What is the NHS?
The purpose of the United Kingdom’s National Health Service is to deliver high-quality services for all. (1) On 5th July 1948 the National Health Service was established in the United Kingdom. Britain was the first western country to offer free at the point of use medical care to the whole population. More than 75 years after the time of post-World War II Labour Prime Minister Clement Attlee introduced the NHS it continues to be a distinguishing feature of the British welfare state. (2)
Ask almost any member of public in the UK and they will tell you how much they value ‘their NHS’ and how they (or a loved one) have experienced amazing care and support from one or a team of the exceptional people that consistently give outstanding care, around the clock, in every town and city across the British Isles and Northern Ireland.
“The best health services should be available, free for all. Money should no longer be the passport to the best treatment. People should get the best that modern science can offer.” (5)
Pressures for the NHS in recent years
“There is no denying that the past few years have been the most challenging in our 75-year history for everyone working in the NHS.” stated Amanda Pritchard NHS Chief Executive in June 2023. (4)
The UK’s health services, like the rest of the world, has had a very difficult few years dealing with many challenges and pressures. This recent period includes the economic ‘austerity’ years and then numerous pressures during Brexit, the covid pandemic, recruitment and retention issues and strikes about pay from qualified medical staff.
In addition, global economic factors have meant that financial inflation has been, in real terms, eating into the value of the limited resources allocated by central government to fund a universal NHS. Furthermore, the NHS needs to deliver high quality services to a growing UK population, that also has an aging population, who are all more likely to be experiencing complex needs.
Many hospital and medical facilities and healthcare buildings need major overdue investment now. Updating the technology and computer networks needed to efficiently keep secure healthcare records of tens of millions of citizens whilst simultaneously providing instant and appropriate multi-departmental information access across the NHS systems, is also a big and important challenge.
Surgeon Reports that NHS is in Critical Condition
This year Lord (Ara) Darzi, surgeon and former health minister, was commissioned to rapidly review the National Health Service’s performance. “His investigation concluded the NHS is in critical condition” (7)
This summer Labour member of Parliament for Ilford North and Secretary of State for Health and Social Care Wes Streeting declared the United Kingdom’s National Health Service to be “broken”. Therefore, ‘the only way is up’ for the senior Labour politicians who are now in power to work with healthcare leaders across the UK, to transform their beloved NHS. Labour’s vision is to transform the NHS into an efficient and effective organisation for everyone in England, Wales, Scotland and Northern Ireland to be proud of every day. (3) (A222_ref6)
The new Secretary of State for Health and Social Care has been forthright with his damming assessment of the state of the nation’s largest publicly funded service, a year after the latest NHS Long Term Workforce Plan was published. (4)
NHS Long Term Workforce Plan – created by 2019 Conservative government
The NHS Long Term Workforce Plan which was first designed in 2019 under a Conservative government aims to focus on ways to train and retain more doctors, dentists, nurses, midwives and healthcare professionals. The strategy also sets out a direction for reform of the NHS which will improve productivity by delivering the training required to meet service needs, whilst providing extra flexibility. The reform plan includes using technology and smarter working practices to free up clinician’s time to care for patients. (4)
The NHS Long Term Workforce Plan explains the importance of the workplace environment and culture and how providing a good work/life balance for NHS employees is key. There are other sections of the plan called NHS People Plan and NHS People Promise which fit into the overall aims of the Long Term Workforce Plan. (4)
This NHS Long Term Workforce Plan talks about Urgent Treatment Centres (UTCs) being important to improving emergency service provision.
The NHS Long Term Workforce Plan recognises that many of the illnesses that the NHS treats are preventable and that prevention is better and cheaper than cure. Therefore, the NHS Long Term Workforce Plan funds specific new evidence based ‘NHS prevention programmes’ including: to cut smoking and reduce obesity partly by enrolling people onto diabetes type 2 prevention programmes, limit alcohol related Accident and Emergency (A&E) admissions and to lower air pollution. (4)
The NHS Long Term Workforce Plan outlines the priorities of raising standards for care quality and achieving improved outcomes in the areas of childbirth, cancer treatment, cardiovascular disease treatment, treating mental health (and preventing suicides), treating diabetes, treating multimorbidity and supporting healthy aging and preventing and supporting people living with dementia.
The NHS Long Term Workforce Plan describes how creating Integrated Care Systems (ICCs) that bring together local organisations to deliver the ‘triple integration’ of: primary and specialist care and physical and mental health services and also health with social care.
The NHS Long Term Workforce Plan reflections with a new Labour government
Some of the aims of the NHS Long Term Workforce Plan such as introducing new legislation to prevent young people smoking and training more midwives have been achieved since the NHS Long Term Workforce Plan was first written. (12)
However, there is a lot of work to do for the new Labour government to for example: reduce poverty in families and raise healthcare service standards and access to good quality housing environments. Deliver important preventative healthcare such as NHS dental services, consistently across the country for every household.
Improving working culture and conditions to ensure trained employees are retained in the UK for a long time (and most often for their whole careers) is also critical to building a more efficient and better NHS over the long term.
