天美影院

As you have heard聽today, Lord Darzi聽has聽published his independent report on the state of our NHS.聽

It is an incredibly comprehensive analysis.聽Some of you will have seen it, there are copies available, please read it.

A raw and honest assessment.聽That is what we asked for.

And聽that is why聽I wanted to come here to the King鈥檚 Fund.聽

Home to many of our country鈥檚 leading healthcare experts.

Because your contributions are going to be vital.

As we get this precious institution back on its feet,

And build an NHS that is truly fit for the future.聽

And look, our starting point couldn鈥檛 be further from that goal.聽聽

Public satisfaction in the NHS has fallen鈥�

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To an all-time low today.聽

Think of the impact that has on staff who are putting in so much day in day out, knowing that confidence is at an all-time low.

And that is because, as everybody in the country knows, the last government broke the NHS.聽聽

But until this morning, we didn鈥檛 know the full scale of the damage,聽which is laid bare in the report.

Even Lord Darzi, with all his years of experience.聽聽

Is shocked by what he discovered.聽聽

It is unforgiveable.

And people have every right to be angry.聽聽

It鈥檚聽not just because the NHS is so personal to all of us.聽

Or because when people can鈥檛 get the care they need鈥�

They鈥檙e off work sick, with huge costs for our economy.

It鈥檚 because some of these failings are literally life and death.聽

Take the waiting times in A&E鈥β�

More than 100,000 infants waited more than 6 hours last year鈥β�

And nearly a tenth of all patients are now waiting for 12 hours or more鈥β�

That鈥檚 not just a source of fear and anxiety鈥β犅�

It鈥檚 leading to thousands of avoidable deaths鈥�.

And that phrase avoidable deaths should always be chilling.

That鈥檚聽people鈥檚 loved ones who could have been saved.聽聽

Doctors and nurses whose whole vocation is to save them鈥β�

Hampered from doing so.聽

It鈥檚 devastating. Heartbreaking. Infuriating鈥β犅�

And that鈥檚 just scratching the surface.聽

High-risk heart attack patients waiting too long for urgent treatment.

Cancer聽diagnosis聽patients聽waiting too long鈥�.聽

With cancer death rates higher than other countries聽

And when it comes to getting help for mental health 鈥β�

鈥�. 345,000 are waiting over a year.

That鈥檚 roughly the entire population of Leicester.

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Covid hit our NHS harder than healthcare systems in other countries.聽聽

The NHS delayed, cancelled, or postponed far more routine care during the pandemic than any comparable health system.聽

And why?聽

Because our NHS went into the pandemic in a much more fragile state.聽聽

Fewer doctor, fewer nurses and fewer beds than most other high income health systems

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What Lord Darzi describes as a 鈥渃alamity without international precedent鈥�.

A 鈥渟corched earth鈥澛燼pproach to health reform, the effects of which are still felt to this day.

And at the same time, they inflicted what the report describes as:聽

鈥渢he most austere decade since the NHS was founded鈥澛犅�

Crumbling buildings.

Decrepit portacabins.

Mental health patients in Victorian-era cells infested with vermin.聽

When we say they broke the NHS鈥β�

That鈥檚 not performative politics.聽

Just look at it.聽

The 2010s were a lost decade for our NHS.

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And it鈥檚 not just the state of our National Health Service in crisis.

It鈥檚 also the state of our national health.聽

We鈥檙e becoming a sicker society.聽

Spending more of our lives in ill-health than ten years ago.聽

There are 2.8 million people economically inactive because of long-term sickness.

As today鈥檚 report聽makes clear -

鈥淭he NHS is not contributing to national prosperity as it could.鈥澛�

But聽perhaps Lord Darzi鈥檚 most damning finding is about the declining physical and mental health of our children.

Fewer children getting vaccinated鈥β�

While those from the most deprived backgrounds鈥β�

Are twice as likely to be obese by reception age.

And much of this is a direct result of wider social injustices..聽

Poor quality housing

Lower incomes,

Insecure employment.

All of it, not just damaging the health of our nation鈥β�

It鈥檚 piling up the pressures on our NHS.

That鈥檚 the report.

But look, I haven鈥檛 come here just to set out this appalling inheritance.聽Though it is really important that we know it and properly understand it in detail.

Getting people back to health and work would not only reduce the costs on the NHS.聽

It would help drive economic growth - and fund public services.

My government was elected on a mandate for change so I鈥檓 also here to talk about how together we fix it.

I feel very deeply the profound responsibility聽for this.

And indeed, the opportunity of this moment.聽

The NHS may be broken, but it鈥檚 not beaten.聽

As the report says, the NHS聽may be in a 鈥渃ritical condition鈥�.聽

But 鈥渋ts vital signs are strong鈥�.

