UK politics: No more money for NHS without reform, says Starmer as he outlines vision for health service – as it happened.H
The prime minister blamed the Tories for ‘breaking’ the NHS and said reform of the service was needed
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Vulnerable prisoners are being forced to inherit the debt of the previous occupant of their cells leading to violence and extortion, the minister Lord Timpson told peers. As Rajeev Syal reports, the prisons minister also said new inmates are being forced to pay twice as much back – which he called ‘double bubble’ – after borrowing cash to buy everyday items such as shampoo and biscuits. Timpson, a former businessman who has been brought into government because of his long running interest in prison reform. Answering a question in the Lords, he said that gangs are forcing vulnerable prisoners into debt, sometimes demanding that they repay cash owed by former prisoners who have since moved out of a cell. Timpson said:
We know that debt drives poor safety and outcomes, and the drug trade really fuels it, so we need to make sure our vulnerable prisoners are not extorted, assaulted, and not forced to do things they don’t want to do.
There have been many instances of prisoners inheriting the debt on the former resident of that cell.
We are now closing this blog but you can read all our UK politics coverage here.
Here is John Crace’s sketch of Keir Starmer’s NHS speech this morning.
Starmer appoints Michael Barber as ‘adviser on effective delivery’
George Osborne will be approve. (See 4.49pm.) In another sign that Keir Starmer has discovered his “inner Tony Blair”, the PM has appointed Sir Michael Barber as his “adviser on effective delivery”.
In a news release the Cabinet Office said:
Sir Michael will support the prime minister in driving forward the delivery of the five national missions. This will include coordinating ambitious, measurable, long-term objectives that deliver change across the UK.
The part-time role is a direct ministerial appointment and will be unpaid. Sir Michael will take up the role for an initial 12-month period, starting in September 2024.
Sir Michael has extensive experience in implementing large-scale system change, working with many governments internationally to drive delivery.
Barber worked for the Blair government, first as chief adviser in the education department and then as head of Tony Blair’s delivery unit. In that role he was seen as a successful innovator capable of getting the civil service machine to deliver tangible improvements in public services. Since then other UK prime ministers have asked him to take on advisory roles, and he has worked as a governance consultant around the world.
Jeremy Hunt hits back at cabinet secretary over criticism of Tory decision not to hold pre-election spending review
Jeremy Hunt has hit back against the cabinet secretary Simon Case after Case accused him of contributing to financial uncertainty when he was chancellor.
Speaking at the Policy Live conference in central London this afternoon, Hunt defended himself for the first time against Case’s accusation that he should have held a spending review while in office to clarify the state of the public finances. Case made the accusation in a letter defending Labour’s claims that the previous government left behind a £22bn fiscal black hole.
Hunt said:
The right time to do a spending review is at the start of a parliament. It needs to be three, or if I could have my way, four years long so that departments have the stability to do long term planning.
And in a barb directly aimed at Case he added:
I don’t remember ever being advised by the Treasury, or indeed the cabinet secretary, to have another spending review a year before an election, because that would have created enormous upheaval.
Ed Balls says ‘marked improvement’ in NHS impossible before election without big increase in health spending now
Ed Balls, the former Labour shadow chancellor, has said that Keir Starmer needs to put a lot of money into the NHS now if he wants people to see a “marked improvement” by the election.
Speaking on on his Political Currency podcast, which he co-hosts with George Osborne, the former Tory chancellor, he said that reform on its own would not be enough.
Balls said:
The reforms are important, but the thing which will make the biggest difference is a big injection of resources. If Labour wants to have delivered change by the next election, that injection of resources has to happen now.
When we [the Blair/Brown government in 1997 – Balls was Brown’s chief adviser] came into power we actually waited, we built up investment in the NHS through the first term, then made a big push in the second term.
Keir Starmer can’t afford to take that long … There is no way on earth there will be a marked improvement in health outcomes or perception of the health service without a substantially bigger increase in health resources over this parliament than what we’ve seen on average in the last 15 years. And if you say he’s not going to do that, then it’s not going to work.
