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Sir Keir Starmer will warn the NHS must “reform or die”, as the government publishes an independent investigation into the state of the health service.

The report – ordered by Health Secretary Wes Streeting days after he took on the role – was carried out by peer and surgeon Lord Darzi.

Politics live: Starmer and Sunak face off again over winter fuel

It will conclude the NHS is in a “critical condition”, with record waiting lists and too much of its budget spent in hospitals, as well as saying the nation’s health had significantly deteriorated over the past 15 years.

However, Lord Darzi will also say the service’s vital signs “remain strong”, as the sector is filled with staff who “shared passion and determination to make the NHS better for our patients”.

In a speech on Thursday, the prime minister will point to the probe’s findings and lay the blame at the Conservatives’ door – especially the impact of their 2012 Health and Social Care Act, which the report described as a “calamity” that had “proved disastrous”, as well as claims there has been a decade of underinvestment.

But he will offer his own solutions, with a 10-year plan from Labour that promises to have “the fingerprints of NHS staff and patients all over it”.

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Sir Keir will say: “Our NHS went into the pandemic in a much more fragile state. We had higher bed occupancy rates, fewer doctors, fewer nurses and fewer beds than most other high income health systems in the world.

“And let’s be clear about what caused that… a ‘scorched earth’ approach to health reform, the effects of which are still felt to this day.

“The 2010s were a lost decade for our NHS… which left the NHS unable to be there for patients today, and totally unprepared for the challenges and opportunities of tomorrow.”

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Minister’s plan to cut NHS waiting list

The prime minister will say there is a “profound responsibility” on the government to address the issues, for both health and economic reasons, promising three “big shifts” in its approach:

• 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

Sir Keir will warn that what he calls “the biggest reimagining of our NHS since its birth” will not be “easy or quick”.

But he will add: “What we need is the courage to deliver long-term reform – major surgery not sticking plaster solutions.

“The NHS is at a fork in the road, and we have a choice about how it should meet these rising demands – raise taxes on working people to meet the ever-higher costs of aging population, or reform to secure its future.

“We know working people can’t afford to pay more, so it’s reform or die.”

Report gives Starmer mandate for change

Lord Darzi’s damning report coincides with the publication of the NHS monthly performance data.

The figures will reinforce what the former health minister has laid bare in his blistering assessment of the health service. From A&E to children’s services, mental health to cancer treatment, his conclusion is that patients are being failed.

It is in this state because the NHS has suffered from consecutive body blows – years of chronic underfunding, a growing population with complex health needs and the impact of the pandemic. This should come as no surprise.

The slow, steady decline of the NHS has been evident for some time. The challenge facing the government is its response.

What does it do now? Lord Darzi recommends three key areas for urgent action: NHS reform that will see a shift away from hospitals towards primary care and community-based services, tackling the NHS estate, and utilising developing technology to improve patient care.

The government has already said it is going to prioritise the longest waits on the elective register. But should it do that while ignoring the root causes as outlined in the report?

There is the danger then that targets will continue to be missed in the mid to longer term.

The challenge facing the government is it does not have time to waste or money to spare. It is evident that fixing the NHS will need both.

Lord Darzi says there is no quick fix and it is likely the prime minister knows already what action must be taken first.

He knows too, that this report gives him a mandate for transformative and desperately needed change.

Shadow health secretary Victoria Atkins said the Tories would “review this report carefully”, but claimed Labour had appeared to have “missed an opportunity to put together meaningful plans for reform”.

She added: “We Conservatives recognise that investment has to be married with reform. This is why we brought forward long-term plans for productivity, tech, ‘Pharmacy First’, virtual wards, attracting pharmaceutical research and training and retaining staff. We did this whilst boosting investment in the NHS in real terms every single year.

“The Labour government will be judged on its actions. It has stopped new hospitals from being built, scrapped our social care reforms and taken money from pensioners to fund unsustainable pay rises with no gains in productivity. They need to move from rhetoric to action.”

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Liberal Democrat leader Sir Ed Davey, who campaigned heavily on health and social care during the last election, said the report’s findings showed the NHS was “on its knees after years of the Conservatives driving local health services into the ground”.

He said fixing the problem was “this country’s greatest challenge”, as he called for the government to “make it their top priority”, adding: “That must include recruiting more GPs, fixing our crumbling hospitals and crucially tackling the social care crisis that has been ignored for far too long.”

