Sir Keir Starmer will warn the NHS must “reform or die”, as the government publishes an independent investigation into the state of the health service.
The report – ordered by Health Secretary Wes Streeting days after he took on the role – was carried out by peer and surgeon Lord Darzi.
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It will conclude the NHS is in a “critical condition”, with record waiting lists and too much of its budget spent in hospitals, as well as saying the nation’s health had significantly deteriorated over the past 15 years.
However, Lord Darzi will also say the service’s vital signs “remain strong”, as the sector is filled with staff who “shared passion and determination to make the NHS better for our patients”.
In a speech on Thursday, the prime minister will point to the probe’s findings and lay the blame at the Conservatives’ door – especially the impact of their 2012 Health and Social Care Act, which the report described as a “calamity” that had “proved disastrous”, as well as claims there has been a decade of underinvestment.
But he will offer his own solutions, with a 10-year plan from Labour that promises to have “the fingerprints of NHS staff and patients all over it”.
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Sir Keir will say: “Our NHS went into the pandemic in a much more fragile state. We had higher bed occupancy rates, fewer doctors, fewer nurses and fewer beds than most other high income health systems in the world.
“And let’s be clear about what caused that… a ‘scorched earth’ approach to health reform, the effects of which are still felt to this day.
“The 2010s were a lost decade for our NHS… which left the NHS unable to be there for patients today, and totally unprepared for the challenges and opportunities of tomorrow.”
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The prime minister will say there is a “profound responsibility” on the government to address the issues, for both health and economic reasons, promising three “big shifts” in its approach:
• Using more technology to create a “digital NHS”
• Shifting more care out of hospitals and into communities
• Moving from treating sickness to focusing on prevention
Sir Keir will warn that what he calls “the biggest reimagining of our NHS since its birth” will not be “easy or quick”.
But he will add: “What we need is the courage to deliver long-term reform – major surgery not sticking plaster solutions.
“The NHS is at a fork in the road, and we have a choice about how it should meet these rising demands – raise taxes on working people to meet the ever-higher costs of aging population, or reform to secure its future.
“We know working people can’t afford to pay more, so it’s reform or die.”
Health correspondent
Lord Darzi’s damning report coincides with the publication of the NHS monthly performance data.
The figures will reinforce what the former health minister has laid bare in his blistering assessment of the health service. From A&E to children’s services, mental health to cancer treatment, his conclusion is that patients are being failed.
It is in this state because the NHS has suffered from consecutive body blows – years of chronic underfunding, a growing population with complex health needs and the impact of the pandemic. This should come as no surprise.
The slow, steady decline of the NHS has been evident for some time. The challenge facing the government is its response.
What does it do now? Lord Darzi recommends three key areas for urgent action: NHS reform that will see a shift away from hospitals towards primary care and community-based services, tackling the NHS estate, and utilising developing technology to improve patient care.
The government has already said it is going to prioritise the longest waits on the elective register. But should it do that while ignoring the root causes as outlined in the report?
There is the danger then that targets will continue to be missed in the mid to longer term.
The challenge facing the government is it does not have time to waste or money to spare. It is evident that fixing the NHS will need both.
Lord Darzi says there is no quick fix and it is likely the prime minister knows already what action must be taken first.
He knows too, that this report gives him a mandate for transformative and desperately needed change.
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Shadow health secretary Victoria Atkins said the Tories would “review this report carefully”, but claimed Labour had appeared to have “missed an opportunity to put together meaningful plans for reform”.
She added: “We Conservatives recognise that investment has to be married with reform. This is why we brought forward long-term plans for productivity, tech, ‘Pharmacy First’, virtual wards, attracting pharmaceutical research and training and retaining staff. We did this whilst boosting investment in the NHS in real terms every single year.
“The Labour government will be judged on its actions. It has stopped new hospitals from being built, scrapped our social care reforms and taken money from pensioners to fund unsustainable pay rises with no gains in productivity. They need to move from rhetoric to action.”
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Liberal Democrat leader Sir Ed Davey, who campaigned heavily on health and social care during the last election, said the report’s findings showed the NHS was “on its knees after years of the Conservatives driving local health services into the ground”.
He said fixing the problem was “this country’s greatest challenge”, as he called for the government to “make it their top priority”, adding: “That must include recruiting more GPs, fixing our crumbling hospitals and crucially tackling the social care crisis that has been ignored for far too long.”
