Keir Starmer’s full health mission speech today: An NHS fit for the future

It’s fantastic to be here in Braintree, because 16 years ago, I got married here, just down the road at Fennes – as some of you may know and almost as good, this is where two weeks ago, at the local elections, the Labour Party was back on the march in Essex.

But today, I’m here to speak about something that is fundamental to the Labour Party, fundamental to our purpose of working people. The NHS. Just look at it. The eight o’clock scramble, the appointments missed, opportunities missed, to spot the pain that turned out to be a tumour.

Patients who want to go home, are well enough to go home but who have to stay in hospital for months, waiting for a care package. Day long waits in A&E, record numbers off work sick, people pulling their own teeth out, seven million on waiting, waiting, waiting lists. And ambulances – for heart attack and stroke victims – that don’t come in time.

Just think about that for a second, ambulances that don’t come. Can any of you imagine losing someone in that way? I can’t – and I mean that in every sense: I can’t imagine it. It shouldn’t be possible in our country, but it is. A cruel lottery of who lives and who dies that the NHS was founded to stop. And until now, until this point, for 75 years – it has.

It’s one of the greatest privileges of being born in Britain, certainly for all of my life – the knowledge – that if you get ill, if you have a serious accident, you’ll get the care that you need, whatever your circumstances. Not every country has a system like that and the insecurity, the fear without it – is huge.

Nye Bevan – the Labour Health Secretary who created the NHS put it best. He said: “illness is neither an indulgence for which people have to pay; nor an offence for which they should be penalised”.

That’s what we believe. And it’s under threat. I mean it. I don’t think the NHS survives five more years of Tory government.

‘Not sustainable unless we make serious, deep, long-term changes’

People can say – we’ve heard this before, the Labour Party is always saying it’s time to save the NHS, but I say – look squarely in the eyes of the people who work in the NHS, who serve the NHS, and ask them.

Speak to the working people who use the NHS, who depend on the NHS, who need the NHS, what do they say? And go to the people, who believe in the NHS, love the NHS, but have been forced to buy the care they need from the private sector. Listen to them.

At the next election, the NHS is on the line. The Conservative Party that’s brought it to its knees will put it in the ground.

But mark my words, if all we do in the Labour Party is place the NHS on a pedestal and leave it there, that’s not good enough either. We’ve got to fix the fundamentals, renew its purpose, make it fit for the future – that’s what this mission is about.

A new direction for the NHS. To say to the British people: “vote Labour, problem solved” would be an insult to everyone’s intelligence – patients can see how deep the problems go.My approach is different.

It starts with the cause, the central project – “how do we serve working people”, and then it asks – “what do we value; what do we conserve, cherish and protect?

The answer: a public and universal health system, free at the point of use, paid for by general taxation, the NHS. But then it asks – what do we need to change, what are the challenges, the opportunities, how can we save lives, improve lives, provide more dignity?

Innovation – where can it be found? People – how do we unlock their purpose? Technology – how do we make it work for us? And when you’ve asked those searching questions, you turn back, you roll up your sleeves, and you face reality.

And the reality is this: the NHS is not sustainable unless we make serious, deep, long-term changes. That’s my politics. Reform for renewal. National missions for the common good. An NHS fit for the future.

Some people will tell you this is purely a question of money. And money is part of it – I don’t deny that. Like any opposition, we will set out our plans before the election, and like any incoming government, we will make decisions based on a full appreciation of reality – on the state of the NHS and our public finances.

But what’s more important now – I really believe this – is to show our recipe for reform, to put forward a vision of a renewed NHS that can make the most of the money we invest in it.

I’ve run a public service – I know that money makes a difference. But it only gets you so far. You can’t look at the problems now and tell me it’s just about money – that’s not serious.

‘The world has changed’

You can’t ignore the fact the world has changed – that’s denying the evidence before our eyes.

The British people are living longer – life expectancy in 1948 was 68, today it’s over 81. That is a good thing, but it brings new challenges. The nature of disease is different – instead of urgent and acute hospital care, now it’s more about managing chronic, long-term conditions.

