NHS chief says service faces ‘enormous challenges’ as experts warn it ‘may not reach 100th anniversary’
The National Health Service faces a future of “enormous challenges”, its chief executive has warned on its 75th birthday.
In a speech to mark the anniversary of its creation, Amanda Pritchard, the head of the NHS in England, described the publicly-funded service as a “cornerstone of national life” in Britain.
But she said its staff were battling a combination of COVID backlogs and record demand for services – challenges that workers were ready to meet “head on”.
The health chief also said the service would “continue to embrace” technology – something that could help tackle some of the challenges the NHS faced.
It comes as experts warned that the NHS – created in July 1948 – may not reach its 100th birthday without more resources and fundamental reforms.
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Amanda Pritchard, chief executive of NHS England speaking at the NHS anniversary ceremony at Westminster Abbey
The warning, by three leading think-tanks – the King’s Fund, the Health Foundation and the Nuffield Trust – blamed short-term policymaking and a decade of underinvestment, which they said had left the NHS in a “critical condition”.
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”.
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NHS Special: In Full
Speaking during a special anniversary ceremony at Westminster Abbey – attended by dignitaries including Prime Minister Rishi Sunak, Labour leader Sir Keir Starmer, and the Duke and Duchess of Edinburgh – Ms Pritchard said: “Since the day it was founded, the NHS has continually innovated and adapted to meet the changing needs of our patients and communities.
“Recent years have brought a once-in-a-century global health emergency and unprecedented challenges. But throughout, our staff, volunteers and partners up and down the country have continued to do what they do best – looking after patients and their loved ones.
The Duke of Edinburgh speaks to Nurse May Parsons
Nurse May Parsons in the procession at the start of the service
“In doing so they provided a beacon of hope for a nation during dark and uncertain times. It is therefore little wonder that the NHS remains the institution that makes our nation most proud to be British – a cornerstone of national life and our shared identity.”
Speaking to journalists at the event, she also addressed the “enormous challenges” faced by staff, including “recovering services, addressing COVID backlogs that inevitably built up over the pandemic and dealing with record demand for services”.
“This milestone 75th anniversary is an opportunity for us to reflect on their hard work and our achievements but to look to the future of the health service too,” she added.
Professor Sir Stephen Powis, national medical director for the health service in England, also said that staff were meeting these new challenges “head on”.
Waiting lists a ‘major issue’
In an interview with Sky News, Health Secretary Steve Barclay refused to accept that 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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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”.
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‘How high will NHS waiting list go?’
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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Labour: ‘The NHS is in jeopardy’
Ms Caulfield said that the NHS will be “thriving” in 25 years’ time, despite assessments from think-tanks that its future hangs in the balance.
US president-elect Donald Trump has suggested Israel and Hamas could agree a Gaza ceasefire by the end of the week.
Talks between Israeli and Hamas representatives resumed in the Qatari capital Doha yesterday, after US President Joe Biden indicated a deal to stop the fighting was “on the brink” on Monday.
A draft agreement has been sent to both sides. It includes provisions for the release of hostages and a phased Israeli troop withdrawal from Gaza.
Qatar says Israel and Hamas are at their “closest point” yet to a ceasefire deal.
Two Hamas officials said the group has accepted the draft agreement, with Israel still considering the deal.
An Israeli official said a deal is close but “we are not there” yet.
More than 46,500 Palestinians have been killed in Gaza since Israel launched its ground offensive in the aftermath of the 7 October attacks, according to the territory’s Hamas-run health ministry.
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What’s in the proposed deal?
Palestinians inspect the site of an Israeli strike on beachfront cafe in Deir al Balah. Pic: Reuters
Biden hails possibility of agreement
President Biden said it would include a hostage release deal and a “surge” of aid to Palestinians, in his final foreign policy speech as president.
“So many innocent people have been killed, so many communities have been destroyed. Palestinian people deserve peace,” he said.
“The deal would free the hostages, halt the fighting, provide security to Israel, and allow us to significantly surge humanitarian assistance to the Palestinians who suffered terribly in this war that Hamas started.”
Qatari mediators have sent Israel and Hamas a draft proposal for an agreement to halt the fighting.
Analysis:
Deal might be close, but there are many unanswered questions
Pic: Reuters
Trump: ‘We’re very close’
President-elect Donald Trump has also discussed a possible peace deal during a phone interview with the Newsmax channel.
“We’re very close to getting it done and they have to get it done,” he said.
