(Bloomberg) -- England’s National Health Service has been broken by a lack of funding over more than 10 years, according to a report that lays bare the challenge new Prime Minister Keir Starmer faces in rebuilding an organization ingrained in the national psyche.
Austerity, the pandemic and confusion caused by repeated top-down reorganization have left the health service on its knees, the report finds. Its author, Ara Darzi — a prominent surgeon and an independent peer in the House of Lords — laid much of the blame with politicians.
“Two out of three of those shocks were choices made in Westminster,” said Darzi in a statement. “It took more than a decade for the NHS to fall into disrepair so it’s going to take time to fix it.”
Capital investment fell short by £37 billion ($48.3 billion) during the 2010s compared to peer countries in Europe and beyond, the report, commissioned by Health Secretary Wes Streeting, finds. That sum would pay for 40 new hospitals and be enough to rebuild or refurbish every general practitioner’s practice in the country, it noted. The UK has missed opportunities to embrace digital technologies because of the lack of funding, the report said, and lags far behind its peers in terms of resources like CT and MRI scanners.
The study provides the backdrop to a speech Starmer is due to give in London on Thursday, setting out how the government plans to save the NHS.
As when he talks about the UK’s fragile economy, Starmer has been clear that he sees the health care crisis as one of the former Conservative administration’s making. He will call the damage to the NHS “unforgivable” and say it has caused avoidable deaths, according to his office.
The report supports Starmer’s view, focusing largely on failings during the 2010s when the Conservatives were in power – a period the prime minister will describe as a “lost decade” for the NHS.
Darzi’s report also describes “almost constant” reorganization of NHS management and regulatory employees, costing time and distracting from the core function of the health service.
“Accountability is important. But too many people holding people to account, rather than doing the job, can be counterproductive,” it said.
In its cataloging of the nation’s health, the report finds that people are spending more of their lives unwell, that there are sharp increases in rates of depression, and that cancer mortality rates are higher than in peer countries.
The scale of the issues plaguing the health service has been hard to quantify, Darzi said in the report. He added that he his findings shocked him, despite having worked for over 30 years in the NHS.
Starmer campaigned on fixing the health service ahead of a landslide election victory in July. He repeatedly pointed out that former Prime Minister Rishi Sunak had failed to deliver on his promise to reduce waiting lists, which soared in the aftermath of the Covid-19 pandemic.
Polls show Britons trust Labour more than the Tories to make fundamental changes to a service that plays a pivotal role in millions of people’s lives. Founded by Labour after World War II, NHS services range from emergency treatment in hospitals to general practioner appointments and outreach work.
Still, some of Streeting’s suggestions about how to get waiting lists down — including leveraging capacity in private hospitals — have exacerbated long-running fears about the creeping private takeover of NHS services.
The other question is where Labour will find the money to make significant changes. Chancellor of the Exchequer Rachel Reeves has warned that she has inherited a £22 billion black hole in the public finances. She delivers her first budget statement on Oct. 30.
Streeting is working with Reeves ahead of her first spending review to ensure investment in the NHS also leads to reform, he told the BBC on Thursday, without committing to increasing funding.
“If we don’t grasp both the immediate challenge in front of us and deal with the challenge today, but also prepare the NHS for the challenges of the future,” he said, “we’re more likely to have an NHS which goes bust.”
Streeting said his plan for reform requires a shift from hospital to community care with a greater focus on local pharmacies and GP practices, sickness prevention and a faster roll-out of digital services in the health system.
Dozens of hospital operators in England aren’t breaking even, potentially threatening the quality of care they can offer, analysis by Bloomberg has found. More than 40% of these entities, called National Health Service Trusts, had an operating deficit in the fiscal year ended March 2023, a dramatic deterioration from the previous year when less than 20% were losing money.
The government is in the process of creating a 10-year plan that will focus on bringing the NHS’s digital technology up to speed, moving care from hospitals to communities and championing prevention.
Some of Labour’s ambitions were set out under the previous government. Former Health Secretary Matt Hancock’s team banned fax machines and championed a shift to email and away from paper. However, Darzi’s report finds that parts of the NHS have yet to enter the digital era.
--With assistance from Ellen Milligan.
(Updates with the Streeting’s comments from 15th paragraph.)
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