Starmer tells NHS it will get ‘no more money without reform’
Starmer is now talking about how the government will reform the NHS.
He starts by saying:
Let me be clear from the outset what reform does not mean first – it does not mean abandoning those founding ideas of a public service, publicly funded, free at the point of use, the basic principle of dignity, inspired, of course, by Bevan that when you fall ill, you should never have to worry about the bill.
Using comments he made a lot during the election campaign, he stresses how personal support for the NHS is for him. His mother and sister both worked in the NHS, his wife works in the NHS, and the NHS cared for his mother for many years when she was seriously ill, he says.
Starmer says reform “does not mean just putting more money in now,”.
A Labour government will always invest in the NHS, he says. But, he goes on:
We have to fix the plumbing before turning on the taps.
So hear me when I say this – no more money without reform.
I’m not prepared to see even more of your money spent on agency staff who cost £5,000 a shift, on appointment letters which arrive after the appointment, or on paying for people to be stuck in hospital just because they can’t get the care they need in the community.
Key events
In the Commons Wes Streeting is making a statement about the Darzi report. Much of what he says is likely to repeat what he and Keir Starmer have said already today, and what has been reported here, and so I will just be covering it selectively, focusing on what’s new.
How Starmer explained three principles behind Labour’s approach to NHS reform
In his speech Keir Starmer talked in some detail about the the government’s three priorities for reform – more focus on digital and technology, more focus on primary care, and more focus on prevention. Here are the key extracts.
On the need for more digitalisation, and better use of technology
First moving from an analogue to a digital NHS.
We can already see glimpses of the extraordinary potential of technology, like the world’s first ever non-invasive, knifeless surgery for kidney cancer – just imagine that, pioneered by Leeds teaching hospitals. Or the precision cancer scanners – I saw some of them yesterday …
Take an innovation like the NHS app. This could be a whole digital front door to the NHS – appointments, self referral reminders for check-ups and screenings, patients in control of their own data. healthcare so much more transparent …
We’ve got to have fully digital patient record, so that crucial information is there for you whenever you go to the NHS.
(When Starmer is asked about his record as director of public prosecutions, one of the things he talks about with most pride is digitalising CPS records, which he says made a big difference in terms of court efficiency.)
On the need to focus more on primary care
Second, we’ve got to shift more care from hospitals to communities. Now, the King’s Fund has long called for this. Successive governments have repeatedly promised it.
But what’s happened? The opposite. The share of the NHS budget spent on hospitals has actually increased.
This 10-year plan has to be the moment that we change that, the moment we begin to turn our national health service into a neighborhood health service.
That means more tests, scans, healthcare offered on high streets and town centers, improved GP access, bringing back the family doctor, offering digital consultations for those that want them, virtual wards and more patients safely looked after in their own homes, where we can deal with problems early, before people are off work sick, and before they need to go to hospital.
On the need to focus more on prevention
And, third, we have got to be much bolder in moving from sickness to prevention.
We’ve already announced NHS health checks in workplaces, blood pressure checks at dentists and opticians.
But that’s just the beginning. Planning for 10 years means we can make long term investments in new technologies that will help catch and prevent problems earlier.
And there are some areas in particular where we’ve just got to be more ambitious, like children’s mental health or children’s dentistry.
According to polling by YouGov, people are more likely to think the NHS will get worse than that it will get better – although optimism has risen considerably since Labour won the election.
Wes Streeting will be making a statement to MPs about the Darzi report at about 11.30am. He is unlikely to say anything much beyond what Starmer said in his speech, but I will be monitoring it anyway.
Q: Are you going to allow Ukraine to use Storm Shadow missiles to strike targets in Russia?
Starmer says he is off to Washington later for strategic discussions with President Biden about Urkaine and the Middle East. He does not answer the question.
And that is the end of the Q&A.
I will post more analysis and reaction soon.
Starmer suggests plan to impose cap on adult social care costs has not been shelved for good
Q: When will you introduce the cap on adult social care costs (shelved by Rachel Reeves in her statement in July)?
Starmer says the last government promised this, but Labour had to delay the plans because they were “undeliverable” within the time frame proposed by the Tories. The government is reviewing it. But he says this will be included in the 10-year plan. “But it’s got to be done properly,” he says.
UPDATE: Starmer said:
On the capping of the [social care costs], promises were again made by the last government. They were delayed because they were undeliverable.
We’ve looked at them. We don’t think they’re deliverable in the timeframe the last government said, and that’s why we’ve taken them down and we’ll review it.
Now, it is an issue we’re going to have to look at, I readily accept that. We will have it within the 10 year plan. But again, it’s got to be done properly. It’s got to be deliverable.
