My NHS report identified the serious situation. Here is the remedy | Ara Darzi

WWhen the Secretary of State for Health and Social Care, Wes Streeting, asked me to investigate the state of the NHS, I thought I knew what we would find. Anyone who has worked in the NHS in recent years knew it was under pressure. But as a surgeon, I am used to seeing only one piece of the puzzle. When I heard the experiences of millions of patients and staff across the country, I was shocked and angry.

If effective access and high-quality care are central to the NHS’s social contract with the public, then it routinely breaks its promise to the public. Too many people are left waiting in A&E corridors or struggling to see a GP. Quality care should be the organising principle of the NHS. But my research has shown that patient care is stagnating or even declining. It is not surprising that public trust in the NHS is at an all-time low.

And yet it is also clear to me that the NHS, although in critical condition, can recover. Nothing I found called into question the principles of a health service that is funded by the taxpayer and free when it is needed. We have some of the best clinical talent in the world, we are home to ground-breaking medical innovation and our staff are deeply passionate and dedicated.

Now that the reality of what is happening within the NHS has been established, we must begin the process of recovery. The time for looking back is over. It is in this spirit that I have published a second paper – the final report of the IPPR Commission on Health and Welfare – which I have chaired for the past three years with Dame Sally Davies, former chief medical officer. Last week I focused on diagnosis, but this final report is about treatment.

Given all this, it seems ironic that the focus of this work is not the health service at all, but almost everyone and everything. This should come as no surprise. While we may spend a few weeks or, if we are unlucky, months of our lives in hospital, we will spend years of our lives at work, in school and in our communities. If we are to stem the rising demand on our NHS, we need to look at what is happening outside the hospitals and clinics.

This is the “pivot to prevention” that successive governments have talked about but failed to deliver. This new Labour government cannot afford to make the same mistakes. Here’s what Wes Streeting and Keir Starmer must do to ensure they don’t.

First, they should put healthy life expectancy at the heart of everything they do in government. Just as we have ambitious climate targets like net zero, I suggest we need a similar long-term health target that transcends government. Looking at what similar countries have achieved suggests that an ambitious target would be to increase healthy life expectancy by 10 years by 2055. Once that target is set, we should then be assessing government spending and investment decisions against their impact on health in every fiscal event.

Second, the government needs to make health a societal concern. The state acting alone will not optimize our health. The government will need to get businesses and employers on board in particular; they have a huge impact on our health. Sometimes this is positive – innovation in the life sciences, good employment or health-promoting products – and should be encouraged or scaled up. But sometimes it is harmful – alcohol, tobacco, precarious work and online harm – and these should be discouraged.

Let me be clear: if a company makes a profit at the expense of our health, it must pay the social cost. Using levies to embed a “polluter pays” principle would create a powerful new incentive in the market, encouraging companies to prioritise healthier products. Where they are holding back change, the tax they pay would be a valuable new source of revenue, generating billions of pounds that could be invested in prevention.

Third, we need to use the revenue from health taxes to invest in the foundations of good health. I think there is a particular case for investing in the health of our children. I am alarmed by the health challenges that children face: lower vaccination rates, rising rates of severe asthma, high rates of overweight and obese children.

If we tolerate this, better long-term health will be out of reach. Sure Start and free school meals – the former one of the proud legacies of the last Labour government, the latter adopted by the Mayor of London – are both well-proven ways to improve children’s health.

Health is a human right. But as I said in my review, and as IPPR shows today, it is also vital to a strong economy. With record numbers of sick unemployed, there is no path to wellbeing or growth without prioritising health. That is a powerful platform for continued, ambitious action by the new government.