions," said Starmer, who pledged that all reforms would not be a top-down approach but would have "the fingerprints of NHS staff and patients all over it."

Among the priorities highlighted in the speech at the King's Fund annual conference was a need to improve the UK's dismal performance on avoidable and preventable mortality, tackle ill health as a brake on economic productivity, and reduce pressures on the NHS.

"The NHS is the right model, but it's not taking advantage of the opportunities in front of it," said Starmer, promising to keep to the principles of providing a health service that is taxpayer-funded, free at the point of use, and based on need not ability to pay. "No more money without reform. We have to fix the plumbing before we turn on the taps."

The British Medical Association concurred with Starmer's assessment of the previous government's record and called for "continued progress on restoring doctors' pay, preventing the loss of junior doctors to other countries that truly value their contributions and removing absurd pension rules that discourage senior doctors from taking on the extra shifts needed to reduce waiting lists."

The Association of the British Pharmaceutical Industry (ABPI) also welcomed a promise to put "the full weight of the British government behind our world-leading life sciences", but stressed that making better use of new medicines and vaccines has to be "part of the picture."

The trade body's chief executive Richard Torbett said that, in return: "We can't wait to throw our weight behind the NHS's, and society's, recovery."

Meanwhile, the general manager of Sanofi UK & Ireland's vaccine business, Rebecca Catterick, called on the government to make changes to the ecosystem to vaccinations as a key part of its prevention drive, pointing out that falling rates of immunisation is identified in the Darzi report as one of the most serious dangers posed to children's health.

Photo by Nicolas J Leclercq on Unsplash