Starmer says he can reform NHS because reforming organisations has been ‘common theme’ of his working life
Q: [From the Sun] Given you caved in to train drivers, how can Sun readers trust you to overcome resistance from the medical profession?
Starmer replies:
Because I’ve reformed before.
I reformed when I was heading up the Crown Prosecution Service. I wanted to change it, to make it much more victim oriented, and we faced a huge challenge. We took it on. We changed it.
I wanted to drive up conviction rates for violence against women and girls. We faced resistance about how we were doing it. We burst through that and made the change.
So I could give any number of examples. I’ve worked in Northern Ireland where we had to create a new police service. In Northern Ireland there was resistance, but we pressed on and did it.
When I arrived as leader of Labour party, I knew we had to change it. There was a lot of resistance, but we pressed on and did it.
Starmer said that, if there was one “common theme” to what he had been doing professionally “for some time”, it was imposing change.
UPDATE: Starmer said:
If there’s one sort of common theme of what I’ve done for a living for some time now, it’s coming in and bringing about the change, and I’m determined that we will bring about the change here.
Q: When will people see a difference in A&E waiting times?
Starmer says the government is already working on this. It is a “classic example of where you need more technology”. Mainly people are waiting for the results of tests. So “much better use of technology” will make a diffierence.
Q: What kind of preventative health measures are you looking at?
Starmer says prevention will be a priority. He mentions smoking. And teeth – he was shocked by how many children have teeth decay. That is preventable, he says. Diet and lifestyle are important too, he says.
Starmer says he won’t let medical profession block reform
Q: Prof John Bell said this morning the BMA has been a drag on reform. Do you expect them to help you?
Starmer says he knows from his time as DPP that, whenever you try to reform something, some people are opposed. He says he wants to work with professionals. But if there is opposition, “we have to take that on, and we will take that on.”
Q: When will you announce a plan for social care?
Starmer says he wants to work with staff on this. He wants a fair pay system for care workers. Social care is obviously part of his 10-year plan for the NHS.
Q: What would you say to a patient who is on a waiting list in pain about how you will make things better for them?
Starmer says he is not offering a “quick fix”. It will take time and money.
Starmer is now taking questions.
Q: Why will you be able to do this, when other reform plans have not worked?
Starmer says in the past governments have not applied his mission-driven approach.
Starmer is now talking about the government’s three priorities for reform – more focus on digital, more focus on primary care, and more focus on prevention. (See 8.44am.)
He ends by saying the NHS can be reformed, because that has happened before. He says:
It won’t be easy. It won’t be quick. It will take a 10-year plan, not just the work of one parliament, but I know we can do it, because we’ve done reform before. The last Labour government reformed the NHS to deliver better outcomes for patients and better value for taxpayers.
And he says this should be a moment of “hope”, because of what is possible.
Starmer is still talking about NHS reform, and he says it “does not mean trying to fix everything from Whitehall”.
He says the NHS is full of talent. He wants to work with staff on reform, he says.
Starmer tells NHS it will get ‘no more money without reform’
Starmer is now talking about how the government will reform the NHS.
He starts by saying:
Let me be clear from the outset what reform does not mean first – it does not mean abandoning those founding ideas of a public service, publicly funded, free at the point of use, the basic principle of dignity, inspired, of course, by Bevan that when you fall ill, you should never have to worry about the bill.
Using comments he made a lot during the election campaign, he stresses how personal support for the NHS is for him. His mother and sister both worked in the NHS, his wife works in the NHS, and the NHS cared for his mother for many years when she was seriously ill, he says.
Starmer says reform “does not mean just putting more money in now,”.
A Labour government will always invest in the NHS, he says. But, he goes on:
We have to fix the plumbing before turning on the taps.
So hear me when I say this – no more money without reform.
I’m not prepared to see even more of your money spent on agency staff who cost £5,000 a shift, on appointment letters which arrive after the appointment, or on paying for people to be stuck in hospital just because they can’t get the care they need in the community.
Starmer says this cannot all be blamed on Covid. He goes on:
Covid hit our NHS harder than healthcare systems in other countries.
The NHS delayed, canceled or postponed,far more routine care during the pandemic than any comparable health system.
And why? Because our NHS went into the pandemic in a much more fragile state, fewer doctors, fewer nurses, fewer beds than most other high income health systems.
Starmer says that was a result of the “ideologically-driven, top down reorganization of 2012” championed by Andrew Lansley. That was “hopelessly misconceived”, he says. And he quotes what the report says about the Lansley reforms being “a calamity”. (See 9.49am.)