Afternoon summary
Junk food TV advertisements are to be banned from airing before the 9pm watershed as part of the government’s drive to improve public health. As Denis Campbell reports, in addition, online ads for products that are high in fat, salt and sugar will be banned altogether, Andrew Gwynne, the public health minister, told the Commons on Thursday. Both measures will come into force on 1 October 2025.
Vulnerable prisoners are being forced to inherit the debt of the previous occupant of their cells leading to violence and extortion, the minister Lord Timpson told peers. As Rajeev Syal reports, the prisons minister also said new inmates are being forced to pay twice as much back - which he called ‘double bubble’ - after borrowing cash to buy everyday items such as shampoo and biscuits. Timpson, a former businessman who has been brought into government because of his long running interest in prison reform. Answering a question in the Lords, he said that gangs are forcing vulnerable prisoners into debt, sometimes demanding that they repay cash owed by former prisoners who have since moved out of a cell. Timpson said:
We know that debt drives poor safety and outcomes, and the drug trade really fuels it, so we need to make sure our vulnerable prisoners are not extorted, assaulted, and not forced to do things they don’t want to do.
There have been many instances of prisoners inheriting the debt on the former resident of that cell.
We are now closing this blog but you can read all our UK politics coverage here.
Updated
Here is John Crace’s sketch of Keir Starmer’s NHS speech this morning.
Starmer appoints Michael Barber as 'adviser on effective delivery'
George Osborne will be approve. (See 4.49pm.) In another sign that Keir Starmer has discovered his “inner Tony Blair”, the PM has appointed Sir Michael Barber as his “adviser on effective delivery”.
In a news release the Cabinet Office said:
Sir Michael will support the prime minister in driving forward the delivery of the five national missions. This will include coordinating ambitious, measurable, long-term objectives that deliver change across the UK.
The part-time role is a direct ministerial appointment and will be unpaid. Sir Michael will take up the role for an initial 12-month period, starting in September 2024.
Sir Michael has extensive experience in implementing large-scale system change, working with many governments internationally to drive delivery.
Barber worked for the Blair government, first as chief adviser in the education department and then as head of Tony Blair’s delivery unit. In that role he was seen as a successful innovator capable of getting the civil service machine to deliver tangible improvements in public services. Since then other UK prime ministers have asked him to take on advisory roles, and he has worked as a governance consultant around the world.
Jeremy Hunt hits back at cabinet secretary over criticism of Tory decision not to hold pre-election spending review
Jeremy Hunt has hit back against the cabinet secretary Simon Case after Case accused him of contributing to financial uncertainty when he was chancellor.
Speaking at the Policy Live conference in central London this afternoon, Hunt defended himself for the first time against Case’s accusation that he should have held a spending review while in office to clarify the state of the public finances. Case made the accusation in a letter defending Labour’s claims that the previous government left behind a £22bn fiscal black hole.
Hunt said:
The right time to do a spending review is at the start of a parliament. It needs to be three, or if I could have my way, four years long so that departments have the stability to do long term planning.
And in a barb directly aimed at Case he added:
I don’t remember ever being advised by the Treasury, or indeed the cabinet secretary, to have another spending review a year before an election, because that would have created enormous upheaval.
Ed Balls says 'marked improvement' in NHS impossible before election without big increase in health spending now
Ed Balls, the former Labour shadow chancellor, has said that Keir Starmer needs to put a lot of money into the NHS now if he wants people to see a “marked improvement” by the election.
Speaking on on his Political Currency podcast, which he co-hosts with George Osborne, the former Tory chancellor, he said that reform on its own would not be enough.
Balls said:
The reforms are important, but the thing which will make the biggest difference is a big injection of resources. If Labour wants to have delivered change by the next election, that injection of resources has to happen now.
When we [the Blair/Brown government in 1997 – Balls was Brown’s chief adviser] came into power we actually waited, we built up investment in the NHS through the first term, then made a big push in the second term.
Keir Starmer can’t afford to take that long … There is no way on earth there will be a marked improvement in health outcomes or perception of the health service without a substantially bigger increase in health resources over this parliament than what we’ve seen on average in the last 15 years. And if you say he’s not going to do that, then it’s not going to work.
Balls’ argument echoes the SNP’s criticism of Starmer’s health speech this morning. (See 1.43pm.) Ironically Osborne, his co-host, seemed more supportive of Starmer when they discussed the speech in their podcast. Osborne said:
What Keir Starmer is saying is his solution is not more money. That is quite a thing for a new Labour prime minister to say. He says the NHS has reached a fork in the road, and we can either increase taxes on working people to pay for more of the healthcare required by an ageing society, or we can reform – and then he says it’s a case of ‘we can reform or die.’ [See 2.05pm.] It felt to me that that’s the first time I’ve heard Starmer summon up his inner Tony Blair … That’s quite a different message than you had from the Labour Party in recent years, which is ‘There’s not enough money going into the NHS.’
In Osborne’s mind, “inner Tony Blair” is a high compliment. He and David Cameron used to refer to Blair as “the master” as they plotted how the Tories could return to power by copying him.
Balls played a major role in Labour politics for 20 years, culminating in a stint as shadow chancellor under Ed Miliband. But now he is a TV presenter and podcaster. He is married to Yvette Cooper, the home secretary.
Commons leader Lucy Powell floats plan to stop MPs from doing paid media work
And, talking of GB News, Lucy Powell, the leader of the Commons, has today floated a proposal that could lead to one of its most high-profile presenters being taken off air.
