By Stephen Castle
England’s revered National Health Service is reported to be in a “critical” state, as per a government-commissioned analysis which pointed to extensive wait times for care, deteriorating hospital conditions, mental health patients being housed in “vermin-infested cells,” and significantly fewer MRI scanners compared to similar nations.
The incisive review, released late Wednesday, was ordered by the newly elected Prime Minister Keir Starmer after winning the general election. According to polls, the troubling status of the NHS was a significant factor behind many voters choosing his Labour Party in July.
However, the report emphasizes the magnitude of the hurdles the government must overcome to rejuvenate a healthcare system that has been in continuous decline due to years of inadequate funding and bureaucratic interference, compounded by the lingering effects of the pandemic.
In comments made public on Wednesday, Starmer indicated he is developing a 10-year strategy that could represent the “most significant overhaul of our NHS” since its inception in 1948.
The report, authored by Ara Darzi, a surgeon and member of the House of Lords, noted that during the 2010s, under a government led by the Conservatives that initiated stringent austerity measures, the NHS was “starved of capital,” causing it to lag behind other countries in investments in diagnostic tools, technology, and infrastructure.
These findings are unlikely to astonish Britons, whose satisfaction with the health service has reached an all-time low, according to the report, having peaked in 2009. Nevertheless, even Darzi, who has dedicated three decades to the NHS, expressed being “shocked” by his findings and attributed the issues to successive Conservative-led administrations that were in power for 14 years.
Starmer characterized the report’s insights as “unforgivable” in comments shared prior to a forthcoming speech, wherein he intends to assert that the health service must “reform or die.”
“People are justified in being furious,” he stated. “It’s not just because the NHS is so personal to all of us — it’s because many of these failures are matters of life and death.”
Financed through general taxation and payroll contributions, medical services in Britain are provided to patients without any financial exchanges at the point of care, with certain exceptions for dental care and prescription drugs.
The NHS was established after World War II by a Labour administration with the objective of ensuring healthcare access for all citizens, irrespective of their financial means. Its popularity is such that former Chancellor of the Exchequer Nigel Lawson referred to it as “the closest thing the English have to a religion.”
In his address on Thursday, Starmer is anticipated to prepare the public for a prolonged wait before seeing improvements in their health care system. This echoes a warning he issued last month indicating that, given the scale of the challenges he faced in revamping the economy and public services, “things may deteriorate before they get better.”
Starmer indicated that his administration would prioritize the digitization of the NHS, transferring care from overwhelmed hospitals to alternative community settings, and enhancing investment in preventive healthcare.
Darzi’s report highlighted that the lack of investment in the NHS coincided with increasing demand due to Britain’s aging population and rising chronic illness rates.
Among the repercussions: Prolonged wait times for emergency care are believed to have resulted in an additional 14,000 deaths annually. Furthermore, cancer patient outcomes in Britain fall short of those in comparable nations, with significantly higher mortality rates, as noted in the report.
Darzi was especially critical of the major NHS restructuring in 2012 by Conservative Health Secretary Andrew Lansley, which the report labeled as “a calamity without international precedent.”
According to him, the health service’s capacity has been “deteriorated by disastrous management reforms,” while “the trust and goodwill of many frontline staff has been eroded.”
The reforms aimed to stimulate more competition in health services but were condemned for resulting in a fragmented and convoluted system.
Jennifer Dixon, CEO of the Health Foundation charity, stated that the report outlined several “clear priorities” for reform and asserted, “The NHS is weakened but not beyond repair — and staff can restore services if they are allocated the necessary resources.”
Darzi, who was previously affiliated with the Labour Party but departed due to its handling of antisemitism accusations under former leader Jeremy Corbyn, pointed out that government spending increases for the NHS during most of the 2010s were hampered to just 1%, compared to a decades-long average of 3.4%.
Long-standing issues within the health service escalated into crises during the COVID-19 pandemic, and the NHS entered this period with fewer beds and staffing levels than most other affluent health systems, according to the report.
Hospitals postponed, delayed, or canceled more non-urgent care during this time than any other equivalent health system.
Consequently, this led to extended wait times for treatment. Emergency room queues more than doubled, rising from an average of just below 40 individuals on a typical evening in April 2009 to over 100 in April of this year.
