For the 1.4 million people working in the NHS, it’s unlikely that the Darzi Review (published on 12 September) will make for surprising reading. First commissioned by Wes Streeting within days of Labour’s romp to victory on 4 July, the 163-page report is an excoriating state of the nation review of the NHS since 2001. It has been completed by the former Labour health minister, Ara Darzi and received an immediate response from the prime minister, who told an audience of healthcare experts at the King’s Fund that the review is a “raw and honest assessment” of healthcare in the UK.
“The NHS is in critical condition,” Darzi writes, “but its vital signs are strong.” The report makes it categorically clear that many of the problems currently facing the NHS can be traced back to austerity. In October 2010, then chancellor of the exchequer, George Osborne announced an £80m cut to the NHS’s budget; the largest package of cuts since the service was founded. The report describes the 2010s as the “most austere decade” for the NHS since the service was founded in 1948. Spending flatlined in real terms until 2018.
A physical result of this restraint in funding has seen hospital and other healthcare buildings across the NHS estate fall into disrepair. Buildings have been left crumbling or littered with leaks due to raids on the capital funding budget in order to fill in gaps in day-to-day spending. Darzi’s report highlights that the NHS – compared to other countries’ health services – has seen its capital budget wanting of £37bn. This money, the report makes clear, could have been used to build 40 new hospitals, or to refurbish every GP surgery in the country. It points out that instead, “mental health patients [are] being accommodated in Victorian-era cells infested with vermin with 17 men sharing two showers and parts of the NHS operating in decrepit portacabins.”
Indeed, this lack of investment has had consequences which stretch beyond the realms of the NHS’s physical form. The NHS is renowned for its reliance on old, out-dated, rickety tech leaving it exposed to cyber attacks (such as the incident on 3 June which severely disrupted care at Guy’s Hospital, St Thomas’s Hospital and King’s College Hospital in London).
That healthcare staff are reliant on tech which often ends up not working, or breaking down ahead of vital appointments has had a marked impact on their ability to see patients smoothly and efficiently (obviously!). Darzi’s report contends that the wait times and quality of treatment “are at the heart of the social contract between the NHS and the people”. The “NHS has not been able to meet the most important promises made to the people since 2015” the report adds. In that time, it has consistently missed nearly every target it has set for A&E, cancer and hospital waiting lists with 7.6 people still hanging on for their treatment, in comparison to the 2.4m people who were on a healthcare waiting list in 2010.
As a result, Darzi diagnoses the health of the nation has substantially deteriorated, with more and more people spending more and more years in ill health. This has sent national healthcare into a doom spiral: patients present at A&E late into their symptoms well past the point where a simple solution could have been provided; they are, of course, arriving too far into their illnesses because they couldn’t secure a GP appointment in the first place; and so the system is burdened by complicated and expensive cases because it’s burdened by complicated and expensive cases.
But increasing funding for the NHS is not a silver bullet. In fact, Darzi’s report categorically proves that one does not lead to the other. Take, for example, instances where NHS staff numbers have increased since 2010. These have not been accompanied by an improvement in the service’s infrastructure. Hiring more doctors and nurses will only work if they are given adequate equipment and resources to work with.
It’s clear – then – that the new government must seriously consider reforming this major, unwieldly institution if it is to improve the nation’s health. In his speech today, Starmer described the report’s findings as “unforgivable” adding that “people have a right to be angry”. But with the so-called £22bn black hole hanging like an albatross around the neck of this new Labour cabinet, it is difficult to see where the energy for such a comprehensive programme of change will actually come from.
Content from our partners
Related
