With permission, Madam Deputy Speaker, I shall make a statement to the House on “Fit for the Future”, the Government’s 10-year health plan for England.
There are moments in our national story when our choices define who we are. In 1948, the Attlee Government made a choice founded on fairness: that everyone in our country deserves to receive the care they need, not just the care they can afford. It enshrined in law, and in the service itself, our collective conviction that healthcare is not a privilege to be bought and sold, but a right to be cherished and protected.
Now it falls to our generation to make the same choice: to rebuild our national health service, and to protect in this century what Attlee’s Government built for the last. That is the driving mission of our 10-year plan.
In September, Lord Darzi provided the diagnosis: the NHS was broken by 14 years of Conservative under-investment, and by their catastrophic top-down reorganisation. In the past year, Labour has put the NHS on the road to recovery. We promised 2 million extra appointments; we have delivered more than 4 million. We promised 1,000 new GPs on the frontline; we have recruited 1,900. We have taken almost a quarter of a million people off waiting lists, cutting them to their lowest level in two years. And we have launched an independent commission, chaired by Baroness Casey, to build a national consensus around a new national care service to meet the needs of older and disabled people into the 21st century.
Today, the Prime Minister has set out our prescription to get the NHS back on its feet and make it fit for the future. Our plan will deliver three big shifts. The first is from hospital to community. We will turn our national health service into a neighbourhood health service. The principle is simple: care should happen as locally as it can—digitally by default, in a patient’s home if possible, in a neighbourhood health centre when needed, and in a hospital where necessary.
We will put neighbourhood health centres in every community, so people can see a GP, nurse, physio, care worker, and therapist, and they can get a test, scan or treatment for minor injuries, all under one roof. The NHS will be organised around patients, rather than patients having to organise their lives around the NHS. It will be easier and faster to see a GP. We will train thousands more, end the 8 am scramble, provide same-day consultations, and bring back the family doctor. If you are someone with multiple conditions and complex needs, the NHS will co-create a personal care plan, so your care is done with you, not to you.
Pharmacies will play an expanded role in the neighbourhood health service. They will manage long-term conditions, treat conditions such as obesity and high blood pressure, screen for disease and vaccinate against it. We will also reform the dental contract, to get more dentists doing NHS work, rebuilding NHS dentistry.
Over the course of this plan, the majority of the 135 million out-patient appointments done each year will be moved out of hospitals. The funding will follow, so a greater share of NHS investment is spent in primary and community care.
The second shift is from analogue to digital. No longer will NHS staff have to enter seven passwords to login to their computers, or spend hours writing notes and entering data. Our plan will liberate frontline staff from the parts of the job that they hate, so they can focus on the job that they love—caring for patients. For the first time ever, patients will be given real control over a single, secure and authoritative account of their data. The single patient record will mean that NHS staff can see medical records and know a patient’s medical history, so they can provide them with the best possible care.
Wearable technology will feed in real-time health data, so patients’ health can be monitored while they stay in the comfort of their own home, with clinicians reaching out at the first signs of deterioration. The NHS app will become the front door to the health service, delivering power to the patient. You will be able to: book and rearrange appointments for you, your children or a loved one you care for; get instant advice from an AI doctor in your pocket; leave feedback on your care and see what feedback other patients have left; choose where you are treated; book appointments in urgent care so you do not wait for hours; and refer yourself to a specialist where clinically appropriate. Of course, patients can already do all that, but only if they can afford private healthcare. With Labour’s plan, every patient will receive a first-class service—whatever their background and whatever they earn.
The third shift is from sickness to prevention. Working with the food industry, we will make the healthy choice the easy choice to cut calories. We will roll out obesity jabs on the NHS. We will get Britain moving with our new NHS points scheme, and we will update school foods standards so that kids are fed healthy, nutritious meals. We will tackle the mental health crisis with support in every school to catch problems early, 24/7 support with virtual therapists for those with moderate need, and dedicated emergency departments for patients for when they reach crisis point.
The science is on our side. The revolution in artificial intelligence, machine learning and big data offers a golden opportunity to deliver better care at better value. New innovator passports and reform of the National Institute for Health and Care Excellence and the Medicines and Healthcare products Regulatory Agency will see medicines and technology rapidly adopted. Robotic surgery will become the norm in certain procedures, so patients recover from surgery at home rather than in hospital beds. The NHS will usher in a new age of medicine, leapfrogging disease so that we are predicting and preventing, rather than just diagnosing and treating. It is therefore the ambition of the plan to provide a genomic test for every newborn baby by 2035. Thanks to my right hon. Friend the Chancellor, this plan is backed by an extra £29 billion a year by the end of the spending review period, as well as the biggest capital investment in the history of the NHS.
Alongside investment comes reform. This plan slashes unnecessary bureaucracy and devolves power and resource to the frontline. It abolishes more than 200 bodies, because listening to patients, guaranteeing safety and protecting whistleblowers is core business for the NHS and should never have been outsourced. The plan commits to publishing league tables to rank providers. We will intervene to turn around failing providers, and we will reinvent the foundation trust model in a new system of earned autonomy. Pay will be tied to performance, so that excellence is recognised and failure has consequences. Tariffs will be reduced to boost productivity. Block contracts will end, with funding tied to outcomes. The plan gives power to the patient, so hospitals are financially rewarded for better service. It closes health inequalities by investing more in working-class communities, and it establishes a national investigation into maternity and neonatal services to deliver the truth, justice and improvement that bereaved families deserve.
I am sometimes told that NHS staff are resistant to change. On the contrary, they are crying out for it. They suffer the moral injury of seeing their patients treated in unfit conditions. They are ones driving innovation on the frontline, so their fingerprints are all over this plan. The public are desperate for change too. Each of us has our own story about the NHS and the difference it made to our lives. We also know the consequences of failure. To succeed, we need to defeat the cynicism that says that nothing ever changes.
We know that the change in our plan is possible because it is already happening. We have toured the length and breadth of the country and scouted the world for the best examples of reform. If Australia can effectively serve communities living in the outback, we can surely meet the needs of rural England. If community health teams can go door to door to prevent illness in Brazil, we can certainly do the same in Bradford. We know that we can build the neighbourhood health service, because teams in Cornwall, Camden, Northumbria, and Stratford—where I was with the Prime Minister and Chancellor this morning—are already showing us how to do it. We will take the best of the NHS to the rest of the NHS. We will apply to best examples of innovation from around the world to benefit people here at home. Above all else, we will give power to the patient. This plan fulfils Nye Bevan’s commitment in 1948 to put a megaphone to the mouth of every patient. It will restore the founding promise of the NHS to be there for us when we need it.
Of course, we know that there are those on the right who are willing us to fail. They will exploit the crisis in the NHS in order to dismantle it. The hon. Member for Clacton (Nigel Farage) and his cronies argue that universal healthcare could be afforded in the 20th century but not in the 21st. Labour rejects their declinist pessimism and so do the public. But that is the choice—it is change or bust, and we choose change.
We know that the British people are counting on us. It falls to us to ensure that the NHS not only survives but thrives, and we will not let our country down. Of course, if we succeed, we will be able to say with pride that will echo down the decades of the 21st century that we were the generation who built an NHS fit for the future and a fairer Britain where everyone lives well for longer. I commend this statement to the House.