As leader of the Commons, Powell is chair of the Commons modernisation committeee, a new committee set up to modernise some Commons procedures. Most select committees are there to scrutinise the work of government departments, and are chaired by backbenchers. But this one is there to push through Commons modernisation, a government ambition, and that is why it is chaired by a minister. The last Labour government also set up a Commons modernisation committee, but the coalition and Tory governments after 2010 did not see the need for one.
Today Powell has published a six-page memo setting out the committee’s main aims. And it suggests she wants to change Commons rules to stop, or limit, the amount of paid media work that MPs can do. It says:
[The committee] should consider what advantages, if any, outside paid engagements such as media appearances, journalism and speeches furnish to the public, versus the potential conflicts of interest and attention that arise from such paid endeavours. The modernisation committee will wish to consult closely with the parliamentary commissioner for standards, who is best placed to advise on the practicability of any further changes to the rules governing members’ outside interests.
Potentially this could affect many MPs, but one of the biggest losers might be Nigel Farage, the Reform UK leader. Recently figures in the Commons register of members’ interest showed him earning almost £1.2m from GB News.
Since Labour took office rules on outside earnings by MPs have already been tightened. MPs used to be banned from taking a paid job offering parliamentary advice (which can be similar to lobbying – also already banned), but they were allowed to take money for providing general political advice. That is now also banned.
In her memo, Powell also says she wants the committee to consider allocating more time in the chamber for government business and less time for backbench business. She says backbench debates are not well attended, and that they sometimes result in the Commons having to adjourn early because there is no one left wanting to speak. She says:
Given the government’s extensive legislative programme, as set out in the king’s speech, I am committed to treating parliamentary time as the precious resource that it is. This means placing a greater emphasis on members scrutinising government legislation going forwards.
In a post on social media, Darren Grimes, another GB News presenter, said Powell’s plan was unfair.
David Lammy hosted a show on LBC and Labour never saw an issue. When right-leaning MPs get shows though, with big audiences, well, they must be stopped. I see no issue with an MP having a second job, it ought to be up to their constituents, not Labour, to decide if that’s right.
Earlier this year it was often said that the Conservative leadership contest would be largely fought out on, and perhaps even decided by, GB News, the rightwing, pro-Brexit news channel. If Harry Cole from the Sun is correct, that prophecy may turn out to be more accurate than people thought. Cole says the Tories are asking Camilla Tominey, a GB News presenter, and Christopher Hope, GB News’ political editor, to hold Q&A sessions with all the Tory candidates at conference.
NEW: Understand Conservative Party Board met on Tuesday and agreed that the candidates will do Q&A sessions with Camilla Tominey and Chris Hope on the Monday and Tuesday of conference.
— Harry Cole (@MrHarryCole) September 12, 2024
Then all will get back to back 20 min speeches on the Wednesday plus a two minute video.
NEW: Understand Conservative Party Board met on Tuesday and agreed that the candidates will do Q&A sessions with Camilla Tominey and Chris Hope on the Monday and Tuesday of conference.
Then all will get back to back 20 min speeches on the Wednesday plus a two minute video.
It is looking as if the Tory conference will end up as little more than a four-day leadership hustings, and these Q&A sessions may end up as the main events.
Starmer
Energy department to learn lessons from Boris Johnson's Covid vaccine taskforce as it rushes to meet clean energy goal by 2030
Chris Stark, the official at the Department for Energy Security and Net Zero in charge of decarbonising the electricity grid, has said that he wants to follow the vaccine taskforce model to help him meet his goal.
Speaking at a Green Alliance event this morning, Stark said that he had been looking at how the taskforce set up by Boris Johnson was able to rapidly implement a Covid vaccine programme that in normal circumstances would have taken many years.
He has also hired some of the people who worked on the vaccine taskforce to join his green energy programme.
As head of “mission control” at the energy department, which is led by Ed Miliband, Stark is meant to ensure the government hits its target of delivering green energy by 2030.
Stark was previously chief executive at the Climate Change Committee, and when he was there it recommended setting 2035 for the decarbonisation of the electricty grid. At the conference this morning he recalled being asked by Keir Starmer if 2030 would be a realistic target instead.
He said:
The more observant among you will have noticed that my recommended target when I was at the CCC was not 2030, it was 2035, which we felt to be a very ambitious target at the time. And Keir Starmer asked, I think, quite an interesting question, which is, why can’t we do it earlier.
And I and a few others sucked through the teeth and told them, well, it might be possible to do it sooner, but only if you pull all the right levers in the right order. And they didn’t blink at that.
So we are going into this mission for an earlier deadline. Eyes open on the scale of the challenge, but clear I think that it can be done. And that’s the kind of bold mission that I think, I feel we can get behind. And it’s so exciting to have that support right from the top of the government, right the way to the prime minister.
Stark said that in order to meet the goal he is “not pissing about” in making the steps needed to reach the goal, including boosting heat pumps, electric vehicles and renewable energy.
'It's reform or die' - what Starmer said about why NHS needs to change
Downing Street has now published the full text of Keir Starmer’s speech on the Darzi report and NHS reform on its website.
And here is the passage where Starmer talked about the need for NHS reform, saying “it’s reform or die”.
Look, the NHS is at a fork in the road. And we have a choice about how it should meet these rising demands. Don’t act and leave it to die.
Raise taxes on working people or reform to secure its future. Working people can’t afford to pay more. So it’s reform or die.
