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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3:32
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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Labour will eliminate unauthorised sewage spillages in 10 years, the environment secretary has told Sky News.
Steve Reed also pledged to halve sewage pollution from water companies by 2030 as he announced £104 billion of private investment to help the government do that.
“Over a decade of national renewal, we’ll be able to eliminate unauthorised sewage spillages,” he said.
“But you have to have staging posts along the way, cutting it in half in five years is a dramatic improvement to the problem getting worse and worse and worse every single year.”
He said the water sector is “absolutely broken” and promised to rebuild it and reform it from “top to bottom”.
His earlier pledge to halve sewage pollution from water companies by 2030 is linked to 2024 levels.
The government said it is the first time ministers have set a clear target to reduce sewage pollution and is part of its efforts to respond to record sewage spills and rising water bills.
Ministers are also aiming to cut phosphorus – which causes harmful algae blooms – in half by 2028.
Image: Environment Secretary Steve Reed. File pic: PA
Mr Reed said families had watched rivers, coastlines and lakes “suffer from record levels of pollution”.
“My pledge to you: the government will halve sewage pollution from water companies by the end of the decade,” he added.
Addressing suggestions wealthier families would be charged more for their water, Mr Reed said there are already “social tariffs” and he does not think more needs to be done, as he pointed out there is help for those struggling to pay water bills.
The announcement comes ahead of the publication of the Independent Water Commission’s landmark review into the sector on Monday morning.
The commission was established by the UK and Welsh governments as part of their joint response to failures in the industry, but ministers have already said they’ll stop short of nationalising water companies.
Mr Reed said he is eagerly awaiting the report’s publication and said he would wait to see what author Sir John Cunliffe says about Ofwat, the water regulator, following suggestions the government is considering scrapping it.
On Friday, the Environment Agency published data which showed serious pollution incidents caused by water firms increased by 60% in England last year, compared with 2023.
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1:38
Why sewage outflows are discharging into rivers
Meanwhile, the watchdog has received a record £189m to support hundreds of enforcement officers for inspections and prosecutions.
“One of the largest infrastructure projects in England’s history will clean up our rivers, lakes and seas for good,” Mr Reed said.
But the Conservatives have accused the Labour government of having so far “simply copied previous Conservative government policy”.
“Labour’s water plans must also include credible proposals to improve the water system’s resilience to droughts, without placing an additional burden on bill payers and taxpayers,” shadow environment secretary Victoria Atkins added.
The Rivers Trust says sewage and wastewater discharges have taken place over the weekend, amid thunderstorms in parts of the UK.
Discharges take place to prevent the system from becoming overwhelmed, with storm overflows used to release extra wastewater and rainwater into rivers and seas.
Water company Southern Water said storm releases are part of the way sewage and drainage systems across the world protect homes, schools and hospitals from flooding.
Circle’s Dante Disparte says the GENIUS Act ensures tech giants and banks can’t dominate the stablecoin market without facing strict structural and regulatory hurdles.