Lord Ara Darzi has published a full and independent investigation into the state of the NHS and has concluded that the service is in a ‘critical condition’, but it 'can be fixed'.
He reported being “shocked” by what he found during the investigation - not just in the health service but in the state of the nation’s health. He commented: “We want to deliver high quality care for all but far too many people are waiting for too long and in too many clinical areas, quality of care has gone backwards.”
He added: “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. It took more than a decade for the NHS to fall into disrepair so it’s going to take time to fix it. But we in the NHS have turned things around before, and I’m confident we will do it again.”
Key findings from Lord Darzi’s 142-page report included:
- Deterioration: The health of the nation has deteriorated over the past 15 years, with a substantial increase in the number of people living with multiple long-term conditions.
- Spending: Too great a share of the NHS budget is being spent in hospitals, too little in the community, and productivity is too low.
- Waiting times: Waiting lists have swelled and waiting times have surged, with A&E queues more than doubling from an average of just under 40 people on a typical evening in April 2009 to over 100 in April 2024. 1 in 10 patients are now waiting for 12 hours or more.
- Cancer care: The UK has appreciably higher cancer mortality rates than other countries, with no progress whatsoever made in diagnosing cancer at stage one and two between 2013 and 2021.
- Lasting damage: The Health and Social Care Act of 2012 did lasting damage to the management capacity and capability of the NHS. It took 10 years to return to a sensible structure, and the effects continue to be felt to this day.
- Productivity: Too many resources have been being poured into hospitals where productivity had substantially fallen, while too little has been spent in the community.
Responding to the report, Prime Minister Keir Starmer said that the state of the NHS was "unforgiveable" and "people have every right to be angry".
"The NHS may be broken, but it’s not beaten," he asserted, emphasising that what is needed is "major surgery not sticking plasters".
"We’ve got to face up to the challenges…Look at our ageing society and the higher burden of disease. The NHS is at a fork in the road and we have a choice about how it should meet these rising demands," he continued. He suggested that there are two options - to raise taxes on working people or reform to secure the NHS's future. "Working people can’t afford to pay more. So it’s reform or die," he warned.
Secretary of State Wes Streeting said: “I asked Lord Darzi to tell hard truths about the state of the NHS. He has produced an honest, expert, comprehensive report on the appalling state our health service is in. These findings will inform our 10-year plan to radically reform the NHS and get patients treated on time again.”
Amanda Pritchard, NHS England Chief Executive, said: “As this report sets out, staff are the beating heart of the NHS with a shared passion and determination for making the NHS better for patients - but it is also clear they are facing unprecedented challenges.
“Our staff are treating record numbers of patients every day despite ageing equipment and crumbling buildings, a surge in multiple long-term illnesses, and managing the long-lasting effects of the pandemic.
“While teams are working hard to get services back on track, it is clear waiting times across many services are unacceptable and we need to address the underlying issues outlined in Lord Darzi’s report so we can deliver the care we all want for patients.
“As Lord Darzi rightly points out, many of the solutions can be found in parts of the NHS today. That is why we are fully committed to working with government to create a 10-year plan for healthcare to ensure the NHS recovers from Covid, strengthens its foundations and continues to reform so it is fit for future generations.”
Commenting on the publication of Lord Darzi’s Independent Investigation of the National Health Service in England, Sarah Woolnough, Chief Executive of The King’s Fund said: “This is an authoritative and sobering articulation of what patients have been telling us for some time – services are stretched to breaking point and people are losing faith that support will be there when they need it.
“The report is more than a gloomy assessment of how long it will take to recover services, it is a mandate for government to take bold, decisive action. The biggest improvements to health and care in our country will come from prioritising services outside of hospital.
“That means greater investment in the primary and community services that support people before they end up needing hospital treatment. It means political focus on public health strategies that keep people healthy and preventing illness in the first place. And it means finally getting to grips with the much-needed reform of adult social care.
“Lord Darzi’s report also underscores the need to move beyond past lazy criticism of the value of NHS managers and instead recognise that implementing major improvement of the health service requires investment in high quality leaders.
“Ministers now face tough trade-offs between tackling immediate NHS pressures, or prioritising reform of the root causes of the crisis. This report makes it clear that incremental improvement will not do – radical change is needed. The task is not simply to prop the NHS back up, it is to create a new approach to health and care in this country.”
View the full report at: https://www.gov.uk/government/publications/independent-investigation-of-the-nhs-in-england