So let me be clear from the outset, what reform does not mean. First, it does not mean abandoning those founding ideals. Of a public service, publicly funded, free at the point of use …
The problem isn’t that the NHS is the wrong model, it’s the right model, it’s just not taking advantage of the opportunities in front of it. And that’s what needs to change.
Second, reform does not mean just putting more money in. Of course, even in difficult financial circumstances, a Labour government will always make the investments in our NHS that are 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.
I am 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 …That isn’t just solved by more money - it’s solved by reform.
And third, reform does not mean trying to fix everything from Whitehall. It really doesn’t.
When Lord Darzi says the vital signs of the NHS are strong. He’s talking about the talents and passion of our NHS workforce. That’s what he’s talking about. The breadth and depth of clinical talent. The extraordinary compassion and care of our NHS staff.
If we are going to build an NHS that is fit for the future, then I tell you, we are going to do it with our NHS staff and
,with our patients too.
This is the passage explaining the ‘why’ part of Starmer’s reform argument. See 11.39am for the ‘how’ part.
Greens criticise Starmer for putting NHS reform ahead of investment
And the Green party is also calling for more investment in the NHS. In his response to the Darzi report, Adrian Ramsay, the Green party’s co-leader, said it was wrong for Keir Starmer to appear to be more interested in reform than investment. (See 10.25am.) He said:
The Darzi review pulls no punches: the NHS has been harmed by austerity, capital starvation, the disastrous 2012 Health and Social Care Act and the dire state of social care.
It is therefore hugely disappointing to see Labour, like a string of previous Conservative and Labour governments, hooked on reform rather than investment.
Starmer says there can be no money without reform. We say there can be no improvement to waiting times, cancer death rates, treatment for mental health – and many other struggling areas – without more money.
The SNP says the Darzi report vindicates its call for higher health spending. Stephen Flynn, its leader at Wesminster, said:
Lord Darzi’s report exposes the catastrophic damage that fourteen years of Westminster austerity cuts, chronic underfunding and Brexit have done to the NHS.
For more than a decade, the SNP has repeatedly warned about the damage UK government cuts and underfunding were causing our NHS. There is no escaping the fact that alongside constant modernisation, the NHS needs more money - and it needs it now, if it is to deliver the best possible healthcare.
Crime prevention minister has purse stolen at police conference
Diana Johnson, a Home Office minister, “had her purse stolen at an annual conference for senior police officers”, Ramsay Hodgson reports for the Financial Times. Officially Johnson is minister for policing, fire and crime prevention.
This is from my colleague Kiran Stacey.
I think Labour might be taking their "public services are all broken" strategy a bit *too* far. pic.twitter.com/6YCtPKehuO
— Kiran Stacey (@kiranstacey) September 12, 2024
I think Labour might be taking their “public services are all broken” strategy a bit *too* far.
Updated
Here is a video extract from Keir Starmer’s speech this morning.
'Big step in right direction' - NHS and healthcare groups welcome findings in Darzi report
Organisations in the health care sector have largely welcomed the Darzi report, and the government’s proposal to respond with more emphasis on technology, on primary care and on prevention. Here are some of the extracts from statements they have put out.
Prof Philip Banfield, council chair at the BMA, which represents doctors, said in a statement the BMA was glad the problems with the NHS had been properly recognised.
The previous government gaslit doctors and refused to acknowledge the damage caused by years of underinvestment. The BMA has tirelessly spoken out about the challenges our health service faces, particularly regarding staff shortages, so one might expect that Lord Darzi’s review, which echoes many of the association’s concerns, would be met with a sense of relief – finally, someone understands. While the findings are unsurprising, seeing this report so clearly call attention to just how broken our beloved NHS has become, with the devastating impact on our patients, is deeply sobering.
Prof Nicola Ranger, general secretary and chief executive of the Royal College of Nursing, said Darzi’s conclusions were right.
Nursing staff will recognise many of Lord Darzi’s conclusions, not least how sustained austerity, cuts to public health and failure to invest in community services have impacted NHS performance and patient care. The modest increases in the size of the nursing workforce have been significantly outstripped by the demand piled on the NHS in recent years. Nursing staff are now too commonly caring for patients in corridors or left in armchairs, the ‘congestion’ mentioned in the report, which leaves them feeling short-staffed and unable to give the quality of care they would want.
Sir Julian Hartley, chief executive of NHS Providers, which represents hospitals and other NHS trusts, said the proposals were “a big step in the the right direction”.
The NHS is down but not out. The sheer scale of the challenge facing trust leaders and their teams as they strive to get the health service back on track is plain for all to see …
Lord Darzi’s prescription for reforming the health service – by creating a digital NHS, focusing on prevention and public health, and ensuring patients are cared for closer to home- is a big step in the right direction. This must go hand in hand with sustainable funding and investment, an end to chronic workforce shortages and more capital investment to boost productivity and meet growing demand.
Matthew Taylor, chief executive of the NHS Confederation, which also represents trusts, said Darzi’s analysis was sound. In a statement he said:
This report paints a bleak picture of the state of an NHS which, despite working harder than ever before, has been struggling in the face of rising demand, a decade of underinvestment and the impact of the pandemic. NHS leaders will recognise Lord Darzi’s diagnosis of the NHS’ problems and will work with the government to help address them.
The review has rightly identified many of the root causes, not least how we invest much less in our buildings, technology and equipment than many comparable countries.
William Pett, head of policy at Healthwatch England, which represents patients, said patients would welcome the report. In a statement he said:
People will welcome Lord Darzi’s prognosis on the NHS. Although the NHS does much good, patients repeatedly share their frustrations and confusion about accessing care.