Balls’ argument echoes the SNP’s criticism of Starmer’s health speech this morning. (See 1.43pm.) Ironically Osborne, his co-host, seemed more supportive of Starmer when they discussed the speech in their podcast. Osborne said:
What Keir Starmer is saying is his solution is not more money. That is quite a thing for a new Labour prime minister to say. He says the NHS has reached a fork in the road, and we can either increase taxes on working people to pay for more of the healthcare required by an ageing society, or we can reform – and then he says it’s a case of ‘we can reform or die.’ [See 2.05pm.] It felt to me that that’s the first time I’ve heard Starmer summon up his inner Tony Blair … That’s quite a different message than you had from the Labour Party in recent years, which is ‘There’s not enough money going into the NHS.’
In Osborne’s mind, “inner Tony Blair” is a high compliment. He and David Cameron used to refer to Blair as “the master” as they plotted how the Tories could return to power by copying him.
Balls played a major role in Labour politics for 20 years, culminating in a stint as shadow chancellor under Ed Miliband. But now he is a TV presenter and podcaster. He is married to Yvette Cooper, the home secretary.
Commons leader Lucy Powell floats plan to stop MPs from doing paid media work
And, talking of GB News, Lucy Powell, the leader of the Commons, has today floated a proposal that could lead to one of its most high-profile presenters being taken off air.
As leader of the Commons, Powell is chair of the Commons modernisation committeee, a new committee set up to modernise some Commons procedures. Most select committees are there to scrutinise the work of government departments, and are chaired by backbenchers. But this one is there to push through Commons modernisation, a government ambition, and that is why it is chaired by a minister. The last Labour government also set up a Commons modernisation committee, but the coalition and Tory governments after 2010 did not see the need for one.
Today Powell has published a six-page memo setting out the committee’s main aims. And it suggests she wants to change Commons rules to stop, or limit, the amount of paid media work that MPs can do. It says:
[The committee] should consider what advantages, if any, outside paid engagements such as media appearances, journalism and speeches furnish to the public, versus the potential conflicts of interest and attention that arise from such paid endeavours. The modernisation committee will wish to consult closely with the parliamentary commissioner for standards, who is best placed to advise on the practicability of any further changes to the rules governing members’ outside interests.
Potentially this could affect many MPs, but one of the biggest losers might be Nigel Farage, the Reform UK leader. Recently figures in the Commons register of members’ interest showed him earning almost £1.2m from GB News.
Since Labour took office rules on outside earnings by MPs have already been tightened. MPs used to be banned from taking a paid job offering parliamentary advice (which can be similar to lobbying – also already banned), but they were allowed to take money for providing general political advice. That is now also banned.
In her memo, Powell also says she wants the committee to consider allocating more time in the chamber for government business and less time for backbench business. She says backbench debates are not well attended, and that they sometimes result in the Commons having to adjourn early because there is no one left wanting to speak. She says:
Given the government’s extensive legislative programme, as set out in the king’s speech, I am committed to treating parliamentary time as the precious resource that it is. This means placing a greater emphasis on members scrutinising government legislation going forwards.
In a post on social media, Darren Grimes, another GB News presenter, said Powell’s plan was unfair.
David Lammy hosted a show on LBC and Labour never saw an issue. When right-leaning MPs get shows though, with big audiences, well, they must be stopped. I see no issue with an MP having a second job, it ought to be up to their constituents, not Labour, to decide if that’s right.
Earlier this year it was often said that the Conservative leadership contest would be largely fought out on, and perhaps even decided by, GB News, the rightwing, pro-Brexit news channel. If Harry Cole from the Sun is correct, that prophecy may turn out to be more accurate than people thought. Cole says the Tories are asking Camilla Tominey, a GB News presenter, and Christopher Hope, GB News’ political editor, to hold Q&A sessions with all the Tory candidates at conference.
NEW: Understand Conservative Party Board met on Tuesday and agreed that the candidates will do Q&A sessions with Camilla Tominey and Chris Hope on the Monday and Tuesday of conference.
Then all will get back to back 20 min speeches on the Wednesday plus a two minute video.
It is looking as if the Tory conference will end up as little more than a four-day leadership hustings, and these Q&A sessions may end up as the main events.
