Across more than 150 pages, NHS surgeon and independent peer Lord Darzi sets out in clear, painstaking detail the failings of the NHS in England.
The government is promising the “biggest reimagining” of the NHS since it was formed.
But you could be forgiven for feeling a sense of deja-vu about such ideas – these are all things that have been talked about for the past 20 years.
In fact, Lord Darzi produced a report recommending just this in 2007, when he was working for the Blair government.
Lord Darzi is critical of changes to the NHS made by the coalition government in 2012, which saw a big shake-up of management structures.
The Tories have quite rightly pointed out that despite the squeeze in spending on public services, the NHS still saw its budget increase by more than inflation.
And while there is now a completely new government, all the signs are the Treasury will still be playing hardball.
But the problem, as the likes of Matthew Taylor, the head of the NHS Confederation, which represents NHS trusts, points out, is that requires significant upfront capital investment in buildings, technology and equipment.
Lord Darzi’s new report makes this clear, saying £37bn extra would have been invested in capital if the NHS had kept up with spending levels of similar countries during the 2010s.
Instead, it has been left with crumbling hospitals, operations being performed in portacabins and a fifth of GP premises predating the formation of the NHS, in 1948.
The shortcomings of the NHS in England are outlined in extensive detail over more than 150 pages by independent peer and NHS surgeon Lord Darzi.
However, that is the simple part; the difficult part lies ahead.
The “biggest reimagining” of the NHS since its founding is what the government claims to be offering. In the spring, a 10-year plan is anticipated.
In his speech on Thursday, the prime minister hinted at what that would entail, emphasizing a digital revolution, moving healthcare out of hospitals and into the community, and placing more focus on preventing illness in the first place.
You could, however, be excused if these concepts seemed familiar to you because they have all been discussed for the previous 20 years.
Actually, in 2007 while serving in the Blair administration, Lord Darzi wrote a report suggesting precisely this.
Lord Darzi criticizes the 2012 coalition government revisions to the NHS that resulted in a significant reorganization of the organization’s management structures, but why has this not happened?
He claimed that this had been catastrophic and diverted the NHS’s attention from dealing with austerity and the tightest budget settlement in its history.
However, that does not adequately account for the current circumstances.
Even though the recent upheaval was limited to England, the UK as a whole—and particularly Wales and Northern Ireland—is having difficulty meeting its waiting-time targets.
The NHS saw its budget increase by more than inflation, as the Tories have quite rightly pointed out, even though public service spending has been squeezed.
However, it was discovered by succeeding administrations that the funds were constantly being consumed by demands that were growing on a daily basis. Just a standstill was reached by it. It also swiftly began to regress once the pandemic struck.
While the Department of Health found it “impossible to persuade the Treasury” that investing more money would yield a return on investment, Lord Bethell, a Conservative health minister in the Boris Johnson administration, acknowledged that more could have been done.
Even though a new government has taken office, it appears that the Treasury will continue to exert pressure.
In fact, according to the prime minister, there would be “no more money without reform.”.
However, the issue is that it necessitates a large upfront capital investment in buildings, technology, and equipment, as people like Matthew Taylor, the head of the NHS Confederation, which represents NHS trusts, point out.
This is made abundantly evident by Lord Darzi’s latest report, which states that had the NHS spent in the 2010s at the same rate as comparable nations, an additional £37 billion would have been invested in capital.
Rather, it is faced with dilapidated medical facilities, surgeries conducted in makeshift clinics, and a fifth of general practitioner offices existing before the NHS was established in 1948.
Turning around the NHS is arguably the biggest challenge facing the new government, since the health service already receives more than 40p of every £1 spent on the day-to-day operation of public services, and the next winter crisis is undoubtedly just around the corner.