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Short-term policy making and a decade of underinvestment has left the NHS in a “critical condition” as it turns 75, health experts have warned.

Three leading thinktanks said the service may not reach its 100th birthday without more resources being pumped into it and fundamental reforms.

Separately, NHS Providers – which represents hospital trusts – warned of “enormous pressures” amid a record rise in demand for care and “the biggest financial squeeze in its history”.

Politics live: Sunak under fire for missing PMQs again

In an interview with Sky News, Health Secretary Steve Barclay refused to accept Conservative spending cuts have played a role in problems faced by the health service – blaming an ageing population, rising costs and the pandemic instead.

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Health secretary: ‘The NHS needs to evolve’

But Sir Julian Hartley, chief executive of NHS providers, told Sky News: “It is important to remember that it wasn’t just the pandemic.

“From 2010 to 2019, the NHS spent 18% less than 14 other European countries, so in terms of investment in the NHS, and indeed social care – those are critical issues to resolve.”

He said the NHS is the “most pressurised” it has been in his 30-year career, with its challenges including a rise in demand for emergency care, a lack of reform in social care and a staffing crisis.

The size of the waiting list – currently a record 7.4 million people in England – is also a “major issue”, he said.

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How does the NHS compare globally?

While measures have been announced to address some of the problems, such as the recently unveiled long-term workforce plan, Sir Julian said “that is against the backdrop of enormous pressures of industrial action, of the biggest financial squeeze the NHS has seen for some time”.

The warning came after health minister Maria Caulfield told Sky News that the record-high waiting list “will go up before it comes down”, because the NHS is “offering more procedures”.

She could not detail how much she expects the list to rise by, but insisted that the time between referral and treatment is falling.

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‘How high will NHS waiting list go?’

‘Decisive break-point’

Ms Caulfield said that the NHS will be “thriving” in 25 years’ time, despite assessments from thinktanks that its future hangs in the balance.

The King’s Fund, the Health Foundation and the Nuffield Trust said that public support for the NHS is “rock solid”, but the service will not be around to celebrate its 100th anniversary without more investment.

They said the service has “endured a decade of underinvestment”, as they attacked an “addiction to short-termism and eye-catching initiatives” which will not help it survive in the long-run.

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Labour: ‘The NHS is in jeopardy’

In a letter to Prime Minister Rishi Sunak and the leaders of the Labour and Liberal Democrat parties – Sir Keir Starmer and Sir Ed Davey – they said the next election should be “a decisive break point” by ending years of short-term policy making when it comes to the NHS.

The organisations said “unachievable and unrealistic” fast improvements without long-term planning will “doom the service to failure”.

The letter said: “Seventy-five years after its creation, the National Health Service is in critical condition.

“The next government will face a choice between providing the investment and reform needed to preserve the NHS for future generations or continuing with short-termism and managed decline.”

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Dame Elizabeth Anionwu joined Sky News to discuss the NHS on the day of its 75th anniversary.

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Several killed after vehicle drives into crowd at street festival, police in Vancouver say

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Several killed after vehicle drives into crowd at street festival, police in Vancouver say

A number of people have been killed and multiple others injured after a driver drove into a crowd at a street festival in Vancouver, police have said.

The driver has been taken into custody after the incident shortly after 8pm local time on Saturday, police added.

People were in the area near 41st Avenue and Fraser Street for the Lapu Lapu Day Block Party, named after a national hero of the Philippines.

Vancouver’s mayor Ken Sim said in a post on X: “I am shocked and deeply saddened by the horrific incident at today’s Lapu Lapu Day event.”

He added: “Our thoughts are with all those affected and with Vancouver’s Filipino community during this incredibly difficult time.”

Video posted on social media showed victims and debris strewn across a long stretch of road, with at least seven people lying immobile on the ground.

A black SUV with a crumpled front section could be seen in photos from the scene.

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Trump criticises Putin after potentially ‘historic’ meeting with Zelenskyy before Pope’s funeral

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Trump criticises Putin after potentially 'historic' meeting with Zelenskyy before Pope's funeral

Donald Trump has criticised Vladimir Putin and suggested a shift in his stance towards the Russian president after a meeting with Volodymyr Zelenskyy before the Pope’s funeral.

The Ukrainian president said the one-on-one talks could prove to be “historic” after pictures showed him sitting opposite Mr Trump, around two feet apart, in the large marble hall inside St Peter’s Basilica.

The US president said he doubted his Russian counterpart’s willingness to end the war after leaving Rome after the funeral of Pope Francis at the Vatican.

Follow live updates: 200,000 mourn at Vatican

In a post on his Truth Social platform, he said “there was no reason” for the Russian president “to be shooting missiles into civilian areas, cities and towns, over the last few days”.

The two leaders held talks before attending the Pope's funeral
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The two leaders held talks before attending the Pope’s funeral

He added: “It makes me think that maybe he doesn’t want to stop the war, he’s just tapping me along, and has to be dealt with differently, through ‘Banking’ or ‘Secondary Sanctions?’ Too many people are dying!!!”

The meeting between the US and Ukrainian leaders was their first face-to-face encounter since a very public row in the Oval Office in February.

