Keir Starmer – 2022 Keynote Speech on the NHS and Labour’s Health Contract

The speech made by Keir Starmer, the Leader of the Opposition, on 18 January 2022.

Health Contract

Thank you everyone and good morning.

Two weeks ago, I set out the terms of Labour’s new contract with the British people.

To provide people with the security, prosperity and respect they deserve.

Today, I will concentrate on an aspect of security as I set out Labour’s contract for better health.

Two years ago, the pandemic struck.

As I speak, over 150,000 of our fellow citizens have lost their lives.

I am convinced that a swifter response by government could have reduced that number.

Covid affected every aspect of our lives. Children couldn’t go to school. Parents couldn’t get to work. We couldn’t see our families.

Covid is still affecting so many of us.

And the bravery and skill of health workers is helping to see us through.

The least we can do to show the respect they are owed is to ensure that we protect the National Health Service.

The NHS cannot look after us, if we do not look after it.

This is a political crusade for us in the Labour party.

The NHS is Labour’s proudest achievement in office.

As Bevan said when he introduced the National Health Service Act: The NHS would “lift the shadow from millions of homes”.

But this is also a personal crusade for me.

My wife works in our local hospital.

My sister is a care worker.

And my mum was a nurse in the NHS.

She took great pride in what she did all her working life.

But she was also, sadly, a long-term patient of the NHS.

I spent a lot of time as a child visiting my mum in hospital.

I have never forgotten – I never will forget – the care my mum received. The respect with which she was treated.

I want that level of care for everyone.

We all need the security of knowing that the NHS is there for us when we need it.

That will be what my contract will offer. And I cannot stress how badly it is needed.

Rather than concentrating on getting through the pandemic and bringing down waiting lists this self-indulgent Tory party is having a fight about a leader who they should have known from the start is not fit for office.

Boris Johnson is too preoccupied defending his rule breaking and as day follows night when it comes to the National Health Service you can never trust the Tories.

We are witnessing the broken spectacle of a Prime Minister mired in deceit and deception, unable to lead.

But while the Tories bicker and fight each other on whats app, I want to look to the future.

Because the NHS faces new challenges.

We are an ageing population a fact brutally exposed by a virus that hit the oldest the hardest.

We must devise new methods of care to help with long-term conditions.

We need to think about mental as well as physical health.

And we need to think not just about how we treat patients but about how we prevent them from falling ill in the first place.

The Present Crisis

But before we can think about the future we must attend to the present.

When Labour left office 12 years ago, the Conservatives inherited a strong NHS…

Waiting times were the shortest on record.

The overall mortality rate from cancer had fallen by 22%.

That proud record really puts the failure of the Tory years into sharp relief.

Today, NHS waiting lists are the highest since records began.

6 million people in England – more than one in nine – are waiting for consultations and operations.

I would imagine that most people in this room know someone who is either waiting for an operation on an eye, a hip or a knee. Or someone who is worried about the symptoms they are experiencing but cannot get an appointment to see anyone.

The Health Secretary has admitted this backlog is going to get worse.

And it is not good enough to blame all this on Covid.

This mess has been much longer in the making and this government has to bear the responsibility.

Waiting lists were the highest on record before the virus arrived.

Average life expectancy had stalled after decades of improvement.

And the health gap between the poorest and wealthiest parts of the country had increased.

And why are we in this mess?

Why have we got to this point, where the NHS itself is in a critical condition?

It’s not hard to work out what has gone wrong.

The NHS went into the pandemic short of 100,000 staff.

In social care, there were 112,000 vacancies.

Even before the pandemic, patients could not be discharged from hospital bed because there were too few places in social care and too few staff.

The consequences of 12 years of Tory failure are coming in.

This is what always happens with Tory governments.

It always ends this way.

And I am afraid it may well get worse yet.

The Conservatives said they would train more GPs.

The Health Secretary now admits he is not on track to meet that commitment.

These broken promises cost lives.

If there is no GP to go to people will end up going to hospital.

A&E departments become the front door of health and social care.

The first task of a Labour government would be to clear up the mess the Tories have made of the NHS.

The last Labour Government brought waiting times down from 18 months to 18 weeks.

We will need to do the same again.