Gill Walton, chief executive at the Royal College of Midwives, said maternity care should have featured more prominently.
The new health secretary, Wes Streeting MP, said that of all of the issues that keep him awake at night, maternity safety is top of the list, so we remain optimistic and hopeful that our new government understand these pressing issues and will put the safety of mothers and babies, and of midwifery staff at the top of his list. All we’re asking is that every maternity service has the right staff in the right place at the right time.
Rob Yeldham, director of strategy at the Chartered Society of Physiotherapy, welcomed the focus on community care.
We strongly endorse the calls to expand healthcare in the community and to build care around the needs of the individual.
Community rehab keeps people out of hospital and is essential in a time when, more are living with multiple long-term conditions. The recognition of the growing challenge is very welcome.
Dr Sarah Hughes, chief executive of Mind, the mental health charity, said some of the revelations were shocking.
This is a dark day for mental health. Lord Darzi’s findings showing many people in mental health crisis are being held in rooms constructed for a Victorian asylum are disturbing, shameful, but ultimately unsurprising.
UK debt projected to almost triple over next 50 years, watchdog warns
The UK’s debt mountain will almost triple to more than 270% of national income over the next 50 years because of pressures from an ageing population, the climate crisis and security risks, the Office for Budget Responsibility has warned. Phillip Inman has the story here.
Streeting says Labour and Lib Dems have 'much in common' as he says he wants cross-party approach to social care reform
Streeting adopted a very different tone when responding to Daisy Cooper, the Liberal Democrat’s health spokesperson. In her contribution she said the Lib Dems had long called for more focus on primary care, and more focus on prevention. She also said that Labour’s failure to have a plan for social care was “the elephant in the room”.
In response, Streeting said it was “refreshing to have constructive opposition in the chamber”. He went on:
Let me say, and it was clear throughout the election campaign actually, that my party and Liberal Democrats have much in common, both in terms of the commitments we made, which were in some cases identical, and also the shared areas of emphasis, the link between health and wealth, the importance on prevention and the importance of social care.
He said the government was determined to reform social care, working where possible on a cross-party basis.
Updated
Victoria Atkins accuses Labour of 'political posturing' as she defends Tory record on NHS
In her response to Streeting, Victoria Atkins, the shadow health secretary, accuses him of “political posturing” and urged him instead to talk constructively about the future.
She said there was '“much to be proud of” in the NHS. It is looking after 1.6 million people a day, 25% more people than in 2010.
While she quoted figures for how much the Tories had invested in the NHS, she said they had “never pretended that everything was fixed”, that there were easy answers or that as a party they had “a monopoly of wisdom”.
But the last government did announce an NHS productivity plan at the time of the budget, she said. She claimed the proposals in it would lead to a 2% increase in productivity by the end of the decade, unlocking £35bn’s worth of savings. But Darzi had not even mentioned it, he said. She asked if it was being cancelled.
Responding to Atkins, Streeting said:
The first word the shadow secretary of state for health and social care should have said was sorry. She says she never pretended everything was fixed, and that’s true, but it’s about time that she admits that it was their party that broke the NHS in the first place.
He said Atkins, health secretary before the election, was not to blame for everything in the Darzi report. But he said she should “show some humility on behalf of her party” and apologise.
Streeting did not say what was happening to Atkins’ productivity plan.
Wes Streeting’s opening statement to MPs about the Darzi report echoed much of what Keir Starmer said this morning. But he was notably more partisan, and more damning about the opposition.
Referring to the effects of austerity, and the impact of the Andrew Lansley health reforms, which are strongly criticised in the Darzi report (see 9.49am), he said:
It is not just that the Conseratives didn’t fix the roof while the sun was shining. They doused the house with petrol, left the gas on and Covid just lit the match. That’s why waiting lists are stuck on 7.6m long today.
And he was particularly critical of the Tories’s failure to reform the NHS.
Since 2019 the previous government oversaw a 17% increase in the number of staff working in hospitals. Did it lead to better outcomes for patients? No.
At great expense to the taxpayer, the NHS has instead seen a huge fall in productivity. We paid more but got less, a deplorable waste of resources when so many parts of our health and care services were crying out for investment.
As Lord Darzi puts it, British Airways wouldn’t hire more pilots without buying more planes.
Doctors and nurses are wasting their time trying to find beds for their patients, dealing with outdated IT, when they ought to be treating patients.
Theresa May, the former prime minister, has taken her seat in the House of Lords. At the introduction ceremony in the the Lords this moring, she was supported by Lord True, shadow leader in the Lords, and Lady Evans of Bowes Park, his predecessor and leader of the Lords when May was PM.
The dramatic decline in international student numbers coming to UK universities this autumn has been confirmed by the latest Home Office figures for sponsored study visas.
The figures for August, traditionally the peak month for applications by international students, suggest around 20,000 fewer study visas were issued during the month compared with the last two years.
The Home Office said student applications between January to August this year were 278,700, 17% lower than the same period in 2023, which would mean 56,000 fewer than the first eight months of last year. Much of the fall follows the Conservative government’s decision to restrict family dependents accompanying international students to the UK.
Although vice-chancellors say they have recently detected a revival in applications and enquiries since the change of government in July, it may have come too late to repair the damage for courses starting in autumn.
Disgraced Tory donor Frank Hester gave party £5m days before election
Frank Hester gave the Conservatives a further £5m just before the election, according to data from the Electoral Commission, despite the party coming under pressure over his remarks about Diane Abbott that were widely condemned as racist. Rowena Mason has the story here.