The wonder of science has taught us, with ever increasing clarity that our health depends on how we live. Mental health has stepped out from the shadows – and thank goodness.

And with artificial intelligence, with personalised medicine, with new vaccines, we stand on the cusp of a revolution that could transform healthcare for the better. My message today is this – science and technology are the game-changers.

This is the prize – this is what it gives us. An NHS where prevention comes first, where care is closer to home, where patients have more control.

So to everyone working in the NHS today, serving on the frontline now, I say: thank you. Thank you. Without you – there would be no light at the end of the tunnel. But I also say: the walk towards that light will be hard, will feel challenging, difficult.

But do not doubt – it is essential and that the reward for reform will be worth it. And look – don’t doubt this either, the Tories will never deliver this. They voted against the NHS right at the start – and more than once.

And while they have come to accept it as part of the political furniture, in their heart of hearts, they don’t believe in its central promise. For them, it’s a cost, not a cause, and from that mind-set, springs the well of their neglect. The poverty of their ambition, the sticking plaster, crisis management impulse that never sees the opportunities, never addresses the long-term.

It’s not that they don’t care – it’s that their priorities, their ideology, it takes them somewhere else. £200bn a year – that doesn’t square with their small state vision of Britain.

And that’s why we have familiar problems. Every year for 13 years, we’ve had a winter crisis. And every year in about February or March, they do just enough to keep the NHS going, we breathe a bit in the summer, and we go into the next NHS crisis, the next winter. The only difference being, it’s worse than the one that went before.

But you know what’s even worse than that – the Tories underestimate the NHS. Underestimate the bond between people and service. Underestimate what you can do with a mission.

That yes, people go to work in the NHS for a wage, of course they do, but also because they believe in something. This is how we go beyond the ‘sticking plaster’ mind-set, how we solve the crisis and tackle the long-term challenges.

‘No excuses – we will meet these standards again’

I want an NHS back on its feet – of course I do. But I also want an NHS that’s fit for the future and that requires a partnership, between people and service that builds on what is distinctive about the NHS as a health system.

“Protect the NHS” – was the pandemic slogan and we did, and in turn, it protected us. So have no doubt – this mission is a cause.

But it’s a cause that can only succeed if we embrace the need for reform. So – Labour’s national mission on health – to build an NHS fit for the future. And as with all our missions – we set the direction with clear, measurable goals.

Goal one – the next Labour government will deliver an NHS that is there when you need it:

Ambulances – seven minutes for cardiac arrest; A&E – back to the four hour target; GPs – the highest satisfaction levels on record; waiting lists – down; planned treatment within 18 weeks. No backsliding, no excuses – we will meet these standards again. We will get the NHS back on its feet.

Goal two – we will improve healthy life expectancy for all and we’ll halve the inequality gap between different regions of England. Let me explain what that means.

It means we will restart a trend Britain had come to take for granted. That, to be blunt, we should take for granted. A sign of progress – that generation after generation, the people of this country are living healthier lives, happier lives, longer lives. The Tories have reversed that – that’s their legacy.

And look – by focusing on health inequalities, we can make Britain fairer as well. Did you know Black women are four times more likely to die while having a baby than white women?

In my constituency, a girl born in Highgate Hill will live ten years longer than a girl born in Somers Town. That is three miles away. My Labour Party won’t stand by and let that happen – we’ve got to root these inequalities out.

And to achieve this we must zone-in on our biggest killers. Three killers which we know ask demanding questions of our healthcare system.

One – cardiovascular diseases: heart attacks and strokes – we will get them down by a quarter, within a decade. Two – cancer: we will make sure 75% of all cancer is diagnosed at stage one or two.

Let me tell you what that means – the difference it will make. The survival rate for cancer at stage one and two is 81%, but at stage three and four – it’s just 26%. What a difference that would make.

And finally – killer three: suicide. Last year, I went to an event organised by the band New Order, they asked me – for obvious reasons, given their history, did I know anyone that’s died in that way?

I have to admit that took me aback – I’ve never been asked that, certainly not in public before. But you know, I didn’t have to think that long. I do. More than one in fact. Three friends.