Starmer
Energy department to learn lessons from Boris Johnson’s Covid vaccine taskforce as it rushes to meet clean energy goal by 2030
Helena Horton
Chris Stark, the official at the Department for Energy Security and Net Zero in charge of decarbonising the electricity grid, has said that he wants to follow the vaccine taskforce model to help him meet his goal.
Speaking at a Green Alliance event this morning, Stark said that he had been looking at how the taskforce set up by Boris Johnson was able to rapidly implement a Covid vaccine programme that in normal circumstances would have taken many years.
He has also hired some of the people who worked on the vaccine taskforce to join his green energy programme.
As head of “mission control” at the energy department, which is led by Ed Miliband, Stark is meant to ensure the government hits its target of delivering green energy by 2030.
Stark was previously chief executive at the Climate Change Committee, and when he was there it recommended setting 2035 for the decarbonisation of the electricty grid. At the conference this morning he recalled being asked by Keir Starmer if 2030 would be a realistic target instead.
He said:
The more observant among you will have noticed that my recommended target when I was at the CCC was not 2030, it was 2035, which we felt to be a very ambitious target at the time. And Keir Starmer asked, I think, quite an interesting question, which is, why can’t we do it earlier.
And I and a few others sucked through the teeth and told them, well, it might be possible to do it sooner, but only if you pull all the right levers in the right order. And they didn’t blink at that.
So we are going into this mission for an earlier deadline. Eyes open on the scale of the challenge, but clear I think that it can be done. And that’s the kind of bold mission that I think, I feel we can get behind. And it’s so exciting to have that support right from the top of the government, right the way to the prime minister.
Stark said that in order to meet the goal he is “not pissing about” in making the steps needed to reach the goal, including boosting heat pumps, electric vehicles and renewable energy.
‘It’s reform or die’ – what Starmer said about why NHS needs to change
Downing Street has now published the full text of Keir Starmer’s speech on the Darzi report and NHS reform on its website.
And here is the passage where Starmer talked about the need for NHS reform, saying “it’s reform or die”.
Look, the NHS is at a fork in the road. And we have a choice about how it should meet these rising demands. Don’t act and leave it to die.
Raise taxes on working people or reform to secure its future. Working people can’t afford to pay more. So it’s reform or die.
So let me be clear from the outset, what reform does not mean. First, it does not mean abandoning those founding ideals. Of a public service, publicly funded, free at the point of use …
The problem isn’t that the NHS is the wrong model, it’s the right model, it’s just not taking advantage of the opportunities in front of it. And that’s what needs to change.
Second, reform does not mean just putting more money in. Of course, even in difficult financial circumstances, a Labour government will always make the investments in our NHS that are needed. Always.
But we have to fix the plumbing before turning on the taps. So, hear me when I say this, no more money without reform.
I am not prepared to see even more of your money spent on agency staff who cost £5,000 a shift, on appointment letters, which arrive after the appointment or on paying for people to be stuck in hospital just because they can’t get the care they need in the community …
That isn’t just solved by more money – it’s solved by reform.
And third, reform does not mean trying to fix everything from Whitehall. It really doesn’t.
When Lord Darzi says the vital signs of the NHS are strong. He’s talking about the talents and passion of our NHS workforce. That’s what he’s talking about. The breadth and depth of clinical talent. The extraordinary compassion and care of our NHS staff.
If we are going to build an NHS that is fit for the future, then I tell you, we are going to do it with our NHS staff and
,with our patients too.
This is the passage explaining the ‘why’ part of Starmer’s reform argument. See 11.39am for the ‘how’ part.
Photograph: Julian Simmonds/Reuters
Greens criticise Starmer for putting NHS reform ahead of investment
And the Green party is also calling for more investment in the NHS. In his response to the Darzi report, Adrian Ramsay, the Green party’s co-leader, said it was wrong for Keir Starmer to appear to be more interested in reform than investment. (See 10.25am.) He said:
The Darzi review pulls no punches: the NHS has been harmed by austerity, capital starvation, the disastrous 2012 Health and Social Care Act and the dire state of social care.
It is therefore hugely disappointing to see Labour, like a string of previous Conservative and Labour governments, hooked on reform rather than investment.