Victoria Atkins, the shadow health secretary, was doing a media round this morning, but when she was asked on LBC if she approved of the party taking money from Hester just before the election, when his comments about Abbott were public, she ducked the question, telling the presenter, Nick Ferrari:
I completely reject any of the comments that that individual is alleged to have made. I had nothing to do with fundraising in central office. What I do know is that we’re in the middle of a leadership election, and the future of the Conservative Party is being debated now. I am sure that the candidates involved will have answers to this.
Asked repeatedly if the party should return the money donated by Hester, Atkins refused three times to say, insisting “it’s not for me to get involved in party finances”.
Updated
In the Commons Wes Streeting is making a statement about the Darzi report. Much of what he says is likely to repeat what he and Keir Starmer have said already today, and what has been reported here, and so I will just be covering it selectively, focusing on what’s new.
How Starmer explained three principles behind Labour's approach to NHS reform
In his speech Keir Starmer talked in some detail about the the government’s three priorities for reform – more focus on digital and technology, more focus on primary care, and more focus on prevention. Here are the key extracts.
On the need for more digitalisation, and better use of technology
First moving from an analogue to a digital NHS.
We can already see glimpses of the extraordinary potential of technology, like the world’s first ever non-invasive, knifeless surgery for kidney cancer – just imagine that, pioneered by Leeds teaching hospitals. Or the precision cancer scanners – I saw some of them yesterday …
Take an innovation like the NHS app. This could be a whole digital front door to the NHS – appointments, self referral reminders for check-ups and screenings, patients in control of their own data. healthcare so much more transparent …
We’ve got to have fully digital patient record, so that crucial information is there for you whenever you go to the NHS.
(When Starmer is asked about his record as director of public prosecutions, one of the things he talks about with most pride is digitalising CPS records, which he says made a big difference in terms of court efficiency.)
On the need to focus more on primary care
Second, we’ve got to shift more care from hospitals to communities. Now, the King’s Fund has long called for this. Successive governments have repeatedly promised it.
But what’s happened? The opposite. The share of the NHS budget spent on hospitals has actually increased.
This 10-year plan has to be the moment that we change that, the moment we begin to turn our national health service into a neighborhood health service.
That means more tests, scans, healthcare offered on high streets and town centers, improved GP access, bringing back the family doctor, offering digital consultations for those that want them, virtual wards and more patients safely looked after in their own homes, where we can deal with problems early, before people are off work sick, and before they need to go to hospital.
On the need to focus more on prevention
And, third, we have got to be much bolder in moving from sickness to prevention.
We’ve already announced NHS health checks in workplaces, blood pressure checks at dentists and opticians.
But that’s just the beginning. Planning for 10 years means we can make long term investments in new technologies that will help catch and prevent problems earlier.
And there are some areas in particular where we’ve just got to be more ambitious, like children’s mental health or children’s dentistry.
According to polling by YouGov, people are more likely to think the NHS will get worse than that it will get better – although optimism has risen considerably since Labour won the election.
Public expectations for the future of the NHS remain gloomy, although they have ticked up since the election was called
— YouGov (@YouGov) September 12, 2024
Will get better: 30% (+11 from 13 May)
Will get worse: 40% (-12)
Will stay same: 22% (=)https://t.co/N7hGGxYuSQ pic.twitter.com/AFOP4kQgZ8
Wes Streeting will be making a statement to MPs about the Darzi report at about 11.30am. He is unlikely to say anything much beyond what Starmer said in his speech, but I will be monitoring it anyway.
Q: Are you going to allow Ukraine to use Storm Shadow missiles to strike targets in Russia?
Starmer says he is off to Washington later for strategic discussions with President Biden about Urkaine and the Middle East. He does not answer the question.
And that is the end of the Q&A.
I will post more analysis and reaction soon.
Starmer suggests plan to impose cap on adult social care costs has not been shelved for good
Q: When will you introduce the cap on adult social care costs (shelved by Rachel Reeves in her statement in July)?
Starmer says the last government promised this, but Labour had to delay the plans because they were “undeliverable” within the time frame proposed by the Tories. The government is reviewing it. But he says this will be included in the 10-year plan. “But it’s got to be done properly,” he says.
UPDATE: Starmer said:
On the capping of the [social care costs], promises were again made by the last government. They were delayed because they were undeliverable.
We’ve looked at them. We don’t think they’re deliverable in the timeframe the last government said, and that’s why we’ve taken them down and we’ll review it.
Now, it is an issue we’re going to have to look at, I readily accept that. We will have it within the 10 year plan. But again, it’s got to be done properly. It’s got to be deliverable.
Updated
Starmer says he can reform NHS because reforming organisations has been 'common theme' of his working life
Q: [From the Sun] Given you caved in to train drivers, how can Sun readers trust you to overcome resistance from the medical profession?
Starmer replies:
Because I’ve reformed before.
I reformed when I was heading up the Crown Prosecution Service. I wanted to change it, to make it much more victim oriented, and we faced a huge challenge. We took it on. We changed it.
I wanted to drive up conviction rates for violence against women and girls. We faced resistance about how we were doing it. We burst through that and made the change.
So I could give any number of examples. I’ve worked in Northern Ireland where we had to create a new police service. In Northern Ireland there was resistance, but we pressed on and did it.
When I arrived as leader of Labour party, I knew we had to change it. There was a lot of resistance, but we pressed on and did it.
