London, 12 September 2024 (PA Media/dpa/MIA) — Britain's National Health Service (NHS) must reform or die, Prime Minister Keir Starmer will say, as a major report on the health service is published.

Starmer will set out his plans for tackling long waiting lists, improving the nation’s health and shifting the focus towards community services after a damning report from Lord Darzi found the NHS is “in serious trouble”.

The rapid review, completed in nine weeks, diagnoses the problems in the NHS and sets out themes for the Government to incorporate into a 10-year plan for reforming the health service.

The study 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.

Speaking at an event in London on Thursday, Starmer will say: “The NHS is at a fork in the road, and we have a choice about how it should meet these rising demands.

“Raise taxes on working people to meet the ever-higher costs of an ageing population – or reform to secure its future.

“We know working people can’t afford to pay more, so it’s reform or die.”

Starmer will pledge to work on three fundamental areas of reform to make the NHS fit for the future.

He will say this “could amount to the biggest reimagining of our NHS since its birth”, adding: “This Government is working at pace to build a 10-year plan. Something so different from anything that has come before.

“Instead of the top-down approach of the past, this plan is going to have the fingerprints of NHS staff and patients all over it.

“And as we build it together, I want to frame this plan around three big shifts – first, moving from an analogue to a digital NHS. A tomorrow service, not just a today service.

“Second, we’ve got to shift more care from hospitals to communities… And third, we’ve got to be much bolder in moving from sickness to prevention.”

Darzi, a widely respected surgeon and former health minister, argues in his report that the NHS can be fixed.

He says: “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.”

Darzi says the country “cannot afford not to have the NHS, so it is imperative that we turn the situation around”, adding that the health service “is in critical condition, but its vital signs are strong”.

He criticises political decision-making under the Conservatives and the coalition government, including the impact of austerity and the reorganisation of the NHS under Andrew Lansley in 2012.

In his report, Darzi says the “Health and Social Care Act of 2012 was a calamity without international precedent. It proved disastrous”.

He continues: “In the last 15 years, the NHS was hit by three shocks – austerity and starvation of investment, confusion caused by top-down reorganisation, and then the pandemic which came with resilience at an all-time low.

“Two out of three of those shocks were choices made in Westminster.”

As part of his recipe for reform, Darzi says the Government must “re-engage staff and re-empower patients” and must “lock in the shift of care closer to home”.

In his speech on Thursday, Starmer will also point the finger of blame for the current state of the NHS at the previous government, saying it is “unforgivable”.

He will say: “People have every right to be angry. It’s not just because the NHS is so personal to all of us – it’s because some of these failings are life and death.

“Take the waiting times in A&E. That’s not just a source of fear and anxiety – it’s leading to avoidable deaths.

“People’s loved ones who could have been saved. Doctors and nurses whose whole vocation is to save them – hampered from doing so. It’s devastating.”

Professor Kamila Hawthorne, chairwoman of the Royal College of GPs, said: “It makes absolute sense to shift resources into primary care, where patients want to be cared for and where delivering care is most cost effective.”

Conservative shadow health secretary Victoria Atkins said: “We will review this report carefully but it appears that Labour have missed an opportunity to put together meaningful plans for reform.

“We Conservatives recognise that investment has to be married with reform, this is why we brought forward long-term plans for productivity, tech, Pharmacy First, virtual wards, attracting pharmaceutical research and training and retaining staff.

“We did this whilst boosting investment in the NHS in real terms every single year.

“The Labour Government will be judged on its actions.

“It has stopped new hospitals from being built, scrapped our social care reforms and taken money from pensioners to fund unsustainable pay rises with no gains in productivity.

“They need to move from rhetoric to action.”