Mr Zelenskyy said he had a good meeting with Mr Trump in which they talked about the defence of the Ukrainian people, a full and unconditional ceasefire, and a durable and lasting peace that would prevent the war restarting.

Other images released by the Ukrainian president’s office show Sir Keir Starmer and French President Emmanuel Macron were present for part of the talks, which were described as “positive” by the French presidency.

Mr Zelenskyy‘s spokesman said the meeting lasted for around 15 minutes and he and Mr Trump had agreed to hold further discussions later on Saturday.

The world leaders share a moment before the service
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The world leaders shared a moment before the service

Trump and Zelenskyy meet in the Basilica
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Donald Trump and Volodymyr Zelenskyy meet in the Basilica

But the US president left Rome for Washington on Air Force One soon after the funeral without any other talks having taken place.

The Ukrainian president’s office said there was no second meeting in Rome because of the tight schedule of both leaders, although he had separate discussions with Mr Starmer and Mr Macron.

The French president said in a post on X “Ukraine is ready for an unconditional ceasefire” and that a so-called coalition of the willing, led by the UK and France, would continue working to achieve a lasting peace.

There was applause from some of the other world leaders in attendance at the Vatican when Mr Zelenskyy walked out of St Peter’s Basilica after stopping in front of the pontiff’s coffin to pay his respects.

U.S President Donald Trump attends the funeral Mass of Pope Francis, at the Vatican, April 26, 2025. REUTERS/Kai Pfaffenbach
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Donald Trump and the Ukrainian president met for the first time since their Oval Office row. Pic: Reuters

Sir Tony Brenton, the former British ambassador to Russia, said the event presents diplomatic opportunities, including the “biggest possible meeting” between Mr Trump and the Ukrainian leader.

He told Sky News it could mark “an important step” in starting the peace process between Russia and Ukraine.

Professor Father Francesco Giordano told Sky News the meeting is being called “Pope Francis’s miracle” by members of the clergy, adding: “There’s so many things that happened today – it was just overwhelming.”

The bilateral meeting comes after Mr Trump’s peace negotiator Steve Witkoff held talks with Mr Putin at the Kremlin.

They discussed “the possibility of resuming direct negotiations between Russia and Ukraine”, Kremlin aide Yuri Ushakov said.

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Russia and Ukraine have not held direct talks since the early weeks of the war, which began in February 2022.

Mr Trump has claimed a deal to end the war is “very close” and has urged Mr Zelenskyy to “get it done” in a post on his Truth Social platform.

He has previously warned both sides his administration would walk away from its efforts to achieve a peace if the two sides do not agree a deal soon.

Meanwhile, the Polish armed forces said a Russian military helicopter violated its airspace over the Baltic Sea on Friday evening.

“The nature of the incident indicates that Russia is testing the readiness of our air defence systems,” they said in a post on X.

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What we learn from remarkable photos of Trump-Zelenskyy meeting

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What we learn from remarkable photos of Trump-Zelenskyy meeting

On an extraordinary day, remarkable pictures on the margins that capture what may be a turning point for the world.

In a corner of St Peter’s Basilica before the funeral of Pope Francis, the leaders of America and Ukraine sit facing each other in two solitary chairs.

They look like confessor and sinner except we cannot tell which one is which.

Leaning forward hands together in their laps, Donald Trump and Volodymyr Zelenskyy stare at each other in one photo.

In another, the Ukrainian president seems to be remonstrating with the US president. This is their first encounter since their infamous bust-up in the Oval Office.

The two leaders held talks before attending the Pope's funeral
Image:
The two leaders held talks before attending the Pope’s funeral

Other pictures show the moment their French and British counterparts introduced the two men. There is a palpable sense of nervousness in the way the leaders engage.

We do not know what the two presidents said in their brief meeting.

But in the mind of the Ukrainian leader will be the knowledge President Trump has this week said America will reward Russia for its unprovoked brutal invasion of his country, under any peace deal.

Mr Trump has presented Ukraine and Russia with a proposal and ultimatum so one-sided it could have been written in the Kremlin.

Kyiv must surrender the land Russia has taken by force, Crimea forever, the rest at least for now. And it must submit to an act of extortion, a proposed deal that would hand over half its mineral wealth effectively to America.

The world leaders share a moment before the service
Image:
The world leaders shared a moment before the service

Afterwards, Zelenskyy said it had been a good meeting that could turn out to be historic “if we reach results together”.

They had talked, he said, about the defence of Ukraine, a full and unconditional ceasefire and a durable and lasting peace that will prevent a war restarting.

The Trump peace proposal includes only unspecified security guarantees for Ukraine from countries that do not include the US. It rules out any membership of Ukraine.

Ukraine’s allies are watching closely to see if Mr Trump will apply any pressure on Vladimir Putin, let alone punish him for recent bloody attacks on Ukraine.

Or will he simply walk away if the proposal fails, blaming Ukrainian intransigence, however outrageously, before moving onto a rapprochement with Moscow.

If he does, America’s role as guarantor of international security will be seen effectively as over.

This could be the week we see the world order as we have known it since the end of the Second World War buried, as well as a pope.

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