Long delays in the NHS are leading to thousands of unnecessary deaths, research finds

Long delays at hospitals, GPs and mental health services are leading to thousands of unnecessary deaths and have disrupted “the social contract between the NHS and the public”, an investigation has found.

The findings of Lord Ara Darzi’s inquiry, commissioned by Labour when it came to power, will be cited by Prime Minister Keir Starmer, who will warn on Thursday that the NHS must “reform or die”.

In his detailed analysis of the NHS’s woes and the path to recovery, Darzi warns the Prime Minister that it will take his government longer than the five years Labour promised before the election to get treatment waiting times back on track. He has privately estimated the task will take “four to eight years”.

Darzi says: “I have no doubt that significant progress can be made, but it is unlikely that waiting lists can be eliminated and other performance standards restored in a single parliamentary term.”

Starmer is set to make a major speech on the NHS, saying tax rises are not the way to find the extra billions of pounds the health service needs, experts say.

The 142-page report by Darzi, a cancer surgeon and health minister under Gordon Brown, is a scathing critique of how years of neglect of the NHS by previous governments has left it in “critical condition” and unable to provide patients with the timely care they need amid an explosion in demand caused by the UK’s ageing, growing and increasingly ill population.

Darzi’s damning indictment of the Conservatives’ 14-year management of the NHS says A&E is in “a terrible state”. He cites evidence he received from the body representing A&E doctors that “long waiting times are likely to cause 14,000 extra deaths a year – more than double the number of all British armed forces in combat since the health service was established in 1948”.

He describes how the NHS experienced three shocks in the 2010s: the austerity funding under the Conservative-Liberal Democrat coalition government; the “disastrous” reorganisation of Andrew Lansley; and the arrival of Covid – the first two of which were “choices made in Westminster”.

In his response, Starmer will accuse successive Conservative governments from 2010 to July 2024 of inflicting “unforgivable” damage on the NHS, including avoidable deaths due to long waits for A&E care. But he will also seek to reassure voters that the service will improve under a 10-year plan to revive its fortunes, which Labour is expected to unveil early next year.

The Prime Minister promises “long-term health reform – big surgery, not sticking plasters”. He also outlines a future in which much care is moved out of hospitals and into community-based services and there is a determined drive to tackle the rising number of people with long-term conditions such as diabetes, heart disease and lung problems through better prevention measures.

Darzi’s report also found that:

• The number of people having to wait more than a year for hospital treatment that they should receive within 18 weeks has increased fifteenfold since March 2010: from 20,000 to more than 300,000.

• Improvements in cancer survival “slowed significantly in the 2010s.”

• The quality of care in a number of important sectors, such as maternity care, is now a real concern.

• Despite having more staff and a record budget, the NHS is less productive than before because so many of its buildings are so old and the NHS is ‘starved’ for capital funding.

• Many employees have been ‘disconnected’ from their work since Covid and are now doing much less extra work.

• The state of the underfunded social care sector is “dire” and is placing “an increasing burden on families and the NHS, with profound human costs and economic consequences”.

Ed Davey, the leader of the Liberal Democrats, said: “This report shows that the NHS is on its knees after years of Conservative demolition of local health services. Fixing the health service “is the biggest challenge facing this country,” he added.

Starmer is under increasing pressure from his government, which already faces tough decisions over public spending, to find extra funding to boost the NHS’s recovery. Thea Stein, the chief executive of the Nuffield Trust think tank, urged Rachel Reeves to use her first budget next month to plug a billion-pound hole in NHS England’s spending this year.

The Treasury is conducting a multi-year spending review, due to report in spring 2025. But the level of overall government spending planned for the next parliament at present would represent a similar level of cuts to those under David Cameron’s austerity government.

Reeves has already announced a delay to the Conservatives’ new hospital programme, which included a pledge to build or expand 40 NHS hospitals by 2030, citing the £22bn funding gap left by the previous government.

In his speech, Starmer will categorically rule out raising direct taxes to boost the NHS budget. The Health Foundation has estimated that the NHS in England alone is now spending an extra £46 billion by 2029.

Starmer will also say: “The NHS is at a crossroads and we have a choice about how it will meet these increasing demands. Raise taxes on working people to cover the ever-increasing costs of an ageing population, or reform to secure its future. We know working people cannot afford to pay more, so it is reform or die.”