Prime Minister Keir Starmer has promised to deliver the “biggest reimagining of our NHS since its birth” in response to Ara Darzi’s independent investigation into the state of the health service in England.
The report1 by Darzi, a surgeon and former Labour health minister, said the NHS is in a “critical condition,” degraded by years of austerity and “disastrous” structural reforms that were “political choices.”
Starmer said the service must “reform or die” to meet the challenges it faces, promising “major surgery, not sticking plaster solutions.”
A decade of underinvestment
Darzi was commissioned in July by health secretary Wes Streeting to assess all facets of the NHS in England including patient access, quality of care, and overall performance. Publishing his rapid review on 11 September, Darzi said he was “shocked” by what he had found (see box).
He said the health service had been chronically weakened over more than a decade by a lack of capital investment, leaving ballooning waiting lists, emergency departments in “an awful state,” cancer mortality “appreciably higher” than in other countries, falling productivity, public satisfaction at its lowest ever, and many staff exhausted and disengaged, having lost confidence in the service.
Highlighting that the NHS continues to struggle with the aftershocks of the pandemic, Darzi said austerity and capital starvation “helped define” the UK’s response to covid-19, with deteriorating patient access to almost every form of care, a surge in multiple long term conditions, high rates of long term sickness and mental ill health, and capital starved hospitals lacking new scanners and automation.
A sicker society
Many of the social determinants of health—such …
