Starmer’s NHS offering: no more gaslighting, but no more money either | John Crace


Attention all citizens. This is a public service announcement. Stop what you are doing and listen. For your own safety you are advised not to get ill any time in the next 10 years. If you feel a heart attack coming on, then just take a few deep breaths and ignore it.

If you are worried you may have cancer, take two aspirin and go to bed. If you aren’t dead within six months, you will know it was a false alarm. If you think you need mental health services, just pull yourself together. Just stop it. Thank you for your time. There will be further updates in due course.

Having spent the first weeks of his time in Downing Street examining the state of the public finances – far worse than he thought – and the prison service – far worse than he thought – Keir Starmer has now turned his attention to the health service. This too is far worse than he thought.

We’re definitely seeing a pattern here. In fact, it’s a miracle that many of us are still alive. Or stuck in the permanent limbo of A&E. The only reason no one had complained was because everyone was too busy waiting on hold, hoping to get an appointment with their GP.

Speaking at the King’s Fund after the publication of the Darzi report, Keir was happy to cosplay The Grim Reaper. We few. We lucky few who had beaten the odds and survived.

Spare a thought for those who had fallen along the way. The undiagnosed. The misdiagnosed. The diagnosed too late. But don’t ever relax. The Apocalypse is coming for all of us sooner or later. None of us will get out of this alive. No one has ever beaten the system. All we can do is try to stay one step ahead of eternity for as long as possible.

Weirdly, there was something rather uplifting about all this. And not just because Starmer is a natural undertaker. If being prime minister doesn’t work out for him, there’s a job waiting for him as mourner-in-chief to the deceased with no known relatives. The eulogy for the unknown person. Sad face. Sincere face.

What was most welcome was the reassurance. The Grim Reaper was telling us what most of us instinctively already know. Our experience tells us that the NHS is on its knees. That doctors and nurses are fighting a losing battle. That a thousand everyday kindnesses – staff going the extra mile – cannot compensate for a system in collapse. That waiting lists are interminable. That A&E can be a war zone. That hospitals are falling to bits.

So to have a politician acknowledging reality comes as a relief. At last there is someone serious in charge. Someone who isn’t going to gaslight us. Trying to persuade us that any failures are minimal. Transient. Insisting that 40 new hospitals have been built when we all know that at best one waiting room may have been refurbished. We can move on from a state of cognitive dissonance.

Starmer leant on his scythe. Everything was bad. Worse than bad. It was terrible. People were dying unnecessarily everywhere. Dropping like flies. Cardiovascular and cancer outcomes were far worse than other comparable countries. Our children were fatter, our adults were iller. Mental health patients in cells with only mice for company.

And the blame lay squarely with the last government. Fourteen years of under-investment and neglect. The pandemic a smokescreen. During Covid our patients were dying off far quicker than elsewhere. One person was singled out as especially worthy of blame. Step forward, Andrew Lansley. David Cameron’s first health secretary whose top-down reforms had almost singlehandedly wrecked the NHS.

Needless to say, Lansley’s reward for this act of destruction was a seat in the Lords. Establishment politicians like him are only ever allowed to fail upwards. A more fitting punishment would have been to make him an unpaid car park attendant at St George’s hospital. Instead, he remains untouched by his own incompetence and ideology. He now whiles away the hours, collecting his £332 daily attendance fee, and advising companies on health policy as a side hustle. Presumably, people have learned to do the opposite to what he suggests.

Unusually, The Grim Reaper chose not to leave it there, the audience left in a state of terminal despair. Because his minders have now instructed him to leave room for a glimmer of optimism. The faintest gamma ray of hope. So there was a solution, he said. Labour could fix this. Though not with more money. Because there wasn’t any. See above and previous sketches. Though he did get through this speech without mentioning the £22bn black hole. Probably an oversight. But a collector’s item nonetheless.

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Nor would he be raising taxes as working people couldn’t afford this. Watch his lips. Instead, he was going to reform the NHS back to health. Making everything digital. Cancer surgery via AI. Treating people in the community. Stopping people getting ill in the first place. Sorting out social care for good. Allowing doctors and nurses time to do their job rather than hunt for beds.

It all sounded wonderful. Though how any of this was going to happen without more money was rather glossed over. Just trust the process. Want to believe and it will happen. Still, it was a change to hear a prime minister who was on nodding terms with the reality of the NHS and a desire to improve it. The bad news was that it was all going to take 10 years. Not all of us were going to live that long. Though our sacrifice would not have been in vain.

‘Broken but not beaten’: Starmer outlines plans for NHS reform – video

Just under an hour later, the health secretary, Wes Streeting, was on his feet in the Commons saying much the same thing in his ministerial statement. Though, Wes being Wes, it was said with rather more force. It was the Tories wot wrecked the NHS. Lansley and the rest of them had blood on their hands. What they had done was unforgivable. The least they could do was say sorry.

An apology was the last thing on the mind of the shadow health secretary, Victoria Atkins. Rather, she wanted to let people know the NHS wasn’t really in that much of a state. Its shortcomings had been exaggerated. People should enjoy their 40 new hospitals. Be grateful for Lansley. And if people had been dying off more quickly than they should have been, then it was their fault. Lack of moral fibre.

The thing about Vicky is that she’s not that bright. Not something that prevents her being a high flyer in the current Tory party. It would be a start if she could learn to read the room. The Speaker shut her up in mid-sentence. An act of kindness.



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