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Shouts of ‘genocide’ in Commons as David Lammy denounces Israel’s ‘intolerable’ actions in Gaza

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Shouts of 'genocide' in Commons as David Lammy denounces Israel's 'intolerable' actions in Gaza

The foreign secretary has denounced Israel’s actions in Gaza as “intolerable” but stopped short of saying it had committed genocide.

MPs could be heard shouting “genocide” in the Commons chamber as David Lammy announced the government was suspending its trade negotiations with Israel and summoning Tzipi Hotovely, Israel’s ambassador to the UK, to the Foreign Office.

The UK has also sanctioned a number of individuals and groups in the West Bank which it says have been linked with acts of violence against Palestinians – including Daniella Weiss, a leading settler activist who was the subject of Louis Theroux’s recent documentary The Settlers.

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Israel immediately criticised the UK government actions as “regrettable” and said the free trade agreement talks, which ministers have now backed out of, were “not being advanced at all by the UK government”.

Oren Marmorstein, a spokesperson for the Israeli foreign affairs ministry, said: “If, due to anti-Israel obsession and domestic political considerations, the British government is willing to harm the British economy – that is its own prerogative.”

Mr Lammy’s intervention came in response to Israel ramping up its latest military offensive in Gaza and its decision to limit the amount of aid into the enclave.

Tom Fletcher, head of the UN Office for the Coordination of Humanitarian Affairs, accused Israel of “deliberately and unashamedly” imposing inhumane conditions on Palestinians by blocking aid from entering Gaza more than 10 weeks ago.

He also told the UN’s security council last week that it must “act now” to “prevent genocide” – a claim that Israel has vehemently denied.

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Aftermath of strike on Gaza school-turned-shelter

Speaking in the Commons, the foreign secretary said the threat of starvation was “hanging over hundreds of thousands of civilians” and that the 11-week blockade stopping humanitarian aid reaching Gaza was “indefensible and cruel”.

Israeli Prime Minister Benjamin Netanyahu has agreed to allow a limited amount of aid into the besieged enclave in response to global concern at reports of famine.

Mr Lammy said Mr Netanyahu’s govenrment was “isolating Israel from its friends and partners around the world, undermining the interests of the Israeli people and damaging the image of the state of Israel in the eyes of the world”.

“We are now entering a dark new phase in this conflict,” Mr Lammy added.

“Netanyahu’s government is planning to drive Gazans from their homes into a corner of the strip to the south and permit them a fraction of the aid that they need.”

Referring to one of the far-right ministers in Mr Netanyahu’s government, he said Bezalel Smotrich “even spoke of Israeli forces cleansing Gaza, destroying what’s left of residents, Palestinians being relocated, he said, to third countries”.

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Surgeon compares Gaza to ‘killing fields’

MPs from across the house shouted “genocide” as Mr Lammy said: “We must call this what it is. It is extremism. It is dangerous. It is repellent. It is monstrous and I condemn it in the strongest possible terms.”

In the Commons, a number of Labour MPs urged the government to go further against Israel.

Yasmin Qureshi, the Labour MP for Bolton South and Walkden, said there needed to be a “full arms embargo” and said: “Can I ask the foreign secretary what additional steps he’s going to be taking in order to stave off this genocide?”

Another Labour MP told Sky News that while the statement was “better than previously…without a concrete timeline and a sanctioning of responsible ministers, it’s hard to know what tangible difference it will make.”

Read more:
British surgeon in Gaza says it is now ‘a slaughterhouse’
Gaza at mercy of what comes next – analysis
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Israeli officials have said its plans to seize all of Gaza and hold it indefinitely. – which would move the civilian population southward – will help it achieve its aim of defeating Hamas.

Israel also believes the offensive will prevent Hamas from looting and distributing humanitarian aid, which it says strengthens the group’s rule in Gaza.

Mr Netanyahu has defended Israel’s actions in Gaza and reacted angrily to a joint statement penned by the leaders of the UK, France and Canada, in which they urged Israel to end its military offensive in Gaza and lift restrictions on humanitarian aid allowed into the enclave.

