The NHS needs wholescale reform, not tinkering

The Labour party is already beginning to think about life after the election. Should Sir Keir Starmer succeed in gaining the keys to Downing Street, addressing the issue of chronic NHS underperformance will almost immediately become one of his party’s primary concerns.

Shadow health secretary Wes Streeting has begun to set out how his party might go about this formidable task, telling The Telegraph that Labour would tell NHS staff to work evenings and weekends, pool staff and resources across regions for these shifts, and oversee the “biggest expansion of NHS staff in history”.

Many of these steps are welcome, insofar as they go, although implementing them may be a challenge. When the Conservatives have attempted to shift the NHS away from its Monday to Friday culture they have been met with fierce resistance, and it is questionable whether the staff’s preference for a Labour government will be enough to overcome its preference for the status quo.

The deeper issue, however, is that Mr Streeting is still in essence proposing more of the same. The fundamental problem with the NHS is not a lack of resources, or even the lack of accountability, which has seen whistleblowers persecuted by their colleagues. It is the very nature of the organisation as a state-dominated healthcare system.

As Mr Streeting himself noted in December, “If we just pour ever-increasing amounts of taxpayer money into a broken system, we will continue to get worse health outcomes than other leading economies.” He was correct in this observation. The pride taken by the British Left in the NHS being “free at the point of use” is worth little if what this means in practice is that it fails to treat the rich and the poor alike. Deep, structural reform is needed in order to give Britain the medical care that it deserves.

But while Mr Streeting returned from Australia last year full of praise for its healthcare system, his party has shied away from the radical reform that mimicking it would entail, preferring instead to tinker around the edges of the NHS. Repeating the same endless cycle of reforms and funding boosts will result in the same endless cycle of crises and decline.

Until the need for a complete rethink of healthcare is acknowledged, we will continue to labour under a system that has left this country under-treated and overtaxed.