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Keir Starmer Warns NHS Faces "Managed Decline" Without "All Sorts Of Reform"


5 min read

Labour leader Keir Starmer has warned that the NHS must “reform or die” as he set out a sweeping range of reforms he would implement in the health service if he became prime minister.

Speaking on the BBC’s Sunday with Laura Kuenssberg, the Labour leader said he wanted to “look at all sorts of reform” including expanding the use of the private sector, but insisted that the NHS would always be "free at the point of use".

Starmer had previously pledged during his campaign to become party leader that he would “end outsourcing in the NHS”, claiming at the time that “public services should be in public hands”.

He defended his change in position on Sunday morning, claiming that “a lot has changed” in the three years since he replaced Jeremy Corbyn as leader.

“We've been through Covid, we are still going through an awful conflict in Ukraine and the Tory government has done huge damage to our economy.”

He added that it was wrong to assume that the public would want a leader who “dogmatically insists that whatever was the position before can never change even when the circumstances have changed”.

“We would make more use of the private sector to clear waiting lists… because we have to clear the waiting lists, and we're in the worst crisis we've ever seen for the NHS,” Starmer continued.

His comments expand on an editorial by the Labour leader for The Sunday Telegraph, in which he said the NHS needed “unsentimental reform” and warned that “well-meaning reverence” for it had “supplanted reality”.

He insisted that the NHS should not be “off-limits” and “treated as a shrine rather than a service”, claiming that it was “incumbent on those who want to fix it to be frank about what has gone wrong”.

Changes he said he would oversee under a Labour government included gradually making GPs direct NHS employees rather than independent contractors, and allowing people to access NHS specialists without necessarily needing a GP referral. 

"It's time for us to think about a new, sustainable system, one that allows GPs to focus on caring for patients rather than the admin that comes with effectively running a small business," he said.

He said it was essential to end the “bureaucratic nonsense you encounter every day in the health service” by allowing people to bypass GPs and self-refer to specialist services, and said he would double the number of graduating doctors and nurses.

Shadow Health Secretary Wes Streeting has also recently claimed the NHS was in an “existential” crisis and that he would not "pretend the NHS is the envy of the world".

Hinting at the changes announced by Starmer today, Streeting said in December that the NHS was not "delivering a standard of care that patients should be satisfied with", and that a Labour government "will give the NHS the investment and staff it needs”.

Starmer also hinted on Sunday morning that his position on scrapping university tuition fees had also changed, claiming the shift had been necessitated by the “damage that’s been done to the economy” under the Conservatives.

“I think the tuition fee system needs to be changed. I don't think it's working. I don't think anybody would say it's working,” he told the BBC.

“But looking at the damage that's been done to the economy, [Shadow Chancellor Rachel Reeves] and I have had to be very clear that we will only make commitments that we can afford at the next general election. So we need to look at that promise again.”

He said his party’s focus if they entered Downing Street would be “stabilising the economy”, as well as “restoring our public services and reforming them so they're fit for purpose”.

“I think having that narrow focus as we go into the election will be absolutely fundamental because people are crying out for hope, for change, for the light at the end of the tunnel,” Starmer continued.

Challenges in the NHS have come under the spotlight in recent weeks as thousands of NHS workers have gone on strike over pay and working conditions.

The British Medical Association (BMA), which is currently balloting junior doctor members on whether they would be willing to hold strike action in March, has warned that “future of the NHS is balanced on a knife-edge” with patients' suffering set to continue worsening. 

They accused the government earlier this month of making "a political choice" to ignore the "intolerable" and "unsustainable" crisis in the NHS, and said that "patients are dying unnecessarily because of that choice".

The Royal College of Nursing (RCN), which held the first strike in its history last month, is due to stage its latest round of walk-outs on Wednesday and Thursday this week.

Paramedics who are members of the Unite union are also set to hold the second 24-hour strike of the month on 23 January, also citing pay levels and working conditions.

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Read the most recent article written by Eleanor Langford - Who Is Going On Strike And When In February?