The Israeli prime minister said: “By asking Israel to end a defensive war for our survival before Hamas terrorists on our border are destroyed and by demanding a Palestinian state, the leaders in London, Ottawa and Paris are offering a huge prize for the genocidal attack on Israel on October 7 while inviting more such atrocities.

“No nation can be expected to accept anything less and Israel certainly won’t. This is a war of civilisation over barbarism. Israel will continue to defend itself by just means until total victory is achieved.”

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‘Khan Younis looks like Stalingrad’: British doctor in Gaza describes horror – and has message for world leaders

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'Khan Younis looks like Stalingrad': British doctor in Gaza describes horror - and has message for world leaders

A British doctor working in Gaza has urged world leaders to “stop talking and do something” as he described how people are starving and the “massive extent of destruction”.

Dr Tom Potokar – who has compared Gaza to a “slaugherhouse” because of the bombardment by Israeli forces – is part of a group of British specialist doctors and surgeons currently working in Khan Younis.

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Palestinians struggle to get donated food at a community kitchen in Khan Younis. Pic: AP
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Palestinians struggle to get donated food at a community kitchen in Khan Younis. Pic: AP

Sky News spent two days filming with them in Nasser and Amal hospitals – two of the last functioning hospitals in southern Gaza.

They are plastic surgeons and orthopaedic specialists. The operating theatres are a rare zone of calm as the medics work with the war outside and a constant stream of wounded needing urgent treatment.

All the patients are malnourished. Children are suffering the worst. The lack of food and water has made them weak and more vulnerable to their injuries.

Hospitals in Gaza have repeatedly come under attack during the war. The Israel Defense Forces (IDF) claims Hamas has been hiding in them or in tunnels underneath.

Nasser hospital hasn’t escaped. The burns unit was one of the busiest parts of the hospital, until it was destroyed in an airstrike.

The doctors sleep and spend downtime in small living quarters within the hospital itself. Food is one ready meal a day, only 400 calories. The 11-week blockade is affecting everyone.

Destruction in the burns unit at Nasser hospital
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Destruction in the burns unit at Nasser hospital

A baby brought into the burns unit at Nasser hospital
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A baby is brought into Nasser hospital to be treated for burns

Dr Potokar was working in the European hospital on the western edge of Khan Younis but had to evacuate last week when it came under missile fire and had to close.

He went to Amal hospital next to Nasser and is working again.

He says he’s seen a dramatic change since he was last in Gaza shortly after the Hamas attack on 7 October 2023.

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Aftermath of strike on Gaza school-turned-shelter

“The difference this time I think is the intensity,” he says.

“Back in October to December ’23 was the last time I was here, there was a lot of wounded, and it was very intense as well.

“I think the difference this time is because of the blockade there’s so little stuff getting in, there’s no food getting in so people are starving, there’s very little medical supplies coming in but also the other very noticeable thing is the massive extent of destruction – I mean Khan Younis looks like Stalingrad.”

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Surgeon compares Gaza to ‘killing fields’

Speaking about what he has witnessed in Gaza, Dr Potokar added: “What can you say, it’s horrific, it’s a slaughterhouse. That’s what it is, it’s a slaughterhouse.”

He also urged world leaders to “stop talking and do something”.

Read more:
What aid has entered Gaza and where is it going?
Dad wrongly pronounced dead in 2014 is killed in airstrike

Dr Tom Potokar holds the ready meals the doctors eat
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Dr Potokar holds ready meals in the hospital

Dr Tom Potokar with a patient at the Amal hospital
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The British doctor with a patient at the Amal hospital

The United Nations says 100 aid trucks were cleared for entry into Gaza on Tuesday, but Tom Fletcher, a former British diplomat who now heads the UN Office for the Coordination of Humanitarian Affairs, warned that 14,000 babies could die in the next 48 hours if they don’t receive urgent aid.

On Monday evening, the IDF-declared combat zone was only a few streets from the Nasser hospital. Drones flew low overhead through the day.

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British surgeon records video diary from Gaza

“An evacuation order for most of Khan Younis went out today, which meant we lost several members of the team,” said Dr Victoria Rose, a plastic surgeon.

“My anaesthetic nurse and Graeme’s orthopaedic colleague had to leave us mid-case to go and evacuate their families to an area of safety.”

