‘If you don’t reform the NHS I fear it will die’: Sir Keir Starmer pledges overhaul of GP services
Sir Keir Starmer has promised to overhaul GP services if he gets into power, saying the NHS will “die” without drastic change.
The Labour leader revealed his plans in the Sunday Telegraph, including making family doctors direct employees of the NHS and allowing patients to self refer to specialists.
Speaking to broadcasters later, he issued a stark warning about the service, saying: “Frankly, if you don’t reform the NHS then I fear it will die.”
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Dr Philip Banfield, chair of the British Medical Association, criticised the plans, saying GPs were “one of the most efficient and effective parts of the health service”.
Labour has already unveiled some of its proposals for the NHS if it took power at the next election, including funding more medical school places by scrapping the non-dom tax status and introducing a 10-year plan for reform.
Sir Keir gave more detail today, with a focus on primary care, saying: “When people can’t walk through that front door they inevitably end up going through another, more expensive one – the hospital.
“Quality care in the community provided by GPs is the difference between a diabetes patient living a happy, fulfilled life versus needing an emergency amputation. It is that stark.”
Writing in the newspaper, he said he would phase in a new system as existing GPs retire, replacing their contracts with direct NHS employment for new practitioners, allowing them to “focus on caring for patients rather than the admin that comes with effectively running a small business”.
He also said he would “be ruthless with the bureaucratic nonsense”, so, for example, people with back pain could refer themselves to a physio, or people needing tests could do them at home, rather than going through a GP.
Speaking later from central London, the party leader said: “I am a passionate defender of the NHS but in order to preserve the NHS going forward it has to change.
“And what we have seen is the worst NHS crisis under this government and every year it just gets worse. I think if we reform the NHS we can… make it fit for the 21st century and have it absolutely focused on patients.”
‘Managed decline’ under Tories
Sir Keir attacked the government’s handling of the service, accusing them of “just presiding over the managed decline – and that I will not accept for a Labour government”.
He also headed off his critics, pointing to his previous work running a public body.
“I have long believed in reform of public services,” he added. “When I ran the Crown Prosecution Service I could see the reform we needed.
“We will always have, whether it be the NHS or any other public service, people who say, ‘well don’t do it, it has always been done this way’. They are nearly always wrong.
“Of course there will be challenges whenever you reform something but frankly, if you don’t reform the NHS then I fear it will die.”
Dr Banfield is one of those against the changes, specifically the plan for self-referral.
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He also told Sky News about his wife’s experience spending 12 hours on an A&E trolley.
He told Sky News’ Sophy Ridge that he had met with Labour’s shadow health secretary Wes Streeting this week to discuss the proposals and “we had to agree to disagree”, with the chair claiming the MP “doesn’t understand general practice”.
“GPs are one of the most efficient and effective parts of the health service in the way that they manage risk, they are superb at it,” Dr Banfield added.
He also said Labour “have a lot of work to do between now and an election” to get his organisation onside.
“We have offered to help them with that and we’ll do business with anyone who has the right policies,” he said.
World
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The COP29 climate talks have reached a last ditch deal on cash for developing countries, pulling the summit back from the brink of collapse after a group of countries stormed out of a negotiating room earlier.
The slew of deals finally signed off in the small hours of Sunday morning in Azerbaijan includes one that proved hardest of all – one about money.
Eventually the more than 190 countries in Baku agreed a target for richer polluting countries such as the UK, EU and Japan to drum up $300bn a year by 2035 to help poorer nations both curb and adapt to climate change.
It is a far cry from the $1.3trn experts say is needed, and from the $500bn that vulnerable countries like Uganda had said they would be willing to accept.
But in the end they were forced to, knowing they could not afford to live without it, nor wait until next year to try again, when a Donald Trump presidency would make things even harder.
Bolivia’s lead negotiator Diego Pacheco called it an “insult”, while the Marshall Islands’ Tina Stege said it was “not nearly enough, but it’s a start”.
UN climate chief Simon Stiell said: “This new finance goal is an insurance policy for humanity, amid worsening climate impacts hitting every country.
“No country got everything they wanted, and we leave Baku with a mountain of work still to do. So this is no time for victory laps.”
The funding deal was clinched more than 24 hours into overtime, and against what felt like all the odds.
The talks were rocked from the start by the incoming presidency of climate denier Mr Trump, the moment Argentina’s team were recalled back to Buenos Aires by their right-wing president and a controversial letter that sent shockwaves through the United Nations.
Pic: AP
The fraught two weeks of negotiations pitted the anger of developing countries who are footing the bill for more dangerous weather that they did little to cause, against the tight public finances of rich countries.