So now what are Labour going to do to improve NHS services?
11 priorities in the action plan to transform service standards across the UK
- Cut waiting times
Labour’s official website pledges to build an NHS fit for the future by committing to cut NHS waiting times with 40,000 more appointments every week. Patients should expect to wait no longer than 18 weeks from referral for consultant-led treatment for non-urgent health conditions. (5)
Sir Keir Starmer and his team started their term in power by negotiating a pay settlement deal with the British Medical Association which means that resident (or junior) doctors and hospital staff will be working consistently every day without any strike action. This will be an improvement in NHS performance as strike action has disrupted recent services at many NHS hospitals around the country in recent months and years. (7)
- Sir Keir Starmer’s NHS action plan for 2025 and beyond
According to industry experts Labour leaders are introducing a plan which centres around three key areas: ‘analogue to digital’, ‘hospital to communities’ and ‘sickness to prevention’. (7)
- Analogue to Digital & Modernisation
The new Labour government pledge to double the number of cancer scanners.
A new ‘Fit For the Future’ fund to double the number of CT and MRI scanners (some of which utilise new Artificial Intelligence software) will allow the NHS healthcare specialists to catch cancer and other conditions earlier, saving lives.
Keir Starmer’s plan aims to maximise the potential of clinical trials available to the general public using the latest ‘app’ software technology. This means connecting with more people with certain health conditions via their smart phones.
Labour’s Health Minister Wes Streeting and his team aim to improve the utilisation of the existing NHS smart phone ‘app’ to notify patients about local services information, vaccinations and health checks. (5)
Modernisation
The New Hospitals Programme in progress under the previous Conservative leadership will be fully delivered by the Labour government if all goes according to plan. (5)
- Hospital to Communities & Transition to Neighbourhood Health Services
Labour’s manifesto idea to deliver “more care delivered in local communities to spot problems earlier.” involves shifting resources to primary care and community services. This means that local communities will also need the financial support to deliver the services that Labour leaders are recommending in their action plans. (5)
A return to community care whenever the availability of specialists and technology allows will certainly be welcomed by people who find it difficult to travel any more than a very local distance to attend an appointment. Travelling out of their neighbourhood is often difficult for residents. This particularly affects the elderly and people who are disabled or unwell, who are the very people we need to support locally if it is possible.
Labour’s official website states that Sir Keir Starmer’s senior healthcare team plan to recruit an additional 8,500 NHS mental health staff to support adults and children. This mental health recruitment drive will need very careful budgeting as it will likely cost more than £250 million in salaries alone, per year.
- Social Care Reform
Labour strives to ensure that “everyone lives an independent, prosperous life” and social care is key to achieving this outcome. (5)
Two areas that Labour will focus on are inconsistent social care standards and chronic healthcare staff shortages. Labour wants to introduce reforms under a programme entitled ‘National Care Service’ which will be delivered locally (see Transition to Neighbourhood Health Services).
Critics have suggested that the current Labour policy, or lack of a “serious policy agenda” for social care (7) means that reform of care services is currently an afterthought. It is quite possible that more research is currently being carried out by Labour experts into the best ways of improving the vital but complex and ‘failing in many areas’ social care system.
We may find that new Labour policy is launched with confidence soon. However, morale in social care is often low and time is of the essence to fix the NHS care system that is in crisis in several areas such as hospice care and emergency mental health support services.
- Hospital to Communities
Labour aims to work closely with healthcare providers and trade unions to improve patient services, and terms and conditions and training standards for social care workers. They aim to develop the role of social care workers in the community to provide more support and care services to patients locally, often in their homes. This is part of a strategy to free up hospital beds which will in turn provide better medical services for the most seriously ill who need it most urgently.
This means that more experienced and qualified community care workers can be approved to undertake basic but important nursing duties (that would otherwise involve a trip to the doctors or hospital clinic) and this practice can help people live healthier and for longer in their own homes.
- Mental Health Provision
Equally Sir Keir Starmer and his senior team are aware of the need to update mental health provision for young people. They have outlined a plan to do this by setting up ‘Young Future’s’ hubs in every community and recruiting 8,500 new staff nationally, whilst addressing outdated mental health legislation. (5)
- Sickness to Prevention
Labour is launching a new Dentistry Rescue Plan.
Labour’s Dentistry Rescue Plan will include resources to support very young children with education and healthcare for improved oral healthcare.
The Labour manifesto also prioritises the return of the family doctor. (5)
Labour has committed to delivering the Tobacco and Vapes Bill that was proposed by the Conservative government last year. The Tobacco and Vapes Bill is currently on its final stages in the House of Commons and if approved by the House of Lords it should be approved as law in 2025.
The Tobacco and Vapes Bill will have a major impact on cutting down access to harmful smoking and vaping in teenagers and young adults and be key to achieving the first ‘smoke free’ generation in the UK soon.
