Prime Minister Keir Starmer issued a stark warning on Thursday, stating that Britain's state-run National Health Service (NHS) must either "reform or face extinction," following an independent report that described the revered institution as being in a "critical condition." Starmer, whose Labour Party secured a landslide victory in July, pledged to undertake "the most significant reimagining" of the NHS since its inception 76 years ago. His address in central London came on the heels of the release of a 142-page investigative report, which revealed that the health of Britons has declined over the past 15 years.
The report's author, Lord Ara Darzi, an independent member of the House of Lords, attributed the NHS's decline to inadequate investment compared to other nations, top-down reorganizations, and the impact of the COVID-19 pandemic. "What we require is the courage to implement long-term reforms—major surgery, not just temporary fixes," Starmer emphasized, noting that it would take a decade to rebuild the service. "The NHS stands at a crossroads, and we must decide how it will meet these challenges." He proposed two options: either raise taxes on working people to cover the escalating costs associated with an ageing population, or implement reforms to ensure the NHS's future. "Working people cannot afford to pay more, so it's either reform or face extinction," Starmer asserted.
Starmer outlined three key areas of reform for a 10-year plan aimed at revitalizing the NHS, which, despite its struggles to meet demand, remains a source of national pride due to its universal healthcare model. He announced that the NHS would transition fully from analogue to digital systems, shift more care from hospitals to community settings, and adopt a more proactive approach to health prevention rather than just treating illness. Starmer assured that these reforms would not undermine the NHS's founding principle of providing free treatment at the point of care, and he reiterated that he would not allocate additional funds without accompanying reforms.
The Labour Party ousted the Conservatives from power on July 4, in part due to a promise to "fix" the NHS, which they accused the Tories of having "broken" during their 14-year tenure. "The 2010s were a lost decade for our NHS, a period during which the Conservatives left the NHS incapable of serving patients today and wholly unprepared for the challenges and opportunities of tomorrow," Starmer added. Darzi's report highlights that the NHS is experiencing a surge in patients with multiple chronic conditions such as diabetes and high blood pressure. It also points out that the UK has higher cancer rates than other countries and is lagging in the treatment of major health conditions. Additionally, the report notes that waiting lists have ballooned to 7.6 million, with one in ten patients in accident and emergency departments now waiting 12 hours or more before being seen.
Darzi expressed shock at his findings but maintained that the NHS's core strengths remain intact. Just over a year ago, his predecessor, former Tory Prime Minister Rishi Sunak, announced a 15-year initiative to recruit over 300,000 staff to address the chronic shortage of doctors and nurses. At the time, it was projected that the NHS would face a staff deficit of 360,000 by 2037 due to an ageing population, insufficient domestic health worker training, and challenges in recruiting and retaining staff, partly due to new visa regulations. "The challenge is evident before us; the changes required could amount to the most significant reimagining of our NHS since its creation," the Prime Minister stated.
Starmer, whose mother was an NHS nurse, has spent much of his first two months in office blaming the Tories for leaving Labour with a dire legacy across various sectors, from healthcare to the economy and prisons. The Conservatives, led by Sunak, whose parents were both NHS professionals, accuse Starmer of exaggerating the nation's issues to pave the way for future tax hikes.
