Prime Minister Keir Starmer has vowed to implement sweeping changes to the National Health Service (NHS) following the release of a major inquiry that described the health system as being in a “critical condition.”
The findings, presented by prominent cancer surgeon and former health minister Lord Ara Darzi, have highlighted an urgent need for reform, citing long-standing neglect as a primary cause of the NHS’s inability to meet patient demands.
Starmer laid out his vision for a comprehensive overhaul of the NHS and public health measures in England. He emphasized that “major surgery, not sticking plasters” is required to fix the deep-rooted issues within the system, acknowledging that the reforms would be bold and might face “loud opposition.”
In his speech, Starmer reinforced the urgent need to confront a growing, aging population burdened by increasing levels of disease. He stressed that the NHS must “reform or die,” and that the process could take up to a decade.
“We need to have the courage to deliver long-term reform – major surgery not sticking plasters. We’ve got to face up to the challenges – an aging society, a higher burden of disease,” he said.
Prevention Key To NHS Recovery Plan
The Darzi report exposed alarming findings, pointing to a significant backlog in patient care and overcrowded A&E departments.
Long wait times were noted as a particular concern, with emergency doctors suggesting that delays could be contributing to as many as 14,000 additional deaths per year.
The report’s conclusions have raised urgent questions about the viability of the current system.
Starmer made it clear that prevention will be a cornerstone of his 10-year recovery plan for the NHS.
Tackling issues such as tooth decay, smoking, and obesity are central to his vision, with the Prime Minister expressing dismay over the number of children requiring hospital admission to remove decayed teeth. “There’s diet, there’s a healthy lifestyle, we are going to have to get into that space,” Starmer remarked.

While acknowledging that some of these preventative measures might be controversial, he maintained that the government must be “bold, even in the face of loud opposition.”
Starmer insisted that while some reforms may not be universally popular, they are necessary for the long-term sustainability of the NHS, the economy, and the health of future generations. “I will do the right thing for our NHS, our economy, and our children,” he added.
The Prime Minister also expressed his readiness to confront resistance to workforce productivity reforms in the NHS. He emphasized the importance of collaboration with staff, while also warning against those who might hinder change.
“We will do it with people, and we will; we will do it together, and we will,” he stated while acknowledging that certain groups might resist efforts to reform the system.
“No More Money Without Reform,” Starmer Warns
As the October budget approaches, Starmer issued a clear message: there will be no further funding for the NHS unless it is paired with meaningful reform.
He criticized the inefficiencies within the system, citing the excessive use of expensive agency staff and the delays in care that result in patients remaining in hospitals longer than necessary.
“I’m not prepared to see even more of your money spent on agency staff who cost £5,000 a shift, on appointment letters which arrive after the appointment, or on paying for people to be stuck in hospital just because they can’t get the care they need in the community.”
Keir Starmer
Social care, another crucial aspect of healthcare in England, will be addressed in the government’s 10-year plan. However, Starmer made it clear that any changes to social care must be realistic and achievable.
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