The UK has been hit much harder by the coronavirus pandemic than other developed countries because the NHS has been “severely weakened” by disastrous government policies over the past decade, a wide-ranging report due to be published this week will conclude.
An NHS review by world-renowned surgeon Professor Ara Darzi, commissioned by Health Secretary Wes Streeting in July, will find that the NHS has “cut routine clinical activities to a much greater extent than other health systems” in many key areas during the coronavirus crisis.
Hip and knee replacement surgeries, for example, fell by 46% and 68% respectively. Hospital discharges across the UK fell by 18% between 2019 and 2020, but Lord Darge will say this is lower than the OECD average of 10%.
In a key section of the report, MPs will conclude that the NHS is still suffering the aftereffects of failing to respond properly to the coronavirus shock at the time.
“It is impossible to understand the current state of the NHS without recognising how much care has been cancelled, suspended or postponed during the pandemic… The impact of the pandemic has been magnified because the NHS was seriously weakened in the decade before the pandemic hit.”
Mr Darge will be particularly critical of the top-down reorganisation of the NHS by Andrew Lansley, the former Conservative health secretary under David Cameron, saying it “undermined health reform”.
“The 2012 Health and Social Care Act was a disaster of international unprecedented proportions, with disastrous results,” Mr Darge said, adding: “The result of the chaos has been a permanent loss of capacity for the NHS… this is a key part of explaining the overall poor performance of the NHS.”
“Far from liberating the NHS as it promised, the Health and Social Care Act 2012 trapped more than a million NHS workers in a dysfunctional system for nearly a decade.”
Lord Lansley defended his reforms and said Darge should focus on the “here and now” rather than going back to a “Conservative fault” narrative that went back more than a decade.
“The 2012 act created NHS England and gave powers to the NHS. Administrative costs have been reduced by £1.5 billion. Waiting times have fallen to their lowest levels and the longest waits have virtually been eliminated,” Mr Lansley said, adding that if his plans had been fully implemented the NHS would have been more internationally competitive.
The Conservative Party is preparing to criticise the Durge report as politically motivated because its author was a minister under the previous Labour government and a Labour member until he resigned in 2019.
But Labour will likely point to Mr Darge's distinguished career and the fact that he held key roles during the Conservative government, including as the UK's international ambassador for health and life sciences from 2009 to March 2013. In 2015 he was also appointed non-executive director of Monitor, the NHS regulator which oversees quality and performance management in England.
The Darge report also found that more than 100,000 babies (aged 0-2 years) waited more than six hours in emergency departments in England last year, which NHS bosses see as a turning point.
Mr Streeting is expected to use the report as the basis for his own fantasies about reform. The current NHS England Long Term Plan, introduced in 2019, was drawn up before the pandemic, which has led to lengthening waiting lists with 6.39 million people waiting for 7.62 million treatments.
Mr Streeting said last year that he believed the NHS needed three big shifts – from disease to prevention, from hospitals to GP and community services, and “from an analogue service to one that embraces the technological revolution”.
Two other major reports being published this week also paint a bleak picture for the health service's prospects under current spending constraints.
A survey of trust chief executives and financial officers by NHS Providers, the membership organisation for users of hospital, mental health, community and emergency services, found that more than half (51%) are “very concerned” about whether they can deliver their priorities within the tight financial constraints for 2024-2025.
Nine in ten people felt that the financial situation was tougher than last year. Measures that should be considered included “extending the freeze on vacancies,” “effectively reducing staff numbers,” and “reducing services.”
Sir Julian Hartley, chief executive of NHS Providers, said the message was that with funds so tight, we must find ways to secure multi-year investment in reforms that improve productivity “rather than a stop-and-start approach to NHS funding that leaves us constantly worrying about cuts followed by stop-gap short-term funding announcements”.
And a report by the NHS Confederation and health consultancy Carnal Farrar found that Labour's pledge to create 40,000 extra appointment slots per week in England will not stop waiting lists from growing.
This represents just 15% of what is needed to get 92% of patients into regular inpatient treatment within 18 weeks, a key goal that has not been met for nearly a decade.
Matthew Taylor, chief executive of the NHS Confederation, said waiting lists were unlikely to fall significantly until spring or summer next year.
He added: “We need to be realistic about the fact that unless we do something very innovative, demand is going to increase substantially. Almost everyone agrees that we need to transform the NHS by investing in prevention. To do that, [opening new services before old ones close].
“None of this can be achieved for free. What Rachel Reeves needs is recognition that the long-term sustainability of the health service, the public sector and the wider economy depends on tipping the health demand curve.”
The Prime Minister, Keir Starmer, would echo Mr Darge's assessment, telling the BBC's Laura Kuenssberg on Sunday morning that the Conservatives had “destroyed” the NHS in an “unforgivable” way.
He added: “Our job now, through Lord Darji, is to understand properly how that happened and to deliver reform, starting with the first step – the appointment of 40,000 more people.”