And聽we need is the courage to deliver long-term reform.

Major surgery not sticking plasters.聽聽

We鈥檝e got to face up to the challenges鈥�.

Look at聽our ageing society.聽

And the higher burden of disease.聽

Look, the NHS is at a fork in the road.

And we have a choice about how it should meet these rising demands.

Don鈥檛 act and leave it to die.

Raise taxes on working people.

Or reform to secure its future.聽

Working people can鈥檛 afford to pay more.

So it鈥檚 reform or die.聽

So聽let me be clear from the outset, what reform does not mean.聽聽

First, it does not mean abandoning those founding ideals.聽

Of a public service, publicly funded, free at the point of use.

That basic principle of dignity.

Inspired聽of course聽by Bevan,

That when you fall ill,

You should never have to worry about the bill.聽

That is as true today as when the NHS was founded 76 years ago.聽

And I believe that so deeply.聽聽

As some of you will know,聽my mum and my sister both worked for the NHS.聽

My wife works for the NHS.聽

The NHS cared for my Mum throughout聽what was a very

But 鈥渋ts vital signs are strong鈥�.

long illness鈥β�

The NHS runs through my family like a stick of rock.聽

And you know, this isn鈥檛 just about emotion.

It鈥檚 about hard facts too.聽

The NHS is uniquely placed for the opportunities of big data and predictive and preventative medicine.

So the problem isn鈥檛 that the NHS is the wrong model.聽

It鈥檚 the right model.

It鈥檚 just not taking advantage of the opportunities in front of it.聽

And聽that鈥檚 what needs to change.

Second, reform does not mean just putting more money in.聽聽

Of course, even in difficult financial circumstances.

My government will always make the investments in our NHS that are needed.聽 Always.聽聽聽

But we have to fix the plumbing before turning on the taps.

So hear me when I say this.聽

No more money without reform.

I am not prepared to see even more of your money spent

On agency staff who cost 拢5,000 a shift聽

On appointment letters, which arrive after the appointment,

Or on paying for people to be stuck in hospital

Just because they can鈥檛 get the care they need in the community.聽聽

Tonight, there will be 12,000 patients in that聽very聽position.

That鈥檚 enough to fill 28 hospitals.聽

So聽we can鈥檛 go on like this.聽

As Lord Darzi has said -

NHS staff are 鈥渨orking harder than ever鈥澛�

But 鈥減roductivity has fallen.鈥澛犅�

Because patients can鈥檛 be discharged,

And clinicians are spending their time trying to find聽more聽beds.

Rather than treating more patients.聽聽

That isn鈥檛 just solved by more money - it鈥檚 solved by reform.聽

And third, reform does not mean trying to fix everything from Whitehall.聽It really doesn鈥檛.

When Lord Darzi says the vital signs of the NHS are strong.聽

He鈥檚 talking about the talents and passion of our NHS workforce.聽聽That鈥檚 what he鈥檚 talking about.

The breadth and depth of clinical talent.聽

The extraordinary compassion and care of our NHS staff.聽聽

If we are going to build an NHS that is fit for the future鈥β犅�

Then I tell you, we are going to do it with our NHS staff.聽

And聽indeed,聽with聽our聽patients too.聽聽

We are going to change it together.聽

Now, that starts with the first steps,

40,000 extra appointments every week.聽

But we鈥檝e got to do the hard yards of long-term reform.聽聽

So this government is working at pace

To build a Ten-Year Plan.聽

Something so different from anything that has聽gone before.

This plan will be framed around three big shifts,

Three fundamental reforms,

Which are rooted in what Lord Darzi has set out today.聽

First, moving from an analogue to a digital NHS.

Already we can see glimpses of the extraordinary potential of technology,

Like the world鈥檚 first ever non-invasive, knifeless surgery for Kidney cancer鈥β燡ust imagine that.

Pioneered by Leeds Teaching Hospitals.聽

Or the precision cancer scanners鈥�

I saw just yesterday.

Or simply for transforming how we manage a condition.

We went聽to Kingsmill Hospital earlier this year聽and met a 12-year old called Molly.

She used a smartphone to monitor her glucose levels鈥β�

Instead of being forced to repeatedly prick her fingers.聽聽

It made such a difference to her daily life and gave great reassurance to her mum聽who could remotely check on the settings and the findings.

We鈥檝e got to make these opportunities available to everyone.聽聽

We鈥檝e got to use technology to empower patients and give them much greater control over their healthcare.聽

Take an innovation like the NHS app.

This could be a whole digital front door to the NHS.聽

Appointments, self-referral, reminders for check-ups and screenings.