Starmer says there can be no money without reform. We say there can be no improvement to waiting times, cancer death rates, treatment for mental health – and many other struggling areas – without more money.
The SNP says the Darzi report vindicates its call for higher health spending. Stephen Flynn, its leader at Wesminster, said:
Lord Darzi’s report exposes the catastrophic damage that fourteen years of Westminster austerity cuts, chronic underfunding and Brexit have done to the NHS.
For more than a decade, the SNP has repeatedly warned about the damage UK government cuts and underfunding were causing our NHS. There is no escaping the fact that alongside constant modernisation, the NHS needs more money – and it needs it now, if it is to deliver the best possible healthcare.
Crime prevention minister has purse stolen at police conference
Diana Johnson, a Home Office minister, “had her purse stolen at an annual conference for senior police officers”, Ramsay Hodgson reports for the Financial Times. Officially Johnson is minister for policing, fire and crime prevention.
This is from my colleague Kiran Stacey.
I think Labour might be taking their “public services are all broken” strategy a bit *too* far.
Here is a video extract from Keir Starmer’s speech this morning.
‘Big step in right direction’ – NHS and healthcare groups welcome findings in Darzi report
Organisations in the health care sector have largely welcomed the Darzi report, and the government’s proposal to respond with more emphasis on technology, on primary care and on prevention. Here are some of the extracts from statements they have put out.
Prof Philip Banfield, council chair at the BMA, which represents doctors, said in a statement the BMA was glad the problems with the NHS had been properly recognised.
The previous government gaslit doctors and refused to acknowledge the damage caused by years of underinvestment. The BMA has tirelessly spoken out about the challenges our health service faces, particularly regarding staff shortages, so one might expect that Lord Darzi’s review, which echoes many of the association’s concerns, would be met with a sense of relief – finally, someone understands. While the findings are unsurprising, seeing this report so clearly call attention to just how broken our beloved NHS has become, with the devastating impact on our patients, is deeply sobering.
Prof Nicola Ranger, general secretary and chief executive of the Royal College of Nursing, said Darzi’s conclusions were right.
Nursing staff will recognise many of Lord Darzi’s conclusions, not least how sustained austerity, cuts to public health and failure to invest in community services have impacted NHS performance and patient care. The modest increases in the size of the nursing workforce have been significantly outstripped by the demand piled on the NHS in recent years. Nursing staff are now too commonly caring for patients in corridors or left in armchairs, the ‘congestion’ mentioned in the report, which leaves them feeling short-staffed and unable to give the quality of care they would want.
Sir Julian Hartley, chief executive of NHS Providers, which represents hospitals and other NHS trusts, said the proposals were “a big step in the the right direction”.
The NHS is down but not out. The sheer scale of the challenge facing trust leaders and their teams as they strive to get the health service back on track is plain for all to see …
Lord Darzi’s prescription for reforming the health service – by creating a digital NHS, focusing on prevention and public health, and ensuring patients are cared for closer to home- is a big step in the right direction. This must go hand in hand with sustainable funding and investment, an end to chronic workforce shortages and more capital investment to boost productivity and meet growing demand.
Matthew Taylor, chief executive of the NHS Confederation, which also represents trusts, said Darzi’s analysis was sound. In a statement he said:
This report paints a bleak picture of the state of an NHS which, despite working harder than ever before, has been struggling in the face of rising demand, a decade of underinvestment and the impact of the pandemic. NHS leaders will recognise Lord Darzi’s diagnosis of the NHS’ problems and will work with the government to help address them.
The review has rightly identified many of the root causes, not least how we invest much less in our buildings, technology and equipment than many comparable countries.
William Pett, head of policy at Healthwatch England, which represents patients, said patients would welcome the report. In a statement he said:
People will welcome Lord Darzi’s prognosis on the NHS. Although the NHS does much good, patients repeatedly share their frustrations and confusion about accessing care.
Gill Walton, chief executive at the Royal College of Midwives, said maternity care should have featured more prominently.