- Expanding services – Dentistry Rescue Plan
Labour plan to provide 700,000 more urgent dental appointments “and recruit new dentists to areas that need them most.” In recent years it has been very difficult to persuade the limited number of qualified dentists to work in rural and other less popular locations and work within strict NHS payment contracts. (5)
- Expanding services – maternity care
Labour is promising to train thousands more midwives as part of the NHS Workforce Plan which was started by the previous Conservative government.
- Expanding services – Dementia prevention and treatment
Labour wants to champion a plan that will put Britain at “the forefront of transforming treatment for dementia” (14)
Possibility of the change in UK law regarding Assisted Dying under Labour leadership.
Labour life peer Lord Falconer of Thoroton has sponsored a bill to propose amending the law regarding ‘Assisted Dying’ in the House of Lords which has reached its second reading stage. The ‘Assisted Dying for Terminally Ill Adults Bill has received its second reading this week in the House of Commons put forward by Labour’s Kim Leadbeater. (9)
The Terminally Ill Adults Bill which includes strict safeguards, could enable terminally ill adults expected to die within six months to seek help to end their life if two doctors and a High Court judge verify, they are eligible and have made their decision voluntarily.
Kim Leadbeater explained that this bill could prevent “harrowing deaths” and as predicted it has proved controversial as ministers have expressed concerns that although admirable in its aims, some vulnerable people may feel pressured to end their own lives inappropriately. As with many important moral questions this is a complicated area with many serious aspects and consequences to consider which could have a massive impact on our society in the long term. (10)
Improving NHS services: the big picture
Decisions that are made by the Chancellor and in central government about who, how much and when to fund all the departments involved in running a nation with more than 67 million people have a direct impact on what funds are available to enable Labour’s admirable National Healthcare Service transformation and improvements strategy to be a success.
We will look at all these important strategic areas in more detail in our next article at HotEnough.com very soon. It is admirable to focus on creating the best National Healthcare Service possible fit for the 21st century.
Article image: Original spray paint mural in photograph at St. Richards Hospital, Chichester, West Sussex by Horace Art in 2021 https://horacegallery.com/ photo by A. Howse
(1) ‘What We Do’ NHS England official website, 18 November 2024 ‘What We Do’ NHS England official website
(2) ‘The founding of the NHS: 75 years on’ Gov.UK official Government website, 13 July 2023 ‘The founding of the NHS: 75 years on’ Gov.UK
(3) ‘Labour’s first week: Eight key plans, and the challenges ahead’ Matt McGrath, Kevin Peachey, Nick Triggle, James Landale, Daniel Sandford, Simon Jack, Sima Kotecha, BBC News, 13 July 2024 ‘Labour’s first week: Eight key plans, and the challenges ahead’ Matt McGrath, Kevin Peachey, Nick Triggle, James Landale, Daniel Sandford, Simon Jack, Sima Kotecha, BBC News
(4) ‘NHS Long Term Workforce Plan’ Official NHS publication ref PR00104_ii, published 30 June 2023 and updated 4 January 2024 ‘NHS Long Term Workforce Plan’ Official NHS publication
‘NHS Long Term Workforce Plan’ Official NHS publication – long read
(5) ‘Build an NHS fit for the future’ Labour official website, 18 November 2024 ‘Build an NHS fit for the future’ Labour official website
(6) ‘What drugs are there for people living with Alzheimer’s disease?’ Alzheimer’s Society official website, 18 November 2024 ‘What drugs are there for people living with Alzheimer’s disease?’ Alzheimer’s Society official website
(7) ‘Labour’s first 100 days in health and care policy’ Leo Ewbank, Jennie Leggat, The Health Foundation, 11 October 2024 ‘Labour’s first 100 days in health and care policy’ Leo Ewbank, Jennie Leggat, The Health Foundation
(8) ‘2024/25 NHS priorities and operational planning guidance’ NHS Confederation, 28 March 2024 2024/25 NHS priorities and operational planning guidance’ NHS Confederation
(9) The Terminally Ill Adults (End of Life) Bill 2024-25, House of Lords, 24 October 2024 The Terminally Ill Adults (End of Life) Bill 2024-25, House of Lords
(10) ‘Assisted dying could stop harrowing deaths, says MP behind bill’ BBC News, 16 November 2024 Assisted dying could stop harrowing deaths, says MP behind bill’ BBC News, 16 November 2024
(11) Terminally Ill Adults (End of Life) Bill, Private Members’ Bill (Ballot Bill) Kim Leadbeater Terminally Ill Adults (End of Life) Bill, Private Members’ Bill (Ballot Bill) Kim Leadbeater
(12) ‘Registration data reports’ Nursing and Midwifery Council, 18 November 2024 ‘Registration data reports’ Nursing and Midwifery Council
(13) ‘NHS in numbers today’ NHS official website, 18 November 2024 ‘NHS in numbers today’ NHS official website
(14) ‘At a tipping point – what do party manifestos mean for dementia?’ Alzheimer’s Research UK, 18 November 2024 ‘At a tipping point – what do party manifestos mean for dementia?’ Alzheimer’s Research UK