Starmer said that, if there was one “common theme” to what he had been doing professionally “for some time”, it was imposing change.
UPDATE: Starmer said:
If there’s one sort of common theme of what I’ve done for a living for some time now, it’s coming in and bringing about the change, and I’m determined that we will bring about the change here.
Updated
Q: When will people see a difference in A&E waiting times?
Starmer says the government is already working on this. It is a “classic example of where you need more technology”. Mainly people are waiting for the results of tests. So “much better use of technology” will make a diffierence.
Q: What kind of preventative health measures are you looking at?
Starmer says prevention will be a priority. He mentions smoking. And teeth – he was shocked by how many children have teeth decay. That is preventable, he says. Diet and lifestyle are important too, he says.
Starmer says he won't let medical profession block reform
Q: Prof John Bell said this morning the BMA has been a drag on reform. Do you expect them to help you?
Starmer says he knows from his time as DPP that, whenever you try to reform something, some people are opposed. He says he wants to work with professionals. But if there is opposition, “we have to take that on, and we will take that on.”
Updated
Q: When will you announce a plan for social care?
Starmer says he wants to work with staff on this. He wants a fair pay system for care workers. Social care is obviously part of his 10-year plan for the NHS.
Q: What would you say to a patient who is on a waiting list in pain about how you will make things better for them?
Starmer says he is not offering a “quick fix”. It will take time and money.
Starmer is now taking questions.
Q: Why will you be able to do this, when other reform plans have not worked?
Starmer says in the past governments have not applied his mission-driven approach.
Starmer is now talking about the government’s three priorities for reform – more focus on digital, more focus on primary care, and more focus on prevention. (See 8.44am.)
He ends by saying the NHS can be reformed, because that has happened before. He says:
It won’t be easy. It won’t be quick. It will take a 10-year plan, not just the work of one parliament, but I know we can do it, because we’ve done reform before. The last Labour government reformed the NHS to deliver better outcomes for patients and better value for taxpayers.
And he says this should be a moment of “hope”, because of what is possible.
Starmer is still talking about NHS reform, and he says it “does not mean trying to fix everything from Whitehall”.
He says the NHS is full of talent. He wants to work with staff on reform, he says.
Starmer tells NHS it will get 'no more money without reform'
Starmer is now talking about how the government will reform the NHS.
He starts by saying:
Let me be clear from the outset what reform does not mean first - it does not mean abandoning those founding ideas of a public service, publicly funded, free at the point of use, the basic principle of dignity, inspired, of course, by Bevan that when you fall ill, you should never have to worry about the bill.
Using comments he made a lot during the election campaign, he stresses how personal support for the NHS is for him. His mother and sister both worked in the NHS, his wife works in the NHS, and the NHS cared for his mother for many years when she was seriously ill, he says.
Starmer says reform “does not mean just putting more money in now,”.
A Labour government will always invest in the NHS, he says. But, he goes on:
We have to fix the plumbing before turning on the taps.
So hear me when I say this – no more money without reform.
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.
Starmer says this cannot all be blamed on Covid. He goes on:
Covid hit our NHS harder than healthcare systems in other countries.
The NHS delayed, canceled or postponed,far more routine care during the pandemic than any comparable health system.
And why? Because our NHS went into the pandemic in a much more fragile state, fewer doctors, fewer nurses, fewer beds than most other high income health systems.
Starmer says that was a result of the “ideologically-driven, top down reorganization of 2012” championed by Andrew Lansley. That was “hopelessly misconceived”, he says. And he quotes what the report says about the Lansley reforms being “a calamity”. (See 9.49am.)
Starmer sets out some of the most negative findings in the report.
Take the waiting times in A&A - more than 100,000 infants waited more than six hours last year.
And nearly a tenth of all patients are now waiting for 12 hours or more.
That’s not just a source of fear and anxiety, it’s leading to thousands of avoidable deaths.
And that phrase, avoidable deaths should always be chilling … [it means] people’s loved ones who could have been saved, doctors and nurses whose whole vocation is to save them hampered from doing so.
It’s devastating, heartbreaking, infuriating and that’s just scratching the surface.
High-risk heart attack patients waiting too long for urgent treatment, cancer diagnosis waiting too long, with cancer death rates higher than in other countries. And when it comes to getting help for mental health, 345,000 are waiting over a year. That’s roughly the entire population of Leicester.
Tories broke the NHS, says Starmer
Starmer is speaking now. He starts by saying the Darzi report is “an incredibly comprehensive analysis”, and a “raw and honest assessment”.
He says the King’s Fund is full of experts whose contribution will be vital as the government tries to get the NHS back on its feet.
Public satisfaction with the NHS has fallen from an all-time high, under the last Labour government, to an all-time low, under the Tories.
They “broke” the NHS, he says.
Even Lord Darzi, with all his years of experience, is shocked by what he discovered. It is unforgivable, and people have every right to be angry.
Starmer says the NHS failings are literally a matter of life and death.
Updated
Sarah Woolnough, the King’s Fund chief executive, is introducing Starmer.
This is what she has said about the Darzi report in a statement released overnight.
The review is more than just a gloomy assessment of how long it will take to recover services, it is a mandate for government to take bold, decisive action.
The biggest improvements to health and care in this country will come from prioritising services outside of hospital. That means greater investment in the primary and community services that support people before they end up needing hospital treatment. It means political focus on public health strategies that keep people healthy and prevent illness in the first place. And it means finally getting to grips with the much-needed reform of adult social care.
