Keir Starmer has outlined a 10-year plan for the NHS based on a shift from hospitals to community health hubs, a renewed focus on prevention and an embrace of technology, which was billed as perhaps the last chance to save the health service in its current form.
Speaking at a health centre in Stratford, east London, alongside Wes Streeting, the health secretary; and Rachel Reeves, the chancellor – who had not been expected to appear – Starmer insisted this would be different to the long list of previous NHS revamps that achieved little.
“We’re putting in the resources, we’re putting in the priorities and we’ve got the resolve to see this through,” he said. “In the end, I genuinely think it is only Labour governments that can do this.
“I want in 10, 20, 30 years for people to look back and say this was the government that seized the moment and reformed the NHS so it’s fit for the future.”
Setting out the broad details of the plan, a 165-page document published as Starmer spoke, the prime minister said the service in England would be shifted “from being only a sickness service to a health service which is genuinely preventative – prevents diseases in the first place”.
This would involve, he said, more of a focus on areas such as screening and early diagnosis, and on vaccinations and lifestyle-based measures such as pharmacy-based weight-loss services and measures to make supermarket foods healthier.
Another pillar, he said, would be to move away from a “hospital-dominated service” to one more based around community health centres such as the one he spoke in, saying this was needed to reflect the gradual societal shift away from acute health crises to more chronic, longer-term conditions.
“We will always need hospitals,” he said. “They will always be important for acute services in particular. But disease has changed, and we must change with it.”
The final focus, he said, would be on “a truly digital health service”, based on hi-tech diagnostic and treatment options, but also a gradually expanded NHS app, which Starmer said would be “like having a doctor in your pocket, providing you with 24-hour advice, seven days a week; an NHS that really is always there when you need it”.
The plan says the NHS is “at an existential brink” after years of neglect by the Conservatives, and only Labour’s radical transformation will stop it losing support as a taxpayer-funded model of care.
It says that Labour last year inherited an NHS where many people cannot get to see a GP or dentist, waiting lists have soared, staff are demoralised and outcomes from killer diseases such as cancer are worse than in other countries.
“That is why the NHS now stands at an existential brink,” it says. With the ageing population creating more illness “without change, this will threaten yet worse access and outcomes – and even more will opt out and go private if they can afford to.
“They will increasingly wonder why they pay so much tax for a service they do not use, eroding the principle of solidarity that has sustained the NHS. We will be condemned to a poor service for poor people.”
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But health experts disputed that analysis. Thea Stein, the chief executive of the Nuffield Trust, said: “The government is right about the serious problems it diagnoses in the NHS, and largely right in the vision it proposes to win back public faith. But we do not agree with the prophecy of extinction.”
Although public satisfaction with the NHS had collapsed to just 21% , and patients were “dismayed” by the difficulty of accessing care, support for its founding principles – taxpayer-funded, available to all and free at the point of use – remained “high and resilient”, she added.
The plan does not set out clearly how the proposed changes to the NHS’s ways of working will be implemented, Stein said. “This plan contains a litany of initiatives and the belief that they will be the NHS’s saviour, with little detail on how the ailing health service is to deliver these changes.”
Speaking before Starmer, Streeting said urgent change was needed in part to see off voices calling for the current model of the NHS to the abandoned, a seemingly allusion to Reform UK, which has talked previously of a more insurance-based version.
“There have always been those who whispered that the NHS is a burden, too expensive, inferior to the market, and today those voices grow louder, exploiting the crisis in our NHS in order to dismantle it,” he said.
“We also know the consequences of failure. That’s why we can’t afford to fail. To succeed, we need to defeat the cynicism that says that nothing ever changes.”
Reeves, making her first public appearance since she was seen in tears at prime minister’s questions in the Commons, which sparked questions about her future, spoke only briefly, saying that the government’s fiscal discipline had allowed it to give more resources to the NHS.