Keir lays bare ‘broken’ NHS with thousands of avoidable deaths & tells patients ‘you have a right to be angry’

• Digital Transformation: transition to digital healthcare with innovations like fully digital patient records and the NHS app for self-referrals and data transparency.
• Community-Based Care: shift care from hospitals to local communities, increase GP access, and offer virtual consultations and home-based care through virtual wards.
• Prevention Focus: prioritise prevention with NHS health checks, early interventions, and focus on children's mental health and dental care.
• Integrate Health and Social Care: streamline health and social care to reduce hospital stays and free up resources.
• Workforce Support: end NHS strikes and employ trainee GPs to strengthen the healthcare workforce.
• Long-Term Commitment: a decade-long reform plan to future-proof the NHS.

By Sam Blanchard, Health Correspondent

LORD Darzi's review is shocking but not surprising. It is grim to read all the NHS's faults and failings in one place but people working in and around the health service knew what it would say long before it was written. Unions and member organisations have been screaming about 'challenges' and 'pressures' for years, while millions of patients felt the same problems as anger and agony. We already knew patients were waiting too long, dying too soon and crying out for help. So, too, are staff who worked their fingers to the bone through the pandemic thinking things would improve when Covid blew over - only to find better times never came. Two of Lord Darzi's three main explanations are 'political choices' (the Covid pandemic is number three), which gives Labour a free pass to blame the Tories - but Starmer and Streeting must turn bark into bite, and fast. They say they cannot raise taxes for it and any extra cash would risk being taken from budgets needed for Britain's many other crises, the Health Secretary admitted in a speech last night. Darzi's review calls for more money for GPs - but overloaded hospitals won't open their purses. It calls for spending on new technology and modern buildings - but staff will strike again without pay rises. There is no magic money tree and no magic medicine tree, either. Many of the problems are baked in for years to come: we can improve public health and urge Brits to live healthier lifestyles but that could take a generation to have an impact. The diagnosis is as clear as it can be. Any prescription from Labour will anger somebody somewhere, but it must be unflinching and government and the NHS must actually commit to it for a decade or more.

– The health of the nation has deteriorated, with more years spent in ill-health. Factors affecting health, such as poor quality housing, low income and insecure employment, “have moved in the wrong direction over the past 15 years, with the result that the NHS has faced rising demand for healthcare from a society in distress”.

– There has been a “surge” in multiple long-term conditions, including a rise in poor mental health among children and young people. Fewer children get their vaccines and fewer adults now participate in things such as breast cancer screening.

– Waiting times targets are being missed across the board, including for surgery, cancer care, A&E and mental health services. The report says “long waits have become normalised” and “A&E is in an awful state”, with long waits likely to be causing an additional 14,000 more deaths a year, according to the Royal College of Emergency Medicine. By April 2024, about one million people were waiting for mental health services. The overall NHS waiting list stands at 7.6 million.

– People are struggling to see their GP. “GPs are seeing more patients than ever before, but with the number of fully qualified GPs relative to the population falling, waiting times are rising and patient satisfaction is at its lowest ever level.”

– Cancer care still lags behind other countries and cancer death rates are higher than in other countries. There was “no progress whatsoever” in diagnosing cancer at stage I and II between 2013 and 2021. However, more recent figures show some improvement.

– Progress in cutting death rates from heart disease has stalled while rapid access to treatment has deteriorated. For example, the time for the highest-risk heart attack patients to have a rapid intervention to unblock an artery has risen by 28% from an average of 114 minutes in 2013-14 to 146 minutes in 2022-23.

– The NHS budget “is not being spent where it should be” and too great a share is being “spent in hospitals, too little in the community, and productivity is too low”. Too many hospital beds are taken up with people needing social care.

– Between 2009 and 2023 the number of nurses working in the community fell by 5%, while the number of health visitors dropped by nearly 20%.

– At the start of 2024, 2.8 million people were economically inactive due to long-term sickness, with most of the rise since the pandemic down to mental health conditions. The report said “being in work is good for wellbeing” and having more people in work grows the economy. “There is therefore a virtuous circle if the NHS can help more people back into work.”

– Raids on capital budgets have left the NHS with crumbling buildings and too many outdated scanners, and “parts of the NHS are yet to enter the digital era”. The report says the “NHS is in the foothills of digital transformation”.

– The NHS delayed, cancelled or postponed far more routine care during the pandemic than any comparable health system.

– Too many NHS staff are “disengaged” and there are “distressingly high-levels of sickness absence”. The pandemic was “exhausting” for many and the result has been a “marked reduction in discretionary effort across all staff groups”.

– Regulatory-type organisations now employ some 7,000 staff, or 35 per NHS provider trust, having doubled in size over the past 20 years.