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:
• 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.
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“That isn’t just solved by more money, it’s solved by reform.”
Image: 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 correspondentAshish 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.
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Breaking down Keir Starmer’s NHS speech
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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Kosovo feels a “political duty” to process failed migrants from the UK, if legal issues can be overcome, the country’s prime minister has told Sky News.
Albin Kurti said there is “limited capacity” in the small nation, which has a population of fewer than two million people, but that he expected a “successful result” from negotiations.
Talks are under way, he confirmed, between officials from both countries about a migrant returns deal for those whose claims have been ruled ineligible by the UK, and are awaiting deportation to their country of origin.
A Home Office team is exploring options for how one could work, Sky News understands, although no formal request has yet been made to Kosovo to host a facility.
Mr Kurti, who is attending a Western Balkans Summit in London this week, said: “We want to help the UK, we consider that that is our friendly and political duty.
“We have limited capacity but still we want to help, and as we speak, there is regular communication between our teams of state officials from our ministry of internal affairs and lawyers about how to do this smoothly for mutual benefit.
“Of course, we want, as a country, to benefit but we consider it first and foremost our obligation to help you because you helped us a great deal and will never forget that.”
Image: Rescued migrants are brought in by the RNLI to Dover earlier this month. Pic: PA
Western Balkans key allies
Sir Keir Starmer has identified the countries of the Western Balkans as key allies in the fight against irregular migration, with 22,000 people using this route to reach the UK last year.
The UK government has signed agreements to tackle smuggling gangs with Serbia, Albania, North Macedonia and Kosovo.
Keir Starmer said earlier this year that the government was in talks with unnamed countries about setting up “return hubs” which he called an “important innovation” for individuals who have exhausted all appeals in the UK system.
Kosovo is the first to confirm these negotiations are under way, and further discussions about it are likely in the margins of this week’s summit.
The small eastern European nation and the UK have strong ties, with Sir Tony Blair feted in the country for his government’s role in spearheading NATO airstrikes on Serbia in 1999, which helped end the Kosovo War.
In June, Kosovo made an agreement with the US, negotiated under the Biden administration, to take up to 50 US deportees who met certain criteria. But it is understood only one or two have arrived due to legal issues.
Kosovo would likely be seeking a defence agreement and UK investment in return, with the country concerned about Russian aggression and hostility from neighbouring Serbia.
Image: Tony Blair receiving a hero’s welcome in Kosovo in 1999. Pic: Reuters
Kosovo wants security support
Mr Kurti added: “We would like mainly to get support in security – be that through strategic agreements, or through equipment and projects we might do. Our two teams are working on this, but I think this will have a successful result.”
It is not expected the UK will make a formal request until further legal issues are worked through, which could be significant.
A controversial deal made by Italy in 2023 to send thousands of migrants to two detention centres in Albania has cost millions of euros and been halted by multiple legal obstacles.
Andi Hoxhaj, Balkan expert at King’s College, said: “Such a deal is unlikely to happen at the Summit. Nevertheless, I expect some statement indicating that the UK and one or two Western Balkan countries are close to reaching an agreement.”
“Establishing an agreement with the UK would not be politically sensitive in Kosovo. The country continues to seek deeper ties with one of its strongest allies-one that played a crucial role in its path to independence.”
Kosovo has convict deal with Denmark
Sir Keir was left embarrassed on a visit to the Albanian capital in May when he announced the UK was in talks about return hubs in the Balkans, only for Albanian Prime Minister Edi Rama to say he would not allow the UK to “dump immigrants” in his country when it is in a “marriage” with Italy.
Under Yvette Cooper, the Foreign Office has shifted focus to migration – with more staff working on the issue, drawing up sanctions on people smugglers and pursuing returns agreements.
Kosovo has also ratified a deal with Denmark – another active contributor to the NATO-led Kosovo peacekeeping force – to take 300 convicts from its overcrowded prisons, due to start in 2027.
Return hubs are different from offshore processing – which is what the Conservatives had proposed with the Rwanda scheme.
It is proposed that individuals would only be sent to a return hub if their claim for asylum in the UK had been rejected – and they were awaiting deportation.
By sending them to a third country, the government hopes it will prevent people trying to frustrate and delay the process of removal and that it could act as a deterrent to people coming in small boats.
Only 3% of people of small boat arrivals in 2018-24, or around 5,000 people, were returned from the UK, according to the Oxford Migration Observatory, although removals of failed migrants from all routes has increased in the past year.
Officers should focus on “tackling real crime and policing the streets”, Downing Street has said – after the Metropolitan Police announced it is no longer investigating non-crime hate incidents.
The announcement by Britain’s biggest force on Monday came after it emerged Father Ted creator Graham Linehan will face no further action after he was arrested at Heathrow Airport on suspicion of inciting violence over three posts he made on X about transgender issues.
Sir Keir Starmer’s spokesman said police forces will “get the clarity they need to keep our streets safe” when a review of non-crime hate incidents by the National Police Chiefs’ Council and College of Policing is published in December.
“The police should focus on tackling real crime and policing the streets,” he said.
“The home secretary has asked that this review be completed at pace, working with the National Police Chiefs’ Council and the College of Policing.
“We look forward to receiving its findings as soon as possible, so that the other forces get the clarity they need to keep our streets safe.”
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He said the government will “always work with police chiefs to make sure criminal law and guidance reflects the common-sense approach we all want to see in policing”.
After Linehan’s September arrest, Met Police Commissioner Sir Mark Rowley said officers were in “an impossible position” when dealing with statements made online.
Image: File pic: iStock
On Monday, a Met spokesperson said the commissioner had been “clear he doesn’t believe officers should be policing toxic culture war debates, with current laws and rules on inciting violence online leaving them in an impossible position”.
The force said the decision to no longer investigate non-crime hate incidents would now “provide clearer direction for officers, reduce ambiguity and enable them to focus on matters that meet the threshold for criminal investigations”.
Justice minister Sarah Sackman said it is “welcome news” the Met will now be focusing on crimes such as phone snatching, mugging, antisocial behaviour and violent crime.
Asked if other forces should follow the Met’s decision, she said: “I think that other forces need to make the decisions that are right for their communities.
“But I’m sure that communities up and down the country would want that renewed focus on violent crime, on antisocial behaviour, and on actual hate crime.”
The Met said it will still record non-crime hate incidents to use as “valuable pieces of intelligence to establish potential patterns of behaviour or criminality”.
Industry watchers welcomed the idea of “skinny” master accounts as another sign of the end of crypto’s banking troubles, in what insiders describe as “Operation Chokepoint 2.0.”