“If they don’t get it done, there’s going to be a lot of trouble out there, a lot of trouble, like they have never seen before.
“And they will get it done. And I understand there’s been a handshake and they’re getting it finished and maybe by the end of the week. But it has to take place, it has to take place.”
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Pic: AP
Israeli official: Former Hamas leader held up deal
Speaking on Tuesday as negotiations resumed in Qatar, an anonymous Israeli official said that an agreement was “close, but we are not there”.
They accused Hamas of previously “dictating, not negotiating” but said this has changed in the last few weeks.
“Yahya Sinwar was the main obstacle for a deal,” they added.
Sinwar, believed to be the mastermind of the 7 October attacks, led Hamas following the assassination of his predecessor but was himself killed in October last year.
Under Sinwar, the Israeli official claimed, Hamas was “not in a rush” to bring a hostage deal but this has changed since his death and since the IDF “started to dismantle the Shia axis”.
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Biden: ‘Never, never, never, ever give up’
Iran ‘weaker than it’s been in decades’
Yesterday, President Biden also hailed Washington’s support for Israel during two Iranian attacks in 2024.
“All told, Iran is weaker than it’s been in decades,” the president said.
Mr Biden claimed America’s adversaries were weaker than when he took office four years ago and that the US was “winning the worldwide competition”.
“Compared to four years ago, America is stronger, our alliances are stronger, our adversaries and competitors are
weaker,” he said.
“We have not gone to war to make these things happen.”
The US president is expected to give a farewell address on Wednesday.
A draft ceasefire deal on the table between Israel and Hamas would see 33 hostages set free and a phased withdrawal of IDF forces from parts of Gaza.
President Joe Biden said an agreement to stop the fighting was “on the brink” and high level negotiations between the two sides resumed in Qatar on Tuesday.
The deal would see a number of things happen in a first stage, with negotiations for the second stage beginning in the third week of the ceasefire.
It would also allow a surge in humanitarian aid into Gaza, which has been devastated by more than a year of war.
Details of what the draft proposal entails have been emerging on Tuesday, reported by Israeli and Palestinian officials.
Relatives and supporters of Israeli hostages hold photos of their loved ones during a protest on 8 January. Pic: AP
Hostages to be returned
In the first stage of the potential ceasefire, 33 hostages would be set free.
These include women (including female soldiers), children, men over the age of 50, wounded and sick.
Israel believes most of these hostages are alive but there has not been any official confirmation from Hamas.
In return for the release of the hostages, Israel would free more than 1,000 Palestinian prisoners and detainees.
People serving long sentences for deadly attacks would be included in this but Hamas fighters who took part in the 7 October attack would not be released.
An arrangement to prevent Palestinian “terrorists” from going back to the West Bank would be included in the deal, an anonymous Israeli official said.
Read more:
A timeline of events since the 7 October attacks
The hostages who still haven’t returned home
Smoke billows as buildings lie in ruin in Beit Hanoun in Gaza. Pic: Reuters
Phased Israeli withdrawal from Gaza
The agreement also includes a phased withdrawal of Israeli forces from Gaza, with IDF troops remaining in the border perimeter to defend Israeli border towns and villages.
Security arrangements would be implemented at the Philadelphi corridor – a narrow strip of land that runs along the border between Egypt and Gaza – with Israel withdrawing from parts of it after the first few days of the deal.
The Rafah Crossing between Egypt and Gaza would start to work gradually to allow the crossing of people who are sick and other humanitarian cases out of Gaza for treatment.
Unarmed North Gaza residents would be allowed to return to their homes, with a mechanism introduced to ensure no weapons are moved there.
“We will not leave the Gaza Strip until all our hostages are back home,” the Israeli official said.
What will happen to Gaza in the future?
There is less detail about the future of Gaza – from how it will be governed, to any guarantees that this agreement will bring a permanent end to the war.
“The only thing that can answer for now is that we are ready for a ceasefire,” the Israeli official said.
“This is a long ceasefire and the deal that is being discussed right now is for a long one. There is a big price for releasing the hostages and we are ready to pay this price.”
The international community has said Gaza must be run by Palestinians, but there has not been a consensus about how this should be done – and the draft ceasefire agreement does not seem to address this either.
In the past, Israel has said it will not end the war leaving Hamas in power. It also previously rejected the possibility of the Palestinian Authority, which exercises limited governing powers in the West Bank, from taking over the administration of Gaza.
Since the beginning of its military campaign in Gaza, Israel has also said it would retain security control over the territory after the fighting ends.
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