And if I asked everyone in this room the same question. I guess you wouldn’t have to think that long either. Suicide is the biggest killer of young lives in this country, the biggest killer.

That statistic should haunt us, and the rate is going up. Our mission – must be and will be – to get it down.

Labour will give patients choice

So there’s no time to dither. This mission starts with people – that’s at the heart of the crisis right now.

That’s why we’re committed to the biggest expansion of NHS training in its history – more nurses, doctors, midwives and health visitors. All fully-funded by removing the non-dom tax status.

It’s why we’ll leave no stone unturned when it comes to finding new ways to cut waiting lists. Labour’s has done it before – and we’ll do it again.

Imagine you’re waiting for a knee operation and the waiting list isn’t going down at your local hospital but in the trust next-door they have a specialist orthopaedic centre and things are moving much more quickly.

I say – you should be able to go there instead. I say – there shouldn’t be a separate waiting list at this hospital, a separate waiting list at that hospital. Hospitals should work together.

So I can announce today, to cut waiting lists more quickly, patients should be able to visit nearby hospitals when faster treatment is available, and Labour will give them that choice.

And that’s only the beginning. As I keep saying: we’ve got to go beyond the sticking plaster approach.

I talked earlier about the light at the end of the tunnel, the reward for reform. We’ve got to hold on to that – and there are grounds to be optimistic. But it will require three shifts. Shifts we must place at the heart of everything we do on health.

‘End the 8am scramble’ for GPs

Shift one – we must move care away from hospitals and closer to the community, the NHS must become a Neighbourhood Health Service. I’ll put it bluntly – at the moment we aren’t good enough at treating people early in the community.

We leave it to hospitals – and quite often that’s too late. And if we change this it will save lives and money.

That’s why we’re going to improve GP access – end the 8am scramble. We’ll train more GPs, but we’ll also make the future of general practice more sustainable.

As the contractor model declines in some communities, we won’t let patients go without the care they need. We’ll bring fragmented services together, make sure salaried GPs serve all communities.

And we’ll modernise the appointments system. For those who want real continuity of care – we’ll bring back the family doctor, that’s what people with long-term conditions need.

But for those who just want a quick appointment at their convenience, who want a digital consultation, we’ll give those patients a different route. Seriously – it can’t be beyond us to offer different options for different people. We’ve just got to roll up our sleeves and get it done.

And one more thing – we’ve got to fix the backdoor problem. We can’t have hospitals blocked up by patients who are desperate to go home and ready to be discharged.

So we’ll make good on the integration of health and social care. Backing successful community models like the centre at Bromley-by-Bow where they bring together in one place – doctors, nurses, physiotherapists, social carers – to provide joined up care in the community, keeping people out of hospital.

And look, we will recruit and retain more carers with a fair pay agreement. This is fundamental – it’s about who and what we respect, about dignity, it’s about better standards at work, more progression, more training, more rights, and yes – about pay. A fair deal for our carers – that’s what people clapped for.

No vaping, junk food, sugary snack adverts to children

Shift two – we must move from a mind-set that views health as all about sickness. To one where we put prevention first – right across society.

So we’ll take bold action where early intervention can make a huge difference – on mental health. Make no mistake – we intend to revolutionise mental health treatment in this country: 8,500 new mental health professionals, specialist access in every school, guaranteed treatment inside four weeks for anyone who needs it.

And look – this mission we’re launching today isn’t just an NHS mission – it’s a health mission. When we talk about a new deal for working people on employment rights, about good work for all – that’s a health policy.

When we say we will provide breakfast clubs, with healthy food, for all primary school children – that’s a health policy. When we commit to restoring a decent homes standard, to regulating the water industry, a new clean air act – they’re all health policies.

And when I say we will take on the social media companies who push dangerous misogyny on our children, I am saying, very clearly to those who profit from harming our children – no, not in Britain.

Today we go further on that. We will change advertising rules and we will make sure that products which are harmful to our children’s health – vaping, junk food, sugary snacks – cannot be advertised to our children. No – not in Britain.

‘From an analogue to a digital NHS’

Shift three – technology. A revolution that will accelerate the first two shifts and herald a different kind of healthcare.

