The new Labour government has already made some progress in reforming the health system but there is much more to do, says KEITH VENABLES.
The new Labour government’s first King’s Speech on 17 July included two health related bills – the Tobacco and Vapes Bill, and the Mental Health Bill – and Keir Starmer’s administration quickly agreed above inflation pay claims for all health workers and a 22.3% settlement for junior doctors.
It also commissioned Lord Darzi to investigate NHS data. His report, published in mid-September, condemned the Tories for 14 years of underfunding and privatisation, stating that the health service is in “critical condition”.
The question now is, what policies will Keir Starmer and health secretary Wes Streeting come up with in response?
Streeting has consistently and strongly hinted that privatisation will be part of any new package, although Darzi concludes that the NHS, when funded to succeed, was one of the very best health systems in the world, and can be again.
“Nothing that I have found draws into question the principles of a health service that is taxpayer funded, free at the point of use, and based on need, not ability to pay,” he said.
He points out that public health budgets have been slashed by 25% while our growing and less healthy population increases demand. He catalogues problems, such as delays in accessing care, missed targets and lost lives, and identifies the main causes of poor productivity.
Austerity
The first of these is austerity, the Tory cuts that ensured the NHS was in poor shape before the Covid pandemic hit.
There has also been a severe lack of capital investment (a £37bn shortfall compared with peer countries), which has left a crumbling estate that is not conducive to productivity, meaning services are disrupted every day at multiple hospitals.
Viewing the 2012 Health and Social Care Act as “a calamity without international precedent”, Darzi warns that further top-down reorganisations are neither necessary nor desirable.
“The 2010s were the most austere decade since the NHS was founded, with spending growing at around 1 per cent in real terms,” he says. “The 2018 funding promise was broken… Spending increased… below the historic rate (of 4% per year)… The NHS has been starved of capital and the capital budget was repeatedly raided to plug holes in day-to-day spending.”
So far Streeting has said the health system needs three ‘big shifts’:
- from hospital to community care
- from analogue to digital
- from treating sickness to preventing it.
For the campaign group, Keep Our NHS Public, the necessary shifts are:
- from underfunding towards funding the NHS to succeed
- from private outsourcing to restoring publicly provided NHS services
- fromfragmentation of services to a reunited national NHS
- from underfunding towards a national service for care, support and independent living.
Darzi argues for proper funding and no reliance on privatisation. So far, Starmer’s team has not offered to increase NHS funding. There may be a battle ahead.
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Keith Venables is a former co-chair of Keep Our NHS Public, and a coordinator of the Independent Working Class Education Network.
This article partly relies on KONP documents.
See also: ‘Labour in Government: Lords Reform & Remaining Wrongs’ by Chris Wilson.
