Major NHS investigation says health service is in 'critical condition', setting out need for reform
Today, a sobering report into the state of the NHS in England was released, following a nine week independent investigation by Ara Darzi, an academic surgeon and independent peer.
Lord Drazi was asked by Labour to carry out an investigation into the state of the health service shortly after the election.
The findings – surely coming as little surprise to people who have struggled with long waiting lists – paint a distressing picture. Realities, including that waiting times for procedures have ‘ballooned;’ that cancer care ‘lags behind other countries’ and that A&E is in an ‘awful state’ mean that Lord Darzi has stated that the NHS is in ‘critical condition.’
Thanks, though, to the ‘extraordinary depth of clinical talent’ in the health service and ‘the shared passion and determination to make the NHS better for our patients’, he said that its ‘vital signs are strong’, expressing his belief that ‘just as we in the NHS have turned around performance before, we can do it again.’
The new government has said that the review's findings will help to inform a 10-year plan to reform the NHS.
What are the investigation’s key findings?
The report found that:
A&E is in an ‘awful state’, with stressed services and long waiting times likely leading to an extra 14,000 more deaths a year, according to the Royal College of Emergency Medicine.
Inadequate levels of money being pumped into the NHS has resulted in mental health patients living in ‘Victoria-era cells infested with vermin with 17 men sharing two showers; ‘crumbling buildings’ and ‘parts of the NHS operating in decrepit portacabins.’
More people in the UK are becoming unwell, with 2.8 million people currently unable to work because of poor health.
Cancer care is lagging behind that of comparable countries. ‘The UK has appreciably higher cancer mortality rates than other countries,’ the report states.
Why is the NHS in its current crisis?
The current state of the NHS can be pinned down to four deeply interlinked factors, the report states. These are:
Austerity
Under the last Conservative government, ‘the 2010s were the most austere decade since the NHS was founded, with spending growing at around 1% in real terms,’ the report states.
Capital
‘The NHS has been starved of capital and the capital budget was repeatedly raided to plug holes in day-to-day spending,’ reads the report. ‘The result has been crumbling buildings that hit productivity – services were disrupted at 13 hospitals a day in 2022-23.
‘The backlog maintenance bill now stands at more than £11.6 billion and a lack of capital means that there are too many outdated scanners, too little automation, and parts of the NHS are yet to enter the digital era.’
Shortfall of £37 billion of capital investment. ‘These missing billions are what would have been invested if the NHS had matched peer countries’ levels of capital investment in the 2010s.’
‘That sum could have prevented the backlog maintenance, modernised technology and equipment, and paid for the 40 new hospitals that were promised but which have yet to materialise. It could have rebuilt or refurbished every GP practice in the country’, states the report.
The Covid-19 pandemic
‘The combination of austerity and capital starvation helped define the NHS’s response to the pandemic. It is impossible to understand the current state of the NHS without understanding what happened during it.’
The difference between the health service and that of comparable health systems is stark. ‘…the NHS delayed, cancelled or postponed far more routine care during the pandemic than any comparable health system.
‘Between 2019 and 2020, hip replacements in the UK fell by 46 per cent compared to the OECD average of 13%. Knee replacements crashed a staggering 68% compared to an average fall of 20%. Across the board, the number of discharges from UK hospitals fell by 18% between 2019 and 2020, the biggest drop across comparable countries.’
How does Lord Darzi recommend things change?
In the report, Lord Dazi noted that there is an urgent need to:
Re-engage staff and re-empower patients
Lock in the shift of care closer to home by hardwiring financial flows
Simplify and innovate care delivery for a neighbourhood NHS
Drive productivity in hospitals
Tilt towards technology
Contribute to the nation’s prosperity
Reform to make the structure deliver
What has the prime minister said?
In the wake of the review, Keir Starmer has pledged reform of the NHS, including moving more care from hospitals and into the community, digitising services which are currently analogue and focusing on prevention of sickness, rather than curing.
What are experts saying?
Of the investigation, William Roberts, Chief Executive of charity Royal Society for Public Health, said:
‘Lord Darzi's investigation shows that our national health service is in crisis. This is having tragic consequences on people and communities across the country. To rebuild the NHS we need to move swiftly and decisively to put the Government's ambitions on prevention into practice.’
‘Keeping people well, out of hospital, and off waiting lists is the single most effective way of reducing pressure on the health service. We already have the resources and expertise at our disposal to bring preventative public health services into our communities. Now is the time for the Government to match it's commitment to prevention with action, and we look forward to them engaging with the entire public health community to develop these solutions as a central pillar of the ten year plan.’
‘At the time we need prevention the most we lack the resources to help. Investment in the public health workforce will payoff many times over. We've got nothing to lose and everything to gain. We all stand to benefit from living in a healthier society. Helping people live their lives in better health will benefit individuals, our health service, and our economy which is straining under a workforce crisis caused by ill health.’
You Might Also Like