Patients in control of their own data,

Healthcare so much more transparent,

So you always know your options,

And the standards聽that聽you should expect.聽

And you know, earlier this year I went to Alder Hey Hospital.聽Many of you will know it, it鈥檚 a聽fantastic hospital,聽where they carry out heart surgery on infants,聽which is really humbling to see.

I met the parents of a two-year old who had extremely complicated聽heart聽surgery.聽A tiny infant, an incredible surgery.聽

I asked them about their child鈥檚 history and condition,聽how did he come to be here, what鈥檚 the story behind it,

And聽as they told me,聽I could see them welling up as they went through the history, conditions, all the background through all of that over and over again.聽

They really struggled to tell the story and they have to do this every single time.

Because the records weren鈥檛 held electronically.聽

We鈥檝e got to have fully digital patient records.

So that crucial information is there for you.

Wherever you go in our NHS.聽

And while I鈥檓 on technology

We鈥檙e also going to throw the full weight of the British Government behind our world leading life sciences.

Second, we鈥檝e got to shift more care from hospitals to communities.聽聽

Now聽The King鈥檚 Fund has long called for this.

Successive governments have repeatedly promised it.聽

But what鈥檚 happened?聽

The opposite.聽

The share of the NHS budget spent on hospitals has聽actuallyincreased.

Now聽this Ten-Year plan has to be the moment we change this.

The moment we begin to turn our National Health Service聽

into a Neighbourhood Health Service.聽

That means more tests, scans, healthcare offered on high streets and town centres.聽

Improved GP access.

Bringing back the family doctor.

Offering digital consultations for those who want them,

Then they told me that every time they went to a different hospital, they had to go virtual wards.

And聽more patients can be safely looked after in their own homes.聽

Where we can deal with problems early,

Before people are off work sick and before they need to go to hospital.聽

And we鈥檝e got to make good on the integration of health and social care.

So we can discharge those 28 hospitals worth of patients.

Saving money.聽聽

Reducing the strain on our NHS,

And giving people better treatment.聽聽

And third聽in terms of the shifts,聽we鈥檝e got to be much bolder in moving from sickness to prevention.聽聽

Now聽we鈥檝e already announced NHS health checks in workplaces.聽

Blood pressure checks at dentists and opticians.

And that is just the beginning.聽

Planning for ten years means we can make long-term investments in new technologies

That will help catch and prevent problems earlier.聽

And there are some areas in particular聽

Where we鈥檝e just got to be more ambitious.

Like children鈥檚 mental health.

Or children鈥檚 dentistry.

You know, one of the most shocking things聽that I saw,聽I鈥檝e ever seen鈥β�

This was actually when I was at聽was at Alder Hey Children鈥檚 Hospital again.聽

As I mentioned earlier, I went to the ward where they do heart operations.

The single biggest cause of children going into that hospital鈥�

Between the ages of 6 and 10鈥β�

Was to have their rotting teeth taken out.聽I couldn鈥檛 believe it. I was genuinely shocked.聽

All politicians say they are shocked too often, but I was honestly shocked, the single biggest cause of going into hospital of children between 6 and 10 is having their teeth taken out.

Can you think of anything more soul-destroying?

For those children聽what a price to pay.

And for that brilliant NHS team聽who want to use their talents to save lives.

Instead spending their time taking out rotting teeth.

Something that could be so easily prevented.聽

And look, I know some prevention measures will be controversial.聽

I鈥檓 prepared to be bold even in the face of loud opposition.聽

So no, some of our changes won鈥檛 be universally popular.聽聽We know that.

But I will do the right thing - for our NHS, our economy, and our children.聽聽

Now, the task before us is the work of our generation.聽聽

We鈥檝e already hit the ground running.聽

Negotiating an offer to end the strikes

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Strikes that were costing us all a fortune.

And we inherited 1,000 trainee GPs聽who were聽set to graduate into unemployment鈥β�

Instead we hired聽them.

But only fundamental reform and a plan for the long-term can turn around the NHS and build a healthy society.聽聽

It won鈥檛 be easy,聽it won鈥檛 be聽or聽quick.聽

It will take a ten-year plan.聽

Not the work of just one Parliament.聽聽

But I know we can do it.聽聽

Because we鈥檝e done reform before.

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To deliver better outcomes for patients and better value for taxpayers.

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My Government has a huge mandate for change.

We are mission-driven.

And聽I think the themes of this conference today are fitting for this moment.聽

Challenge. Change.聽And聽hope.聽

Because the challenge is clear before us.聽

The change could amount to the biggest reimagining of our NHS since its birth.聽

And the hope, well that鈥檚 what鈥檚 really exciting and galvanising about this moment.

Because聽if we get this right,聽聽

People can look back and say -聽聽

This was the generation that took the NHS from the worst crisis in its history.聽聽

Got it back on its feet and made it fit for the future.