Today’s major report by peer and NHS surgeon Lord Darzi on the National Health Service aims to perform three very clear political tasks.
The first is to set expectations that the service will not be fixed by the time of the next election by talking about a 10-year, two-parliament programme for change.
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The second is to prepare the ground for more money to go into the NHS – something Sir Keir Starmer appeared to explicitly signal today.
The third is to change the way we think about what’s needed for the NHS.
This means moving away from the way the Tories’ talk about NHS reform – stop focusing on new hospitals as a goal in of themselves and framing social care reform as a means of freeing up NHS beds rather than protecting middle-class wealth, for instance.
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Today, we did not learn the shape of a reborn NHS. Instead, we were treated to some naked politics by a prime minister trying to condition and calm expectations.
The most significant thing from Sir Keir’s interpretation of the report was an apparent acknowledgement that, in time, more money – presumably reasonable sums of more money – will be needed.
Addressing the King’s Fund thinktank, the prime minister said: “A Labour government will always make the investment in our NHS that is needed. Always. But we have to fix the plumbing before turning on the taps.
“So, hear me when I say this, no more money without reform.”
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Look closely at this commitment – there is no question that the funding taps will be turned on in future, according to the PM – albeit not immediately.
He repeats this several times. This hints at proper additional sums. Taps when turned on gush with water – Sir Keir doesn’t appear to be promising a trickle.
But for what, we do not know. When it comes to solutions, the prime minister did not go beyond the slogans in his manifesto – turning the NHS from analogue to digital, for instance, and promising “tough decisions” on public health without even hinting what they are.
Pressed on what is truly different to previous administrations in his approach to the NHS, Sir Keir waxed lyrical about his “determination”, “mandate” and “sense of the future”.
These three things will not fix the NHS.
We will have to wait until the 10-year plan is unveiled next spring to find out what these slogans really mean in practice.