The Prime Minister Sir Keir Starmer is pledging the ‘biggest reimagining of our NHS since its birth’, following the publication of Lord Darzi’s full and independent investigation into the state of the NHS.
Lord Ara Darzi’s probe has concluded the service is in a ‘critical condition’ amidst surging waiting lists and a deterioration in the nation’s underlying health, identifying serious and widespread problems for people accessing services.
He will also address the causes behind the state of the NHS, including the long-term impacts of the 2012 Health and Social Care Act which is described in the report as “a calamity without international precedent” which “proved disastrous”, as well as the far-reaching consequences of underinvestment throughout the 2010s.
Rooted in Lord Darzi’s diagnoses of the challenges facing the NHS, the PM will outline three fundamental areas of reform and the imperative to work with staff and patients throughout this process. He says: “This government is working at pace to build a Ten-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.”
For his report, Lord Darzi examined over 600 pieces of analysis from DHSC, NHS England and external organisations during his investigation. His report will inform the government’s 10-year plan to reform the health service.
Lord Darzi said: “Although I have worked in the NHS for more than 30 years, I have been shocked by what I have found during this investigation - not just in the health service but in the state of the nation’s health. We want to deliver high quality care for all but far too many people are waiting for too long and in too many clinical areas, quality of care has gone backwards. My colleagues in the NHS are working harder than ever but our productivity has fallen.
“We need to rebalance the system towards care in the community rather than adding more and more staff to hospitals. And we need a more honest conversation about performance - the NHS is now an open book.”
Despite the damning analysis, Lord Darzi insists the NHS’s vital signs ‘remain strong’ and he praised staff for their ‘shared passion and determination to make the NHS better for our patients’.
In carrying out the review, Lord Darzi brought more than 70 organisations together in an Expert Reference Group and sought input from NHS staff and patients through focus groups and frontline visits.
Key findings from Lord Darzi’s 142-page report include:
Deterioration: The health of the nation has deteriorated over the past 15 years, with a substantial increase in the number of people living with multiple long-term conditions.
Spending: Too great a share of the NHS budget is being spent in hospitals, too little in the community, and productivity is too low.
Waiting times: Waiting lists have swelled and waiting times have surged, with A&E queues more than doubling from an average of just under 40 people on a typical evening in April 2009 to over 100 in April 2024. 1 in 10 patients are now waiting for 12 hours or more.
Cancer care: The UK has appreciably higher cancer mortality rates than other countries, with no progress whatsoever made in diagnosing cancer at stage one and two between 2013 and 2021.
Lasting damage: The Health and Social Care Act of 2012 did lasting damage to the management capacity and capability of the NHS. It took 10 years to return to a sensible structure, and the effects continue to be felt to this day.
Productivity: Too many resources have been being poured into hospitals where productivity had substantially fallen, while too little has been spent in the community.