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Short-term policy making and a decade of underinvestment has left the NHS in a “critical condition” as it turns 75, health experts have warned.

Three leading thinktanks said the service may not reach its 100th birthday without more resources being pumped into it and fundamental reforms.

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”.

Politics live: Sunak under fire for missing PMQs again

In an interview with Sky News, Health Secretary Steve Barclay refused to accept 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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First NHS baby says service is ‘creaking at the seams’
Who is NHS founder Aneurin ‘Nye’ Bevan?

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How does the NHS compare globally?

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”.

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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‘How high will NHS waiting list go?’

‘Decisive break-point’

Ms Caulfield said that the NHS will be “thriving” in 25 years’ time, despite assessments from thinktanks that its future hangs in the balance.

The King’s Fund, the Health Foundation and the Nuffield Trust said that public support for the NHS is “rock solid”, but the service will not be around to celebrate its 100th anniversary without more investment.

They said the service has “endured a decade of underinvestment”, as they attacked an “addiction to short-termism and eye-catching initiatives” which will not help it survive in the long-run.

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Labour: ‘The NHS is in jeopardy’

In a letter to Prime Minister Rishi Sunak and the leaders of the Labour and Liberal Democrat parties – Sir Keir Starmer and Sir Ed Davey – they said the next election should be “a decisive break point” by ending years of short-term policy making when it comes to the NHS.

The organisations said “unachievable and unrealistic” fast improvements without long-term planning will “doom the service to failure”.

The letter said: “Seventy-five years after its creation, the National Health Service is in critical condition.

“The next government will face a choice between providing the investment and reform needed to preserve the NHS for future generations or continuing with short-termism and managed decline.”

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Dame Elizabeth Anionwu joined Sky News to discuss the NHS on the day of its 75th anniversary.

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At least 34 dead in Ukrainian city of Sumy after Russian missile strikes

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At least 34 dead in Ukrainian city of Sumy after Russian missile strikes

At least 34 people – including two children – have been killed after a Russian missile attack on a Ukrainian city.

The country’s state emergency service said another 117 people have been injured, with 15 children among them, in the northeastern city of Sumy.

Ukraine’s foreign ministry later added that one of the children injured was a baby girl born this year, saying “even newborns are targets for Russia’s crimes”.

Volodymyr Zelenskyy also shared videos on Telegram of the aftermath of the attack on social media, showing dead bodies in the middle of a city street near a destroyed bus.

As it happened: Russian attack is ‘signal’ to US and Ukraine

Firefighters work on site of missile strike in Sumy. Pic: State Emergency Service of Ukraine
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Two children were killed in the strike. Pic: State Emergency Service of Ukraine

Russia ‘dragging out this war’ – Zelenskyy

The Ukrainian president said on social media “only scoundrels can act like this” and that “tough reaction from the world is needed”.

Russia wants exactly this kind of terror and is dragging out this war,” he added. “Without pressure on the aggressor, peace is impossible.

“Talks have never stopped ballistic missiles and air bombs. We need the kind of attitude towards Russia that a terrorist deserves.”

Andriy Kovalenko, a security official who runs Ukraine’s centre for countering disinformation, noted the strike came after a visit to Moscow by US envoy Steve Witkoff.

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From Saturday: Putin meets Trump envoy for talks

US official: ‘This is wrong’

Keith Kellogg, Donald Trump‘s envoy for the Ukraine war, said the attack crosses “any line of decency” and that “there are scores of civilian dead and wounded”.

He added: “As a former military leader, I understand targeting and this is wrong. It is why President Trump is working hard to end this war.”

In response to Mr Kellogg, Mr Zelenskyy’s communications adviser, Dmytro Lytvynm asked: “Don’t you think it’s time to smack the Moscow mule across the nose with a 2X4?”.

Later, US secretary of state Marco Rubio said the strike was “horrifying” and a “tragic reminder of why President Trump and his Administration are putting so much time and effort into trying to end this war and achieve durable peace”.

Pic: AP
Image:
Pic: AP

UK Foreign Secretary David Lammy added he was “horrified” by Russia’s “barbaric strike” on Sumy, and called for an “immediate ceasefire”.

Meanwhile, EU Commission President Ursula von der Leyen said “cruelty struck again” and called the strike a “blatant violation of international law”.

It came hours before a separate Russian strike killed three people in the central district of the southern city of Kherson.

Read more:
Why Putin seems to be raising the stakes
2025 ‘critical year’ for Ukraine, warns minister

The local governor, Oleksandr Prokudin, said a 68-year-old woman was injured and died in hospital and that a 48-year-old man also died after “the occupiers dropped an explosive device from a drone”.

A 62-year-old woman was also killed “as a result of the shelling”.

On Saturday, a Russian guided bomb hit a house in the northeastern Ukrainian town of Kupiansk on Saturday, injuring four people.

Governor Oleh Syniehubov said on Telegram that three others could be trapped under rubble.

It comes after Russian diplomats accused each other of violating a tentative US-brokered deal to pause strikes on energy infrastructure.

“The Ukrainians have been attacking us from the very beginning, every passing day, maybe with two or three exceptions,” Sergey Lavrov, Russia’s foreign minister, said, adding that Moscow would provide a list of Kyiv’s attacks from the past three weeks.

Andrii Sybiha, his Ukrainian counterpart, dismissed the claim saying on Saturday that Russia launched “almost 70 missiles, over 2,200 [exploding] drones, and over 6,000 guided aerial bombs at Ukraine, mostly at civilians” since agreeing to the limited pause on strikes.

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Why Vladimir Putin seems to be raising the stakes

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Why Vladimir Putin seems to be raising the stakes

He may not be the one to sit down with Vladimir Putin, but Keith Kellogg, President Trump’s special envoy for Ukraine, summed up the horror of Sunday’s ballistic missile strikes on Sumy succinctly.

