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Sir Keir Starmer says there is no money for the NHS without reform, as he admits plan will take ‘years not months’
The NHS will not get any more funding without reforming, Sir Keir Starmer has said as he laid out a 10-year plan to fix the health service.
The prime minister stressed his plans to build an NHS fit for the future “do not just mean putting more money in”, and will take a decade to complete.
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Delivering a speech at the King’s Fund in central London, he said: “We have to fix the plumbing before we turn on the taps.
“So, hear me when I say this, no more money without reform.”
The government has promised three “big shifts” in its approach to fix the NHS:
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‘We’re getting NHS back on its feet’
• 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
Describing problems in the NHS, Sir Keir said he wasn’t prepared to spend money “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”.
“Tonight, there will be 12,000 patients in that very position – that’s enough to fill 28 hospitals.
“That isn’t just solved by more money, it’s solved by reform.”
Starmer. Pic: Reuters
Sir Keir was speaking as NHS performance stats dropped showing the overall waiting list for treatment remained unchanged in July, with an estimated 7.62 million procedures waiting to be carried relating to 6.39 million patients.
The list hit a record high in September 2023 with 7.77 million treatments, after which the figures fell for several months before rising in April, May and June of this year.
Dr Nick Murch, president of the Society for Acute Medicine, said the new NHS figures “demonstrate the scale of the short-term challenge”.
In a Q&A after his speech, the prime minister would not be drawn on how soon patients could expect to see improvements.
Asked by Sky News health correspondent Ashish Joshi what he would tell somebody who is ill now, Sir Keir said the success of his plans “is going to be measured in years, not months”.
He said: “I accept the challenge to me, which is that it’s going to take a long time, it’s going to be measured in years, not months, and we need to have something to say for someone who is ill now, which is getting the NHS back on its feet.
“But we can’t duck the long-term change.”
The speech comes after a report commissioned by the new government found the NHS is in a “critical condition”, with record waiting lists and too much of its budget spent in hospitals.
The study, carried out by independent peer and surgeon Lord Darzi, argues the NHS is facing rising demand for care as people live longer in ill health, coupled with low productivity in hospitals and poor staff morale.
It criticises political decision-making under the Conservatives and the coalition government, including the impact of austerity, a “starvation of investment” and the reorganisation of the NHS under the 2012 Health and Social Care Act, which Lord Darzi called “a calamity without international precedent”.
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This meant the COVID pandemic came “when resilience was at an all-time low”, he said.
The report also said “long waits have become normalised”, cancer care lags behind other countries, and describes A&E as being “in an awful state”.
Sir Keir said the Tories “broke the NHS” and “only a Labour government” can reform it, adding that it must “reform or die”.
Today’s major report by peer and NHS surgeon Lord Darzi on the National Health Service aims to perform three very clear political tasks.
The first is to set expectations that the service will not be fixed by the time of the next election by talking about a 10-year, two-parliament programme for change.
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The second is to prepare the ground for more money to go into the NHS – something Sir Keir Starmer appeared to explicitly signal today.
The third is to change the way we think about what’s needed for the NHS.
This means moving away from the way the Tories’ talk about NHS reform – stop focusing on new hospitals as a goal in of themselves and framing social care reform as a means of freeing up NHS beds rather than protecting middle-class wealth, for instance.
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Today, we did not learn the shape of a reborn NHS. Instead, we were treated to some naked politics by a prime minister trying to condition and calm expectations.
The most significant thing from Sir Keir’s interpretation of the report was an apparent acknowledgement that, in time, more money – presumably reasonable sums of more money – will be needed.
Addressing the King’s Fund thinktank, the prime minister said: “A Labour government will always make the investment in our NHS that is needed. Always. But we have to fix the plumbing before turning on the taps.
“So, hear me when I say this, no more money without reform.”
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Starmer: ‘I accept your challenge’ to fix NHS
Read more:
Key points of NHS report
Look closely at this commitment – there is no question that the funding taps will be turned on in future, according to the PM – albeit not immediately.
He repeats this several times. This hints at proper additional sums. Taps when turned on gush with water – Sir Keir doesn’t appear to be promising a trickle.
But for what, we do not know. When it comes to solutions, the prime minister did not go beyond the slogans in his manifesto – turning the NHS from analogue to digital, for instance, and promising “tough decisions” on public health without even hinting what they are.
Pressed on what is truly different to previous administrations in his approach to the NHS, Sir Keir waxed lyrical about his “determination”, “mandate” and “sense of the future”.
These three things will not fix the NHS.
We will have to wait until the 10-year plan is unveiled next spring to find out what these slogans really mean in practice.
A 17-year-old male has been arrested as part of the investigation into a cyber security incident affecting Transport for London (TfL).
The teenager was detained in Walsall on suspicion of Computer Misuse Act offences in relation to the attack, which was launched on TfL on 1 September.
He has been questioned by officers from the National Crime Agency (NCA) and has been bailed.
It is understood some customer data was compromised, including customer names and contact details.
Some Oyster card refund data may also have been accessed. This could include bank account numbers and sort codes of around 5,000 customers.
The NCA has said it is working alongside TfL and the National Cyber Security Centre to manage the incident and minimise risk to customers.
Paul Foster, head of the NCA’s National Cyber Crime Unit, said: “We have been working at pace to support Transport for London following a cyber attack on their network, and to identify the criminal actors responsible.
“Attacks on public infrastructure such as this can be hugely disruptive and lead to severe consequences for local communities and national systems.
“The swift response by TfL following the incident has enabled us to act quickly, and we are grateful for their continued co-operation with our investigation, which remains ongoing.
“The NCA leads the UK’s response to cybercrime. We work closely with partners to protect the public by ensuring cyber criminals cannot act with impunity, whether that be by bringing them before the courts or through other disruptive and preventative action.”
Keep up with all the latest news from the UK and around the world by following Sky News
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Providing customers with an update, TfL said on Thursday: “Although there has been very little impact on our customers so far, the situation is evolving and our investigations have identified that certain customer data has been accessed. This includes some customer names and contact details, including email addresses and home addresses where provided.
“Some Oyster card refund data may have also been accessed. This could include bank account numbers and sort codes for a limited number of customers.
“If you are affected, we will contact you directly as soon as possible as a precautionary measure, and will offer you support and guidance.”
TfL said it has now put in place additional measures to improve its security and will provide further updates as soon as possible.
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