The new health secretary, Wes Streeting MP, said that of all of the issues that keep him awake at night, maternity safety is top of the list, so we remain optimistic and hopeful that our new government understand these pressing issues and will put the safety of mothers and babies, and of midwifery staff at the top of his list. All we’re asking is that every maternity service has the right staff in the right place at the right time.
Rob Yeldham, director of strategy at the Chartered Society of Physiotherapy, welcomed the focus on community care.
We strongly endorse the calls to expand healthcare in the community and to build care around the needs of the individual.
Community rehab keeps people out of hospital and is essential in a time when, more are living with multiple long-term conditions. The recognition of the growing challenge is very welcome.
Dr Sarah Hughes, chief executive of Mind, the mental health charity, said some of the revelations were shocking.
This is a dark day for mental health. Lord Darzi’s findings showing many people in mental health crisis are being held in rooms constructed for a Victorian asylum are disturbing, shameful, but ultimately unsurprising.
UK debt projected to almost triple over next 50 years, watchdog warns
The UK’s debt mountain will almost triple to more than 270% of national income over the next 50 years because of pressures from an ageing population, the climate crisis and security risks, the Office for Budget Responsibility has warned. Phillip Inman has the story here.
Streeting says Labour and Lib Dems have ‘much in common’ as he says he wants cross-party approach to social care reform
Streeting adopted a very different tone when responding to Daisy Cooper, the Liberal Democrat’s health spokesperson. In her contribution she said the Lib Dems had long called for more focus on primary care, and more focus on prevention. She also said that Labour’s failure to have a plan for social care was “the elephant in the room”.
In response, Streeting said it was “refreshing to have constructive opposition in the chamber”. He went on:
Let me say, and it was clear throughout the election campaign actually, that my party and Liberal Democrats have much in common, both in terms of the commitments we made, which were in some cases identical, and also the shared areas of emphasis, the link between health and wealth, the importance on prevention and the importance of social care.
He said the government was determined to reform social care, working where possible on a cross-party basis.
Victoria Atkins accuses Labour of ‘political posturing’ as she defends Tory record on NHS
In her response to Streeting, Victoria Atkins, the shadow health secretary, accuses him of “political posturing” and urged him instead to talk constructively about the future.
She said there was ‘“much to be proud of” in the NHS. It is looking after 1.6 million people a day, 25% more people than in 2010.
While she quoted figures for how much the Tories had invested in the NHS, she said they had “never pretended that everything was fixed”, that there were easy answers or that as a party they had “a monopoly of wisdom”.
But the last government did announce an NHS productivity plan at the time of the budget, she said. She claimed the proposals in it would lead to a 2% increase in productivity by the end of the decade, unlocking £35bn’s worth of savings. But Darzi had not even mentioned it, he said. She asked if it was being cancelled.
Responding to Atkins, Streeting said:
The first word the shadow secretary of state for health and social care should have said was sorry. She says she never pretended everything was fixed, and that’s true, but it’s about time that she admits that it was their party that broke the NHS in the first place.
He said Atkins, health secretary before the election, was not to blame for everything in the Darzi report. But he said she should “show some humility on behalf of her party” and apologise.
Streeting did not say what was happening to Atkins’ productivity plan.
Wes Streeting’s opening statement to MPs about the Darzi report echoed much of what Keir Starmer said this morning. But he was notably more partisan, and more damning about the opposition.
Referring to the effects of austerity, and the impact of the Andrew Lansley health reforms, which are strongly criticised in the Darzi report (see 9.49am), he said:
It is not just that the Conseratives didn’t fix the roof while the sun was shining. They doused the house with petrol, left the gas on and Covid just lit the match. That’s why waiting lists are stuck on 7.6m long today.
And he was particularly critical of the Tories’s failure to reform the NHS.
Since 2019 the previous government oversaw a 17% increase in the number of staff working in hospitals. Did it lead to better outcomes for patients? No.
At great expense to the taxpayer, the NHS has instead seen a huge fall in productivity. We paid more but got less, a deplorable waste of resources when so many parts of our health and care services were crying out for investment.
As Lord Darzi puts it, British Airways wouldn’t hire more pilots without buying more planes.
Doctors and nurses are wasting their time trying to find beds for their patients, dealing with outdated IT, when they ought to be treating patients.