Lord Darzi’s review also underscores the need to move beyond past lazy criticism regarding the value of NHS managers and instead recognise that implementing major improvement to the health service requires investment in high-quality leaders.
Ministers now face tough trade-offs between tackling immediate NHS pressures or prioritising reform of the root causes of the crisis. Today’s review makes clear that incremental improvement will not do – radical change is needed.
Starmer gives speech on NHS
Keir Starmer is about to deliver his speech on the NHS. He is at the King’s Fund in London, a health thinktank.
NHS England waiting list has stablilised at 7.62m, after 3 previous monthly increases, latest figures show
Wes Streeting says he wants to reduce the NHS waiting list by “millions” by the time of the next election. (See 9.21am.) Statistics out today show the figure for NHS England is 7.62m, PA Media reports. PA says:
The size of the waiting list for routine hospital treatment in England was unchanged in July, following three consecutive monthly increases, figures show.
An estimated 7.62 million treatments were waiting to be carried out at the end of July, relating to 6.39 million patients, NHS England said.
The list hit a record high in September 2023 with 7.77 million treatments and 6.50 million patients, after which the figures fell for several months before rising in April, May and June of this year.
Updated
In an interview with LBC, Wes Streeting, the health secretary, said that, although Labour wants more focus on preventative health measures, it would not be bringing in new salt or sugar taxes. He explained:
That wasn’t in our manifesto and the reason why we are reluctant to go down that sort of route is because there is a cost-of-living crisis at the moment and I think we have got to get the balance right.
Crucially, on public health and prevention measures we have got to take people with us …
The priorities we have are the ones that are in our manifesto, which are particularly around children’s health and making sure we are stopping the marketing of junk food at them, stopping the scourge of vaping amongst teenagers, for example.
Those are our priorities and we don’t have plans for sugar and salt taxes.
Tories accuses Labour of not having 'meaningful' plans for NHS reform
The Conservatives have accused Labour of not having a “meaningful” plan for NHS reform.
In a statement released overnight in response to the Darzi report, Victoria Akins, the shadow health secretary, said:
We will review this report carefully but it appears that Labour have missed an opportunity to put together meaningful plans for reform.
We Conservatives recognise that investment has to be married with reform. This is why we brought forward long-term plans for productivity, tech, Pharmacy First, virtual wards, attracting pharmaceutical research and training and retaining staff. We did this whilst boosting investment in the NHS in real terms every single year.
The Labour government will be judged on its actions. It has stopped new hospitals from being built, scrapped our social care reforms and taken money from pensioners to fund unsustainable pay rises with no gains in productivity. They need to move from rhetoric to action.
The Darzi report describes the Health and Social Care Act 2012, passed by the coalition government but championed by Andrew Lansley, the Tory health secretary, as a “calamity”. It says:
The Health and Social Care Act of 2012 was a calamity without international precedent. It proved disastrous. By dissolving the NHS management line, it took a “scorched earth” approach to health reform, the effects of which are still felt to this day. It has taken more than 10 years to get back to a sensible structure. And management capability is still behind where it was in 2011.
Some sanity has been restored by the 2022 Act which put integrated care systems on a statutory basis. This has the makings of a sensible management structure, consisting of a headquarters, seven regions and 42 integrated care boards (ICBs) whose strategy to tackle inequalities, and to improve population health, is set by an Integrated Care Partnership (ICP) that includes local government and the third sector alongside the NHS itself.
In an interview with Sky News this morning Atkins said she was surprised by this because she thought Darzi had been in favour of the Lansley reforms at the time. She said:
The puzzlement of that is that I’m told – I wasn’t in parliament at the time – but I’m told that Lord Darzi supported those reforms at the time.
Streeting says he wants NHS waiting lists down by 'millions' before next election
In interviews this morning Wes Streeting, the health secretary, also said that new money for the NHS would be focused on primary care (GP and community services), rather than on hospitals. He was speaking in an interview on BBC Breakfast, and here are the key points.
Streeting said primary care and community services would be the “first port of call” for extra NHS spending. He explained:
We’ll be setting out our plans in the budget and the spending review, but effectively it means that when it comes to more resources for the NHS, additional resources going in, the first port of call will be primary care and community services, and social care too, because we’ve got to deal with the systemic problems in our health and care services.
Streeting said the government would deliver new hospitals promised by the last government, but more slowly than originally planned. He said:
In terms of the schemes that were on what the last government called the New Hospitals Programme, I am determined to deliver those schemes.
But I might have to do it over a longer period of time because I’ve got to make sure, firstly, the money is there, secondly that the timetables are realistic and we’ve got the supply chain, the labour and the resources that we will need, and thirdly I’ve got to balance the need for new bricks and mortar alongside the need for new technology.
He said the NHS could go bust without reform. He said:
If we don’t grasp both the immediate challenge in front of us and deal with the crisis today, but also prepare the NHS for the challenges of the future in terms of an ageing society and disease and rising costs, rather than a country with an NHS, we’re going to have an NHS with a country attached to it if we’re not careful, and more likely an NHS that goes bust.
He said he wanted to cut NHS waiting lists by “millions” by the time of the next election. He said:
I’m going hell for leather to get the NHS back to what’s known as the constitutional standards, the targets it sets for itself, over the five-year period that we committed to, and to make sure that by the end of this parliament we see waiting lists millions lower than they are today.
In June the NHS waiting list figure was 7.62m, up from 7.6m in May. The figure for July is due out later this morning.
