Keir Starmer's reform plan to plug NHS health gap

Prime Minister demands move from analogue to digital as report highlights 'critical' state of UK medical care

Britain's Prime Minister Keir Starmer during a visit to University College London Hospital. AFP

Prime Minister Keir Starmer has said there is no more money for Britain’s National Health Service without widescale reform.

As part of a ten-year plan to transform the NHS and put millions of Britons back to work, the Labour leader made a key speech highlighting the service's failures, along with a three-point plan to reform it.

While blaming the 14 years of Conservative rule for the NHS’s parlous position, Mr Starmer warned that the failures in the system, which have been blamed for 14,000 premature deaths a year, would take at least ten years to fix.

More money would be poured into the service after it is rapidly digitalised, more people are moved into community care and prevention is used as a key element to cut down hospital numbers.

His warnings came following a two-month deep dive inquiry into the health service’s state by the Iraqi-born peer and former surgeon Ara Darsi who concluded that the NHS was in a “critical condition”.

Golden inheritance blown

Two months into his premiership, Mr Starmer is continuing his pattern of explaining Britain’s current poor state by blaming it on the 14 years of Conservative rule.

He said the country had, when the Tories took power in 2010, been handed a “golden inheritance” of an NHS with short waiting lists and a content staff.

But that had been squandered with ill-advised reforms in 2012 that had been “unforgivable, and people have every right to be angry” over lack of care.

There are currently 7.6 million people waiting for hospital treatment a considerable increase from 2.4 million in 2010.

Ten-year plan - digitial, neighbourly, prevention

The government is working on a ten-year plan that entails “three fundamental reforms”, key of which would be moving from analogue to digital NHS.

More than 12,000 patients were in beds – “enough to fill 28 hospitals” – because there is no provision for them to be looked after at home, the Prime Minister said.

Britain needed to turn its NHS “into a neighbourhood health service” with tests, scans and healthcare offered on the high street along with the return of the family doctor.

Thirdly there needed to be long-term investment in new technologies to catch and prevent problems much earlier, including NHS health checks in workplaces including blood pressure tests.

“The NHS may be broken, but it's not beaten,” Mr Starmer said, but with an ageing population it was at a critical junction where the choice was “don’t act and leave it to die” or “reform or die”.

Cancer care

Lord Ara Darzi, the widely respected surgeon born in Baghdad to Armenian parents, was forensic and eviscerating in his 142-page condemnation of the NHS.

Declining cancer care meant British patients had “significantly worse survival rates” than other countries, with only two-thirds of patients treated within two months of referral.

“The UK has appreciably higher cancer mortality rates than other countries,” he wrote. “No progress whatsoever was made in diagnosing cancer at stage I and II between 2013 and 2021.”

Research showed that only about 5 per cent of eligible patients with brain cancer were able to access whole genome sequencing, which was key to treatment selection.

In addition, more than 30 per cent of patients were waiting longer than 31 days for radical radiotherapy.

Heart failure

Heart disease treatment had “gone in the wrong direction” since 2010 and heart attack victims had to wait 146 minutes on average for emergency artery procedures, up from 114 minutes in 2013, the report found.

Cardiovascular disease mortality rate for people aged under 75 dropped significantly between 2001 and 2010 but improvements “have stalled since then” and the mortality rate started rising during the Covid-19 pandemic.

Quick access to treatment has declined and the percentage of suspected stroke patients to receive the necessary brain scan within an hour of hospital arrival varied from 80 per cent in Kent to just 40 per cent in Shropshire.

Waiting times for accident and emergency units have increased so considerably that patients now have 100 people ahead of them in the queue when attending, up from 40 people in 2009.

Lord Darzi stated that the NHS, which is the world’s fifth largest employer with 1.7 million staff, despite a £165 billion budget – about 40 per cent of Britain’s GDP - with “more resources than ever before” it was “in an awful state”.

Staff disengaged

While staff numbers had risen by 17 per cent since 2019, productivity had decreased by 11 per cent due to a lack of beds and diagnostics.

“Too many staff are disengaged,” the report said. “There are distressingly high-levels of sickness absence – as much as one working month a year for each nurse and each midwife.”

The pandemic had been “exhausting for many and its aftermath continues to reverberate” as NHS staff not only mourned deaths of their colleagues but had to abide by grim Covid rules. This included mothers forced to give birth alone and elderly patients who “had to die without the comforting touch of their loved ones”.

The voices of patients were also “not loud enough” and the NHS needed to treat them “with dignity, compassion and respect”.

Yet patient satisfaction had declined, and complaints increased with a number of failings not acted upon. As a result, the NHS was paying out record sums in compensation which currently total £3 billion or 1.7 per cent of the entire NHS budget.

Reform or we die

A leading health professor at University College London, Dr Ilan Kelman, told The National that it was not a question of “reform or die” for the NHS, as Mr Starmer stated, but for the NHS to reform "or we will continue to die”.

“It's the staff of the NHS in particular who are the most vocal about saying that the NHS is not serving us,” he said. "Doctors are exhausted. Nurses are overworked. The wards are not sufficient to keep people alive.”

But he welcomed Mr Starmer’s plans to reform the service as “people are dying in large numbers when it should be treatable, preventable and dealt with”.

In particular, digitalisation as healthcare staff were “using post it notes when they should be using secure digital services”.

While the 10-year plan was “too long” it was probably the length of time needed for proper reform.

“Currently the NHS is not fit for purpose as it really has been underfunded and deprioritised for far too long across successive governments,” he said.

Victoria Atkins, the former Conservative health secretary, condemned the government’s report as “political posturing”, saying there was “much to be proud of” in the NHS especially as it was looking after 1.6 million people a day, 25 per cent more than in 2010.

But an NHS manager based in southern England told The National that staff had “a lot of trust” in Lord Darzi and that his report was “broadly accurate”.

“What we need is for the NHS to ‘pull’ people out of hospitals into communities rather than ‘push’ them,” he said. “They should be given 48 or 72 hours to recover before returning home and they really need to get behind this issue of taking care of people in the communities.”

He added that the government should not focus on a ten-year plan as it could be scuppered by parliamentary elections in five years. “They should aim to get 80 per cent of the work done in three years then do the rest if they get re-elected,” he said.