Dr Graeme Groom added: “These are people just like you and me, they have their homes, their families, they live normal lives, many are very impressive people and without notice they have to pick up a grab bag and leave… look for food, look for water, look for shelter, but turn up at work each day.”

Dr Graeme Groom in Khan Younis
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Dr Graeme Groom in Khan Younis

With the Israeli military operation getting closer, the doctors are also prepared to evacuate at short notice.

Essential supplies have been gathered and packed ready in a storeroom.

But Nasser hospital has the last remaining ICU department in the whole of southern Gaza – one of only two with a working oxygen supply. If it must be evacuated, then the remaining temporary field hospitals would likely be overwhelmed and unable to cope.

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Student, 23, who lost all four limbs to sepsis calls on people to get meningitis vaccine

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Student, 23, who lost all four limbs to sepsis calls on people to get meningitis vaccine

A medical student who lost all four limbs due to sepsis has called on people to get the meningitis vaccine to help prevent them going through a similar ordeal.

Lily McGarry was rushed to the University Hospital of Wales in Cardiff with flu-like symptoms in January before her condition rapidly worsened and she went into septic shock.

The 23-year-old was diagnosed with meningococcal septicaemia, a type of blood poisoning caused by the same kind of bacteria that causes the most common form of bacterial meningitis.

Ms McGarry, who is originally from Jersey but was studying in Cardiff, survived two cardiac arrests before spending a fortnight in a coma and more than 100 days in intensive care.

The infection caused severe blood flow issues in her body and, as a result, she had to undergo surgery to amputate all four of her limbs at the Morriston Hospital in Swansea.

As the Cardiff University student begins her rehabilitation, her father Stuart McGarry told The UK Tonight with Sarah-Jane Mee his daughter now wants people to have the meningitis vaccine to help prevent protect them against meningococcal septicaemia.

Lily and Stuart McGarry
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Lily and Stuart McGarry

Mr McGarry said: “(Lily) wants to get the message out to everyone. The (meningitis) vaccination rate post-COVID for children has dropped off significantly. She just wanted to get the message over to get vaccinated.

“I mean, obviously, Lily proves that it doesn’t work for 100% of the people 100% of the time.

“But the meningitis vaccination programme in the UK has been phenomenally successful… some of the staff at Cardiff hospital hadn’t seen a case like Lily for 10 years. So it’s proven it’s effective. It works. Get it.”

‘Difficult conversations’

Mr McGarry was in Jersey when he received the call from the hospital to say his daughter was unwell.

“It’s the call that no father wants really,” he said.

“They said that I should come over to Cardiff, that Lily was really unwell, and I said, ‘I’ll pack a bag and get a flight tomorrow’ and the nurse said ‘no, you should be here now’.

“Her mum was in Australia when she received the call – so she would have had the flight from hell to come back all the way from Australia to Cardiff.”

Ms McGarry with her family
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Ms McGarry with her family

Mr McGarry said he later had to have a lot of “very difficult conversations” with NHS staff about what would happen to his daughter’s limbs – with doctors telling him that both of her arms and legs would have to be amputated.

“She’s out of intensive care now after 113 days, she is in the rehabilitation section,” Mr McGarry said.

“The narrative has changed to the body that she has got and what she can do with that.

“I had a wobble for a couple of weeks when I was in front of her and was tearful… she looked me in the eye and she said, ‘Dad, I will make the best of my stumps’.

“And she owned the word ‘stumps’… from that I got a lot of strength because I thought, ‘my God, I think she’s got this’.”

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Lily McGarry during her recovery
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Ms McGarry during her recovery

A GoFundMe account set up to help raise money for prosthetic limbs for Ms McGarry had raised more than £370,000 as of Tuesday night.

Mr McGarry said: “People have been very generous. So there’s that. And that will give Lily that choice down the road.

At the moment, though, we’re focused more on the present – the small steps… getting her wounds to heal.

“The prosthetics – she’s trying now, with just little ones on her arms, just to give her a little bit more independence, which is something she craves.”

Mr McGarry described his daughter as “a delight”, saying: “We went on a walking holiday in the Swiss Alps last year. She was very happy to go walking around, looking at the wonder and the majesty of the Alps, having a nice gooey Swiss fondue and a couple of pints with her dad – it just doesn’t get better.

She’s the best person I know. She’s my daughter.”

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