A relieved Juan Carlos Monterrey Gomez, climate envoy for Panama, said there is “light at the end of the tunnel”.
Just hours ago, the talks almost fell apart as furious vulnerable nations stormed out of negotiations in frustration over that elusive funding goal.
They were also angry with oil and gas producing countries, who stood accused of trying to dilute aspects of the deal on cutting fossil fuels.
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Climate-vulnerable nations storm out of talks
The UN talks work on consensus, meaning everyone has to agree for a deal to fly.
A row over how to follow up on last year’s pledge to “transition away from fossil fuels” was left unresolved and punted into next year, following objections from Chile and Switzerland for being too weak.
A draft deal simply “reaffirmed” the commitment but did not dial up the pressure in the way the UK, EU, island states and many others here wanted.
Saudi Arabia fought the hardest against any step forward on cutting fossil fuels, the primary cause of climate change that is intensifying floods, drought and fires around the world.
Governments did manage to strike a deal on carbon markets at COP29, which has been 10 years in the making and will allow countries to trade emissions cuts.
‘Not everything we wanted’
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The UK’s energy secretary, Ed Miliband, said the deal is “not everything we or others wanted”, but described it as a “step forward”.
“It’s a deal that will drive forward the clean energy transition, which is essential for jobs and growth in Britain and for protecting us all against the worsening climate crisis,” he added.
“Today’s agreement sends the signal that the clean energy transition is unstoppable.
“It is the biggest economic opportunity of the 21st century and through our championing of it we can help crowd in private investment.”
Protesters at the summit in Baku. Pic: AP
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The Azerbaijan team leading COP29 said: “Every hour of the day, we have pulled people together. Every inch of the way, we have pushed for the highest common denominator.
“We have faced geopolitical headwinds and made every effort to be an honest broker for all sides.”
At least 20 people have been killed and 66 injured in Israeli strikes on central Beirut, Lebanese authorities have said.
Lebanon‘s health ministry said the death toll could rise as emergency workers dig through the rubble looking for survivors. DNA tests are being used to identify the victims, the ministry added.
The attack destroyed an eight-storey residential building and badly damaged several others around it in the Basta neighbourhood at 4am (2am UK time) on Saturday.
The central Basta neighbourhood in Beirut
The Israeli military did not warn residents to evacuate before the attack and has not commented on the casualties.
At least four bombs were dropped in the attack – the fourth targeting the city centre this week.
A separate drone strike in the southern port city of Tyre this morning killed two people and injured three, according to the state-run National News Agency.
The victims were Palestinian refugees from the nearby al Rashidieh camp who were out fishing, according to Mohammed Bikai, spokesperson for the Fatah Palestinian faction in the Tyre area.
Israel’s military warned residents today in parts of Beirut’s southern suburbs that they were near Hezbollah facilities, which the army would target in the near future. The warning, posted on X, told people to evacuate at least 500 metres away.
The army said that over the past day it had conducted intelligence-based strikes on Hezbollah targets in Dahiyeh, in Beirut’s southern suburbs, where Hezbollah has a strong presence. It said it hit several command centres and weapons storage facilities.
Pic: AP
Israel has killed several Hezbollah leaders in air strikes on the capital’s southern suburbs.
Heavy fighting between Israel and Hezbollah is ongoing in southern Lebanon, as Israeli forces push deeper into the country since launching a major offensive in September.
According to the Lebanese health ministry, at least 3,670 people have been killed in Israeli attacks there, with more than 15,400 wounded.
It has displaced about 1.2 million people – a quarter of Lebanon’s population – while Israel says about 90 soldiers and nearly 50 civilians have been killed in northern Israel.
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‘Dozens’ of Palestinians killed in Israeli airstrike
Meanwhile, six people, including three children and two women, were killed in the southern Gazan city of Khan Younis.
Some 44,176 Palestinians have been killed since the start of Israel’s military campaign in Gaza, according to the Gaza health ministry.
The ministry does not distinguish between civilians and combatants in its count, but it has said that more than half of the fatalities are women and children.
The war began when Hamas-led militants stormed into southern Israel on 7 October 2023, killing some 1,200 people and taking another 250 hostage.
US envoy Amos Hochstein was in the region this week to try to end more than 13 months of fighting between Israel and Hezbollah, ignited last October by the war in Gaza.
Mr Hochstein indicated progress had been made after meetings in Beirut on Tuesday and Wednesday, before going to meet Israeli Prime Minister Benjamin Netanyahu and defence minister Israel Katz.
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