Keir Starmer has set out Labour’s thinking on how to create a health and care system fit for the future – a core mission for a potential Labour government. To really fix the NHS, three areas require clear focus and action.
The first is to improve people’s access to care outside of hospitals, such as GPs, physios, district nurses, social care and mental health services. This is essential to alleviate the demands on the acute care sector and allow hospitals to prioritise the sickest patients and maintain spare capacity in case of unexpected events. It will also create a system in which people can receive the care they need in the right place at the right time.
The second is to make a career in health and social care more attractive, to recruit and retain the staff we need. Without this, high vacancies across health and social care will continue to pose a serious risk to patient safety, leave people without the support they need, and continue contributing to high levels of stress, burnout and staff leaving.
The third is to take action to tackle the biggest risk factors affecting people’s health, reducing the number of people dying early from cancer, heart disease and mental health conditions. Unless we confront and tackle the nation’s increasing poor health and health inequalities, our economy will continue to be held back by a sick workforce, and health and care services will continue to struggle with increasing demand because of people suffering multiple long-term conditions.
[Read more: Without a GP workforce plan, the NHS will fail]
Encouragingly, a lot of these issues feature in the vision set out by Starmer, although much of the detail of how Labour will address them is missing (this is perhaps unsurprising 18 months out from an election). However, the lack of serious consideration of the role social care plays in supporting our health and well-being is the most disappointing omission.
Still, alongside these three policy focuses, another three enablers are required to realise ambitions. This is where Labour’s thinking may not yet be aligned to what’s needed to put reforms into practice.
The first is funding. The health and social care system has had below average spending rises for the past 13 years. To improve performance, additional funding – increases at least in line with historical averages – will be needed, including long-term investment in buildings and equipment. However, we’ve heard little from Labour about its spending plans.
The second is time. The experience of the 2000s, when ambitious waiting-time targets for hospital and A&E treatment were first introduced, demonstrates that significant improvements can be made. But they took the best part of a decade, and the scale of the challenge facing the NHS now is arguably greater than in 1997 – pressures across every single health and care service, with demoralised staff and a sicker population. To commit to restoring waiting-time standards within five years, when targets haven’t been met since 2015, is perhaps ambition going beyond possibility.
The third ingredient is public engagement and support. Public satisfaction with the NHS is at a record low, but support for the NHS remains massively strong. The public doesn’t want a new model for the NHS, but people do want the current model to work better for them. Being honest with the public about the time it will take to turn services around and the changes that will be needed to shift care out of hospitals will be crucial to keep the public on side in what will be a marathon not a sprint.
[Read more: Can the NHS clear its backlog?]