Key events
Streeting says it will ‘take time’ to restore NHS capital investment to level needed
The Darzi report says the NHS has a £37bn shortfall in capital investment. It says:
On top of that, there is a shortfall of £37 billion of capital investment.
These missing billions are what would have been invested if the NHS had matched peer countries’ levels of capital investment in the 2010s. That sum could have prevented the backlog maintenance, modernised technology and equipment, and paid for the 40 new hospitals that were promised but which have yet to materialise. It could have rebuilt or refurbished every GP practice in the country.
Instead, we have crumbling buildings, mental health patients being accommodated in Victoria-era cells infested with vermin with 17 men sharing two showers, and parts of the NHS operating in decrepit portacabins. Twenty per cent of the primary care estate predates the founding of the health service in 1948.
In interviews this morning, Wes Streeting, the health secretary stressed that the new government would not be able to make up for this shortfall quickly. In an interview on Times Radio, asked if the government would be finding an extra £37bn for the NHS, Streeting replied:
No, not in a big bang, and it’s important I say that up front for two reasons.
One is so the chancellor doesn’t have a heart attack over her breakfast this morning with me writing her spending review for her.
But secondly, and very seriously, I think people know that it’s taken more than a decade to break the NHS and it’s going to take time to get the NHS back on its feet, and to make sure it’s fit for the future …
Because we don’t invest in the capital and the tech, day-to-day spending balloons out of control, and then capital and tech budgets are raided to plug the gaps in day-to-day spending, and so the cycle repeats.
In the spending review, the chancellor and I are determined to break that cycle by really focusing on the capital investment and the tech investment that will help us to bring down ballooning costs on the day-to-day spending and improve the productivity of the system.
Good morning. Keir Starmer has been in office for just over two months, and for much of that time the government has focused on trying to explain to the public just how bad was the legacy the left by the Tories. There has been extensive focus on the economy, and on prisons. Today Starmer is focusing on the NHS.
And, arguably, this is the most important issue at all. According to polling by More in Common, at the next election the single issue most likely to determine whether Labour has succeeded or not is whether NHS waiting lists have fallen.
Today the government has published a 163-page report by Lord Darzi, a senior surgeon and member of the House of Lords who served as a health minister under Gordon Brown, about the state of the NHS. Summing up his findings in an article for the Daily Mirror, Darzi says:
The state of the NHS isn’t an accident. The health service was hit by three big shocks. The 2010s saw the biggest slowdown in funding since it was founded in 1948. The next big shock was the top-down reorganisation of the NHS, which threw it into chaos for years. Then came the shock of the Covid pandemic, which hit the NHS harder than other similar countries – largely because of the other two shocks.
Two of the three shocks identified by Darzi are Tory-linked and, in a speech later this morning, Starmer will describe the damage done to the NHS as “unforgiveable”. According to the advance briefing of the speech, “the PM will say that the scale of the damage done to the NHS revealed by the report is “unforgivable”, recognising the tragic consequences for too many patients and their families”.
Starmer will say:
People have every right to be angry. It’s not just because the NHS is so personal to all of us – it’s because some of these failings are life and death.
Take the waiting times in A&E. That’s not just a source of fear and anxiety – it’s leading to avoidable deaths.
People’s loved ones who could have been saved. Doctors and nurses whose whole vocation is to save them – hampered from doing so. It’s devastating.
The report goes into considerable detail about what is wrong with the NHS. Today we might hear a bit less about how the government intends to fix these problems, but Starmer will set out the outlines of his approach. He will say:
This government is working at pace to build a 10-year plan. Something so different from anything that has come before.
Instead of the top-down approach of the past, this plan is going to have the fingerprints of NHS staff and patients all over it.
And as we build it together, I want to frame this plan around three big shifts – first, moving from an analogue to a digital NHS. A tomorrow service not just a today service.
Second, we’ve got to shift more care from hospitals to communities… And third, we’ve got to be much bolder in moving from sickness to prevention.
Only fundamental reform and a plan for the long term can turn around the NHS and build a healthy society. It won’t be easy or quick. But I know we can do it.
The challenge is clear before us; the change could amount to the biggest reimagining of our NHS since its birth.
Here is Denis Campbell and Jessica Elgot’s overnight story.
And here is an analysis by Denis, the Guardian’s health policy editor.
Here is the agenda for the day.
9.30am: NHS England publishes its monthly peformance figures.
9.30am: The Office for Budget Responsibility publishes its fiscal risks and sustainability report, which looks at long-term risks to the economy.
10am: Keir Starmer delivers his speech on the NHS, and takes questions from reporters.
Afternoon: Starmer flies to Washington, where tomorrow he is meeting President Biden in the White House.
3pm: Nick Clegg, the former deputy PM who is now a senior Facebook executive, takes part in a Q&A at Chatham House on democracy and technology.
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