“We offered the nation and those in the NHS a deal. We would spend this money if, but only if, we also changed the chronic system failures of the NHS. Money had to be accompanied by modernisation; investment, by reform.”
This mantra, for the NHS to “reform or die”, has been a strong thread in the new government’s approach to the sector, from the moment Keir Starmer came to power. But these quotes are not from the prime minister or even his health secretary Wes Streeting, as they try to sell voters on changes they say can fix the ailing health system.
In fact, they’re the words of Tony Blair, introducing New Labour’s 10-year plan for the NHS in 2000. With Blair’s plan came a historic boom in funding, and new performance targets for the NHS.
Following this, with money somewhat abundant for the health service, performance did improve considerably. But this picture declined after 2010 and the dawn of austerity when there was a drop in access to cash for infrastructure and funding increases began to flatline.
Since then, the NHS has gone through various integrations of major “plans” aimed at reviving it: first came the 2015 “Five Year Forward View”, then the 2019 “Long Term Plan” and, now under a Labour administration, a fresh 10-year plan to be unveiled.
Just like Labour’s new pitch to voters, all the previous plans have covered key themes of prevention, greater use of AI and a pledge to transform the NHS’s digital approach.
During a press conference on Monday, the prime minister and health secretary pointed towards prevention policies such as getting children to brush their teeth, stricter smoking reforms and of course the use of technology.
When asked about cancer the PM said: “Even without the sort of funding challenge you’d be wanting to reimagine the NHS when it comes to cancer. This is where AI, I think, is going to be really important for us.
“Because already, if you have a radiologist working with AI doing the scanning, the chances of getting cancer more accurately, getting it much more early go up dramatically, and that will only improve as AI gets quicker and better.
“So that allows us to get in earlier with cancer, which obviously has a massive health impact for the individual concerned in terms of the likelihood of their recovery and future health, but also a massive impact on the NHS.
“Because the earlier you get in, the less of a challenge that it is on the NHS.”
There is ultimately nothing radical in what’s been hinted so far, although all are sound ideas. What will be different this time remains to be seen.
However, a big missing piece, which did feature in the 2000s plan, was a nod to social care. When asked about whether his NHS reforms would work without social care, the health secretary of course said “no”. Aside from legislation changes on care worker’s pay, little has been said of the funding needed to boost social care.
Without it, this latest reboot of the NHS – and all its grand promises – risk turning to another common theme in previous plans: a failure to deliver.