A move from an analogue to a digital NHS. A tomorrow service, not just a today service. Mark my words – this can be transformational. The route to the NHS offering shorter waiting times – better treatment, early diagnosis, and meaningful prevention.

Britain leads the world in science and technology – we can make this happen. This is the game changer. The light at the end of the tunnel. This is what will make the NHS fit for the future.

I’ll give an example. 33 million people downloaded the NHS app during the pandemic – and it’s a good app. But that extraordinary opportunity – it’s been wasted.

Labour would take the app – and innovations like it – we would deepen them, expand them, put them in the hands of patients, and use them: to transform our relationship with the NHS.

Get this right and it means moving to fully digital patient records – never again hand written patient notes getting lost. It means booked appointments, appropriate self-referral routes, reminders to get check-ups and screening, the latest guidance on treatment, patients in control of their own data.

Choosing how it’s used and how it’s shared, this will get rid of a divide between those confident to speak up for themselves and those who can’t. And look – if we make sure everyone is supported – that we take people on this journey, it will mean people can get better choices, will get faster care, can better manage their own health.

In truth, it’s about the politicians catching up with the public and the NHS catching up with the revolution that’s already happened in the rest of our lives, and it doesn’t stop there.

Technology provides more choice and power for patients but it also saves lives. Take artificial intelligence. AI will change the nature of healthcare – and Britain is good at AI.

I’ll give an example. Lung cancer is the number one cause of cancer-related deaths in the UK. 274,000 patients waiting, for 11 days or more, to hear back from the scan which could tell them if they have cancer.

AI can reduce workload and raise productivity. But here’s the real thing, when used properly by a radiologist, it can reduce missed lung cancer diagnoses by 60%.

And because it’s quicker, because it’s more accurate, the lives it could save through early diagnosis are countless. But to make this happen innovators need one route into the NHS not many, incentives to innovate throughout the system, fewer barriers to adoption, fewer hurdles to clear, less bureaucracy, more clinical trials, and a government that uses its full power to back our world leading life sciences.

I owe the NHS ‘everything’

And look – when you add this all together. The sum total of these three shifts, what you get is a plan.

A plan for a future NHS that protects what is precious and embraces what is possible. From everyone waiting, stuck on the call at 8am, to a primary care system that offers different choices for different needs. From long waits at A&E to hospitals that carry a lighter load, because more care is in the community.

An NHS where technology gives patients more responsibility and professionals more time.

Where we diagnose disease earlier, screen people – in supermarkets, libraries, leisure centres, communities. Where we save lives because healthcare is closer to lives.

And above all – where the whole of society contributes to the mission of healthier, happier, longer lives. That’s an ambition we can rally around, a goal that can lift the anxiety, the pain, the fear faced by millions of families across the country, and replace it with the hope of a renewed NHS.

In Place of Fear – that’s what Nye Bevan called his book. And if people want to call me dewy-eyed, want to say I’m a romantic about the values of the NHS – I plead guilty.

The NHS has played an enormous role in my life. My Mum was a nurse, a proud nurse too. But she was also severely ill for most of her life with a rare condition called Still’s disease.

At the age of 11 – she was told two things. One – she would be in a wheelchair by her twenties. Two – that she should forget about having kids.

Now that diagnosis didn’t reckon with Mum’s determination and courage but it also didn’t reckon with the NHS. A doctor at Guy’s Hospital in London refused to give up. He found an experimental treatment for this 11 year old girl and the rest, as they say, is history.

Honestly – lots of people say they owe the NHS everything and I’m definitely one of them. But that’s just the point. Mum’s story isn’t special.

Behind every single door in this country, there is a family who will have their own version. This is who we are, the NHS belongs to everyone. The foundation for the comfort, security and health of working people.

For 75 years: an ever-present in our story – family and nation. My message today is simple, with Labour the story continues, we have a plan. I want the patients of the future to remember this moment, remember the changes we’ll make together. That’s our mission.

We will fight for the NHS, we will fix the NHS, we will reform the NHS. Old values, new opportunities – technology and science, convenience and control, renewal not decline.

An NHS, not just off its knees, but running confidently towards the future. Thank you very much.