No money for NHS without reform, says PM

The NHS will not get any more funding without reforming, Sir Keir Starmer has said as he laid out a 10-year plan to fix the health service.

The prime minister stressed his plans to build an NHS fit for the future "do not just mean putting more money in", and will take a decade to complete.

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Delivering a speech at the King's Fund in central London, he said: "We have to fix the plumbing before we turn on the taps.

"So, hear me when I say this, no more money without reform."

The government has promised three "big shifts" in its approach to fix the NHS:

• Using more technology to create a "digital NHS"
• Shifting more care out of hospitals and into communities
• Moving from treating sickness to focusing on prevention

Describing problems in the NHS, Sir Keir said he wasn't prepared to spend money "on agency staff who cost £5,000 a shift, on appointment letters which arrive after the appointment, or on paying for people to be stuck in hospital just because they can't get the care they need in the community".

"Tonight, there will be 12,000 patients in that very position - that's enough to fill 28 hospitals.

"That isn't just solved by more money, it's solved by reform."

Sir Keir was speaking as NHS performance stats dropped showing the overall waiting list for treatment remained unchanged in July, with an estimated 7.62 million procedures waiting to be carried relating to 6.39 million patients.

The list hit a record high in September 2023 with 7.77 million treatments, after which the figures fell for several months before rising in April, May and June of this year.

Dr Nick Murch, president of the Society for Acute Medicine, said the new NHS figures "demonstrate the scale of the short-term challenge".

In a Q&A after his speech, the prime minister would not be drawn on how soon patients could expect to see improvements.

Asked by Sky News health correspondent Ashish Joshi what he would tell somebody who is ill now, Sir Keir said the success of his plans "is going to be measured in years, not months".

He said: "I accept the challenge to me, which is that it's going to take a long time, it's going to be measured in years, not months, and we need to have something to say for someone who is ill now, which is getting the NHS back on its feet.

"But we can't duck the long-term change."

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The speech comes after a report commissioned by the new government found the NHS is in a "critical condition", with record waiting lists and too much of its budget spent in hospitals.

The study, carried out by independent peer and surgeon Lord Darzi, 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.

It criticises political decision-making under the Conservatives and the coalition government, including the impact of austerity, a "starvation of investment" and the reorganisation of the NHS under the 2012 Health and Social Care Act, which Lord Darzi called "a calamity without international precedent".

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This meant the COVID pandemic came "when resilience was at an all-time low", he said.

The report also said "long waits have become normalised", cancer care lags behind other countries, and describes A&E as being "in an awful state".

Sir Keir said the Tories "broke the NHS" and "only a Labour government" can reform it, adding that it must "reform or die".