In an otherwise excellent column, Jonathan Freedland misses the point over NHS reform (If Keir Starmer is to win an election, he has to restore Britain’s faith in politics, 25 February). To assert that “reform is something a new government could actually do” is not a convincing argument for embarking on unnecessary and disruptive change. The NHS in England is in the midst of major reform following the introduction of integrated care systems arising from the Health and Care Act 2022. The last thing overburdened and demoralised staff need is more reform.
Keir Starmer should resist the temptation to uncritically re-enact the New Labour playbook. Where Tony Blair and Gordon Brown got it right was to inject new money into the NHS, resulting in falling waiting lists and high public satisfaction levels. Where Blair and his health secretary, Alan Milburn, got it wrong was in “redisorganising” the NHS, with their fixation on patient choice, foundation hospital trusts and public-private partnerships. These proved to be costly, disruptive and ineffective, resulting in reform fatigue. What the NHS needs after 13 years of austerity is a restoration of funding and a workforce strategy – no more, no less.
David Hunter
Emeritus professor of health policy and management, Newcastle University