“Today’s Palm Sunday attack by Russian forces on civilian targets in Sumy crosses any line of decency,” he said.

“As a former military leader, I understand targeting and this is wrong.”

Ukraine war latest: At least 34 people killed

Vladimir Putin gave up on decency long before he started this war.

What he seems to be risking by attacks of this scale is Donald Trump‘s patience.

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Russia launches strike on Ukraine

He does not seem to mind if strikes like this make a mockery of US attempts to bring the two warring parties to the table.

He does not seem to care if he alienates his US counterpart, who has been strangely predisposed to fawn over him to date.

Perhaps he is raising the stakes as high as he can to illustrate his strength of hand: Strikes on civilians damage Ukrainian morale – even if they are hardly battlefield wins – and on the battlefield, he is pushing ahead and does not want to stop.

Pic: Reuters
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At least 34 people, including two children, were killed in Sumy on Sunday. Pic: Reuters

Perhaps he knows that if he keeps up his military momentum, President Trump will tire of a conflict he realises he cannot solve and let the matter slip while staying true to his MAGA-economic priorities by letting funds for Ukraine dry up.

Perhaps he thinks President Trump is so keen on a rapprochement with Russia, on the big Putin-Trump bilateral, that the details, the civilian deaths along the way, will all be by-the-by when that long-sought photo-op finally happens.

Whatever it is, President Putin seems to be in no rush to get things settled.

His spokesman told a Russian state reporter on Sunday that talks were under way at several levels but that “of course, it is impossible to expect any instant results”.

Withdrawing his troops would get instant results. But that is not what Vladimir Putin wants.

Read more:
The art of doing a deal with Trump
2025 ‘critical year’ for Ukraine, warns official

His war economy is working for him, and he has the attention of the one country he considers a worthy adversary, the United States.

In the meantime, this attack reinforces why President Zelenskyy’s plea for air defence systems is his top priority. And why a ceasefire cannot come soon enough.

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Israeli air strike hits Gaza hospital

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Israeli air strike hits Gaza hospital

An Israeli air strike has hit a hospital in Gaza City, with pictures showing the devastating aftermath at some of its wards.

The al-Ahli Arab Baptist Hospital was hit by multiple missiles, the Hamas-run health ministry said, adding hundreds of patients, medical personnel, and their companions were on site at the time of the attack.

It said the Israeli army had targeted what it described as “one of the oldest and most vital healthcare institutions operating in the Gaza Strip”.

One patient died during the evacuation as medical staff were unable to provide urgent care, it said.

No other casualties have been reported.

Staff inspecting the damaged hospital. Pic: AP
Image:
Pic: AP

The Israeli Defence Forces (IDF) said they “struck a command and control centre used by Hamas” in the hospital.

“The compound was used by Hamas terrorists to plan and execute terror attacks against Israeli civilians and IDF troops,” they said in a statemement.

“Prior to the strike, steps were taken to mitigate harm to civilians or to the hospital compound, including issuing advanced warnings in the area of the terror infrastructure, the use of precise munitions, and aerial surveillance.

“The Hamas terrorist organisation systematically violates international law while using civilian infrastructure, brutally exploiting the civilian population as a human shield for its terrorist activities.”

The health facility’s director, Dr Fadel Naim, said they were warned of the attack beforehand.

A closer look at what was the hospital's outpatient and laboratory wards. Pic: AP
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A closer look at what was the hospital’s outpatient and laboratory wards. Pic: AP

The outpatient and laboratory wards of the Al-Ahli Arab Baptist hospital. Pic: AP
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Pic: AP

Hamas has denied using hospitals for military purposes throughout the war and has accused Israel of intentionally targeting its medical infrastructure in its ongoing offensive.

The latest strikes come after Israel ended its ceasefire with Hamas and restarted its air and ground offensive.

Prime Minister Benjamin Netanyahu’s government has also imposed a month-long blockade on food, fuel and humanitarian aid – a tactic that rights groups say is a war crime.

Israel reconstructs Morag corridor

The Morag Corridor under construction. Pic: IDF
Image:
The Morag Corridor under construction. Pic: IDF

On Saturday, Israel said it had completed the construction of a new security corridor that cuts off the southern city of Rafah from the rest of Gaza.

The security corridor was referred to by Israeli officials as the Morag Axis, a reference to a former Israeli settlement previously located in an area between the two southern cities of Rafah and Khan Younis.

The prime minister said the move gives Israel control of a second axis in southern Gaza in addition to the Philadelphi Corridor, running along the border with Egypt, which Israel sees as a key line stopping weapons being smuggled into Gaza.

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Israeli forces encircle Rafah

Israel has also gained control of the Netzarim Corridor, which cuts off the northern third of Gaza from the rest of the territory.

Morag’s construction is part of Israel’s pledge to seize large parts of Gaza to pressure Hamas to release remaining hostages and accept proposed ceasefire terms, and it further squeezes Palestinians into shrinking areas of land.

In a statement on Saturday, Israel’s defence minister Israel Katz said his country’s military would soon expand “rapidly” throughout most of Gaza and that Palestinians would “have to evacuate the fighting zones”.

He did not say where Palestinians were supposed to go.

The war between Israel and Hamas began when Hamas-led militants invaded Israel on 7 October 2023, killing around 1,200 people and taking 251 hostage.

Some 59 hostages are still being held in Gaza, with 24 still believed to be alive.

The ensuing Israeli offensive has killed more than 50,000 Palestinians, according to Gaza’s Hamas-run health ministry.

It does not distinguish between civilians and combatants in its count, but has previously said more than half of those killed in the conflict are women and children.

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