With permission, I would like to make a statement on Lord Darzi’s investigation into the NHS.
Unlike the last holders of this office, this Government will be honest about the problems the NHS faces and serious about fixing them. That is why I asked Lord Darzi, an eminent cancer surgeon who served both Labour and Conservative-led Governments with distinction, to conduct an independent investigation into the state of our national health service. I am sure the whole House will want to join me in thanking him for producing this expert, comprehensive report, a copy of which I have placed in the Libraries of both Houses.
I told Lord Darzi that we wanted hard truths, warts and all. His findings are raw, honest and breathtaking. He says:
“Although I have worked in the NHS for more than 30 years, I have been shocked by what I have found”.
He has uncovered an enormous charge sheet, too long to list in this statement, so these are just a few: the NHS has not been able to meet its promises to treat patients on time for almost a decade; patients have never been more dissatisfied with the service they receive; waiting lists for mental health and community services have surged; 50 years of progress on cardiovascular disease is going into reverse; and cancer is more likely to be a death sentence for NHS patients than for patients in other countries. It is not just the sickness in the NHS that concerns Lord Darzi, but sickness in society. Children are sicker today than a decade ago and adults are falling into ill health earlier in life. That is piling pressure on to the NHS and holding back our economy.
Those are some of the symptoms; the report is equally damning on the causes. First, a decade of under-investment left the NHS 15 years behind the private sector on technology, with fewer diagnostic scanners per patient than almost every comparable country, including Belgium, Italy and Greece, and in 2024 mental health patients are treated in Victorian buildings with cockroach and mouse infestations, where 17 men are forced to share two showers.
Secondly, there was the disastrous 2012 top-down reorganisation overseen by Lord Lansley. Lord Darzi’s assessment is damning:
“A calamity without international precedent…it took a ‘scorched earth’ approach to health reform”.
“By 2015…ministers were…putting in place ‘workarounds and sticking plasters’ to bypass the legislation”.
“Rather than liberating the NHS, as promised, the Health and Social Care Act 2012 imprisoned more than a million NHS staff in a broken system for the best part of a decade”.
“the effects…are still felt to this day.”
Just imagine if all the time, effort and billions of pounds wasted on dissolving and reconstituting management structures had instead been invested in services for patients—clearly, the NHS would not be in the mess it finds itself in today.
Thirdly, there was coronavirus. Everyone can see the lasting damage caused by the pandemic, but until now we did not know that the pandemic hit the NHS harder than any other comparable healthcare system in the world.
The NHS cancelled far more operations and routine care than anywhere else. As Lord Darzi writes:
“The pandemic’s impact was magnified because the NHS had been seriously weakened in the decade preceding its onset.”
In other words, it is not just that the Conservatives did not fix the roof while the sun was shining; they doused the house in petrol and left the gas on, and covid just lit the match. That is why waiting lists have ballooned to 7.6 million today. [Interruption.] If I were an Opposition Member, I would not complain about the diagnosis. I would take responsibility.
Fourthly—this sits firmly at Opposition Members’ door, so they should sit and listen—there was the failure to reform. From 2019 onwards, the previous Government oversaw a 17% increase in the number of staff working in hospitals. Did it lead to better outcomes for patients? No. At great expense to the taxpayer, the NHS has instead seen a huge fall in productivity. We paid more, but got less—a deplorable waste of resources when so many parts of our health and care services were crying out for investment. As Lord Darzi has put it:
“British Airways wouldn’t train more pilots without buying more planes.”
Doctors and nurses are wasting their time trying to find beds for their patients and dealing with outdated IT when they ought to be treating patients.
Too many people end up in hospital because they cannot get the help that they need from a pharmacy, a GP or social care. The effective reforms of the last Labour Government, which drove better performance and better care for patients, have mostly been undone, and that is why patients cannot get a GP appointment, an operation or even an ambulance when they need one today. That is what the Conservatives did to take the NHS from the shortest waiting times and highest patient satisfaction in history to the broken NHS that we see today.
Lord Darzi has given his diagnosis. Now it is over to us to write the prescription, and we have three choices. The first is to continue the Conservatives’ neglect, and allow the NHS to collapse. That is the path on which they set the NHS, and the path that it is on today. Or we could—as some of my critics on the left demand—pour ever-increasing amounts of money in without reform, wasting money that is not there and that working people cannot afford to pay. That would be wasteful and irresponsible, so we will not take that path. This Government are making a different choice: we choose recovery and reform. We are taking action today to deal with the immediate crisis by hiring 1,000 GPs whom the Conservatives had left without a job while patients were going without an appointment, and agreeing an offer to end the strikes that they allowed to cripple our health service.
At the same time, we will introduce the fundamental reforms needed to secure the future of our NHS. Earlier today, my right hon. Friend the Prime Minister confirmed that the Government would publish a 10-year plan for change and modernisation, on the foundation of Lord Darzi’s report. Our plan will deliver the three big shifts needed to make our NHS fit for the future. The first is from analogue to digital, giving patients proper choice and control over their own healthcare, and finally realising the untapped potential of the NHS app. There will be fully digital patient records so that your surgeon can see the notes that your GP writes. By marrying our country’s leading scientific minds with the care of more than 1.5 million NHS staff, we will put NHS patients at the front of the queue for cutting-edge medicines and treatments that we can only imagine today.
Secondly, there is the shift from hospital to community, turning our NHS into a neighbourhood as much as a national health service so that patients can get their tests and scans on their high streets and be cared for from the comfort of their own homes. That means bringing back the family doctor and building a national care service that can be there for us when we need it, able to meet the challenges of this century.
Thirdly, there is the shift from sickness to prevention, which means taking the decisions that the Conservatives ducked to give our children a healthy, happy start in life. It means stopping the targeting of junk food ads at children, banning energy drinks for under-16s, reforming the NHS to catch illness earlier—starting by offering health checks in workplaces and on smartphones—and delivering the Tobacco and Vapes Bill that the Conservatives failed to pass, to tackle one of society’s biggest killers.
Lord Darzi’s diagnosis is that the NHS is in a “critical condition”—unless we perform major surgery, the patient will die—but he also finds that
“its vital signs are strong”:
an extraordinary depth of clinical talent, and a shared determination to improve care for patients. This is a public service, free at the point of use, so that whenever we fall ill we never have to worry about the bill. The NHS is broken, but it is not beaten. Every person I have met in the NHS during my first two months as Health and Social Care Secretary is up for the challenge. It will take time, but this party—the party that created the NHS—has turned the NHS around before, and we will do it again. I commend this statement to the House.