Streeting says it will 'take time' to restore NHS capital investment to level needed
The Darzi report says the NHS has a £37bn shortfall in capital investment. It says:
On top of that, there is a shortfall of £37 billion of capital investment.
These missing billions are what would have been invested if the NHS had matched peer countries’ levels of capital investment in the 2010s. That sum could have prevented the backlog maintenance, modernised technology and equipment, and paid for the 40 new hospitals that were promised but which have yet to materialise. It could have rebuilt or refurbished every GP practice in the country.
Instead, we have crumbling buildings, mental health patients being accommodated in Victoria-era cells infested with vermin with 17 men sharing two showers, and parts of the NHS operating in decrepit portacabins. Twenty per cent of the primary care estate predates the founding of the health service in 1948.
In interviews this morning, Wes Streeting, the health secretary stressed that the new government would not be able to make up for this shortfall quickly. In an interview on Times Radio, asked if the government would be finding an extra £37bn for the NHS, Streeting replied:
No, not in a big bang, and it’s important I say that up front for two reasons.
One is so the chancellor doesn’t have a heart attack over her breakfast this morning with me writing her spending review for her.
But secondly, and very seriously, I think people know that it’s taken more than a decade to break the NHS and it’s going to take time to get the NHS back on its feet, and to make sure it’s fit for the future …
Because we don’t invest in the capital and the tech, day-to-day spending balloons out of control, and then capital and tech budgets are raided to plug the gaps in day-to-day spending, and so the cycle repeats.
In the spending review, the chancellor and I are determined to break that cycle by really focusing on the capital investment and the tech investment that will help us to bring down ballooning costs on the day-to-day spending and improve the productivity of the system.
'Unforgivable' - Starmer to deliver damning verdict on how Tories left NHS, as he sets out reform vision
Good morning. Keir Starmer has been in office for just over two months, and for much of that time the government has focused on trying to explain to the public just how bad was the legacy the left by the Tories. There has been extensive focus on the economy, and on prisons. Today Starmer is focusing on the NHS.
And, arguably, this is the most important issue at all. According to polling by More in Common, at the next election the single issue most likely to determine whether Labour has succeeded or not is whether NHS waiting lists have fallen.
Today the government has published a 163-page report by Lord Darzi, a senior surgeon and member of the House of Lords who served as a health minister under Gordon Brown, about the state of the NHS. Summing up his findings in an article for the Daily Mirror, Darzi says:
The state of the NHS isn’t an accident. The health service was hit by three big shocks. The 2010s saw the biggest slowdown in funding since it was founded in 1948. The next big shock was the top-down reorganisation of the NHS, which threw it into chaos for years. Then came the shock of the Covid pandemic, which hit the NHS harder than other similar countries – largely because of the other two shocks.
Two of the three shocks identified by Darzi are Tory-linked and, in a speech later this morning, Starmer will describe the damage done to the NHS as “unforgiveable”. According to the advance briefing of the speech, “the PM will say that the scale of the damage done to the NHS revealed by the report is ‘unforgivable’, recognising the tragic consequences for too many patients and their families”.
Starmer will say:
People have every right to be angry. It’s not just because the NHS is so personal to all of us - it’s because some of these failings are life and death.
Take the waiting times in A&E. That’s not just a source of fear and anxiety - it’s leading to avoidable deaths.
People’s loved ones who could have been saved. Doctors and nurses whose whole vocation is to save them - hampered from doing so. It’s devastating.
The report goes into considerable detail about what is wrong with the NHS. Today we might hear a bit less about how the government intends to fix these problems, but Starmer will set out the outlines of his approach. He will say:
This government is working at pace to build a 10-year plan. Something so different from anything that has come before.
Instead of the top-down approach of the past, this plan is going to have the fingerprints of NHS staff and patients all over it.
And as we build it together, I want to frame this plan around three big shifts - first, moving from an analogue to a digital NHS. A tomorrow service not just a today service.
Second, we’ve got to shift more care from hospitals to communities... And third, we’ve got to be much bolder in moving from sickness to prevention.
Only fundamental reform and a plan for the long term can turn around the NHS and build a healthy society. It won’t be easy or quick. But I know we can do it.
The challenge is clear before us; the change could amount to the biggest reimagining of our NHS since its birth.
Here is Denis Campbell and Jessica Elgot’s overnight story.
And here is an analysis by Denis, the Guardian’s health policy editor.
Here is the agenda for the day.
9.30am: NHS England publishes its monthly peformance figures.
9.30am: The Office for Budget Responsibility publishes its fiscal risks and sustainability report, which looks at long-term risks to the economy.
10am: Keir Starmer delivers his speech on the NHS, and takes questions from reporters.
Afternoon: Starmer flies to Washington, where tomorrow he is meeting President Biden in the White House.
3pm: Nick Clegg, the former deputy PM who is now a senior Facebook executive, takes part in a Q&A at Chatham House on democracy and technology.
If you want to contact me, please post a message below the line (BTL) or message me on social media. I can’t read all the messages BTL, but if you put “Andrew” in a message aimed at me, I am more likely to see it because I search for posts containing that word.
If you want to flag something up urgently, it is best to use social media. I’m still using X and I’ll see something addressed to @AndrewSparrow very quickly. I’m also trying Bluesky (@andrewsparrowgdn) and Threads (@andrewsparrowtheguardian).
I find it very helpful when readers point out mistakes, even minor typos (no error is too small to correct). And I find your questions very interesting too. I can’t promise to reply to them all, but I will try to reply to as many as I can, either BTL or sometimes in the blog.
Updated
