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The government has today launched a major consultation on the future of the NHS as it promises to put patients and staff at the heart of its 10-year health plan.
Billed as “the biggest national conversation about the future of the NHS since its birth”, members of the public will be able to share their views online via change.NHS.uk until the start of next year.
The consultation is part of the government’s plan to transform the NHS into a “neighbourhood health service — shifting more care from hospitals to communities.
The plan, expected to be published in spring 2025, will also see greater use of data and technology, with easier sharing of patient data, saving an estimated 140,000 hours of staff time every year.
Marking the consultation’s launch this morning, Keir Starmer and Wes Streeting visited an NHS site in east London. There, the health secretary said the NHS is going through “objectively the worst crisis in its history”. But, he added, the health service is “broken but it is not beaten”.
The prime minister, meanwhile, repeated his argument that the NHS needed to be transformed into a “neighbourhood health service”, with an emphasis on preventative measures and community care.
Today then: some more thoughts on the government’s approach to the NHS and why it may offer a way forward for Starmer as he navigates the fraught path toward and beyond the budget on 30th October.
Labour’s quest for purpose
Since entering office after fourteen years of exile on 5th July, this Labour government has engaged in a precarious political balancing act — one that, prevailing readings suggest, it is yet to master.
This performance, which has arguably underpinned every action of Keir Starmer’s administration for three full months, concerns Labour’s grim inheritance and its ability to communicate it. Here’s the central dilemma, composed in the form of a question: on what should a nascent government, confronted with such a burgeoning in-tray and a public sceptical of political assurances, focus its messaging?
And around this core quandary revolves a series of other political considerations that Labour has sought to stress. First of all, ministers have at every turn undertaken to manage expectations for what constitutes success in the short and medium terms. Addressing a press conference in late August, days before parliament’s return in September, Keir Starmer cautioned the country that things “will get worse before it gets better.”
The intention, and the result, was that the sunlit uplands foreseen by the Conservative Party’s seismic defeat in July were suddenly cast in shade. Getting rid of the Tories was the easy bit, Starmer’s narrative suggested — now we must undo the damage they wrought across fourteen years of misrule. That, it was duly posited, will take time and “tough decisions.”
In recent weeks, this message has been encapsulated by Labour’s identification of three overlapping “black holes”. First, there is the “financial black hole” — the £22bn of unfunded spending commitments Starmer claims the Tories concealed in government; then there is the so-called “societal black hole” — a reflection of the Conservatives’ “decimation” of Britain’s public services; deeper still, there is the “political black hole” that reputedly represents the damage done to public trust by consecutive Tory administrations.
This approach, which the PM outlined in his address to Labour Party conference in September, reflects Starmer’s second and third imperatives when it comes to his inheritance as prime minister. For Labour’s condemnation of the Conservative record is not merely politically viable and therefore prudent — but ultimately necessary in forging popular and parliamentary consent for the actions Starmer intends to take at the budget on 30th October, and beyond.
The strategy has meant Labour’s messaging since entering government has focussed relentlessly on exposing and deriding Conservative malgovernance. But where in this formula, so trusted by Labour, does one incorporate the hope and possibility that a new government should almost necessarily inspire? In this regard, the consensus in Westminster is that Labour’s emphasis on anti-Tory admonishment has actually crowded out its messaging around the improvements Starmer intends to pursue.
That brings us to the announcements today on the NHS, which could well point to the political equilibrium Labour’s messaging should embrace.
Labour’s NHS reforms focus on three so-called “shifts”. The government plans to move from an analogue to a digital NHS (technology); shift more care from hospitals to communities (primary care); and move from sickness to prevention. Speaking this morning, Starmer said the NHS faces the “worst crisis in its history”. But, the prime minister added, “Together we can build a healthcare system that puts patients first and delivers the care everyone deserves.”
However, Labour’s approach to the NHS is best relayed by Wes Streeting, ever the government’s most effective communicator. Launching the new public consultation today, the health secretary insisted: “Our NHS is broken, but not beaten”. And so Labour plans to fix it.
For months, Labour has repeatedly said it will not plough more money into the health service without first instituting reforms. But recent reports indicate the NHS will, after all, be handed a real-terms funding increase at the upcoming budget.
In this way, Downing Street intends to foreground Labour’s approach to the NHS at its budget — using it to, one, act as a ballast to the government’s “black hole”-heavy messaging and, second, justify the “tough decisions” therein announced.
After months of unsteadiness, it suggests Labour and Starmer are learning to strike a better, more sustainable political balance.
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