People who can afford it, are paying to go private.

Those who can’t afford it are stuck in the queue, waiting for months, if not years, in pain and agony.

That cannot be right.

This is an issue about fairness, as much as it is an issue about health.

People should get treated faster via the NHS.

But it’s outrageous that people are being forced to spend more in the private sector simply because the Tories have run down the public sector.

That’s why the Labour government I lead will invest properly to bring down waiting lists.

We would start by recruiting, training and, crucially, retaining the staff we need.

We have a five-point plan for the transformation of social care.

We would make sure that every older and disabled person who needs care and support can get it when and where they need it.

We would act on the principles of prevention and early intervention; an approach we call “Home First”.

We would give disabled adults choice and control over their support.

We would establish a New Deal for Care Workers to ensure they get the job security they deserve, and the rewards they have earned.

And we would establish a new partnership with families to ensure they don’t put themselves at risk for looking after people they love.

And, as we repair and strengthen, we need to learn to live with Covid.

So that people can live their lives as normal supported by a strong health care system.

I don’t want a government ever again to have to place tough restrictions on our lives, our livelihoods and our liberties.

And I’m delighted to say that Wes Streeting, the shadow health secretary will be setting out the details of our plan for living with Covid in the days to come.

New Problems

But the job will not be done once we have dealt with the immediate crisis.

It’s much bigger than that because health challenges are changing all the time.

In the first half of the 20th century polio, rubella, mumps, tuberculosis, and diphtheria were among the leading causes of death.

The NHS’s treat and cure model proved a remarkable success.

In the second half of the 20th century, these conditions were effectively wiped out.

In 1950, the average life expectancy was 69, today it is 81.

People live for much longer now with conditions that would once have killed them or which they would not have lived long enough to contract.

Many of the pressures on the NHS today are the result of our successes.

I am delighted we are an ageing society.

It’s wonderful that so many people live so long.

But an older society needs a different health system.

One that is as much about prevention as it is about cure.

That is a bit less about the community hospital and a bit more about the community.

A health system that is a bit less about the system and a lot more about the patient.

Many people feel insecure about whether the NHS will be there for them in the future.

I understand that anxiety: I share it.

In fact, it makes me more than anxious.

It makes me angry.

Angry that an important national institution is being allowed to decline.

Angry that this government has the opportunity to do something good but is instead doing nothing.

And angry that so many people who could be helped are suffering.

The shadow that Bevan said was lifting from so many homes is falling again.

So let me tell you what we would do to lift it.

How we would protect an NHS free at the point of use.

How we would secure health care for all.

It is obvious that the NHS needs more money.

But that is not all it needs.

Do not think that the NHS is automatically protected when more investment goes in.

The NHS also needs reform, so that it works in a different way.

We set the NHS up in 1948, to treat the diseases of 1948.

When we were last in government, we started to reform the NHS so that it was pointed more towards the patient so that it answered the needs of the time.

That renewal process has stalled because this government simply doesn’t care enough, if the NHS falls behind.

It will fall to us again to establish the changes that the NHS needs if it is to remain the great institution it has been for more than seven decades.

From Cure to Prevention

Let me give you a flavour of the change I have in mind.

It has been said many times that the NHS is a national sickness service rather than a truly National Health Service.

I see health as about more than hospitals and surgeries, as important as they are.

It is about the towns and cities where we grow up, the food we eat, our access to green spaces.

Health is about the air we breathe.

It is estimated that, every year in the UK, air pollution kills tens of thousands of people.

We would introduce a new Clean Air Act to tackle this silent killer.

Poor health affects our earnings, our relationships, and our sense of purpose.

And its effects are measured in lower productivity and higher crime, in family breakdown, and increased loneliness and depression.

Labour would make wellbeing matter as much as national economic output.

My preferred definition of well-being has been given by Angus Deaton, the winner of the Nobel prize: “all the things that are good for a person, that make for a good life”.

This is about treating people with basic respect.

So we would expect the Treasury under a Labour Government, to weigh every pound it spends not just for its effect on national income but also for its effect on national well-being.

A good example of a policy for well-being is supporting our mental health.

A Labour government would treat mental health as seriously as physical health.

We would guarantee mental health treatment in less than a month.

We’ll recruit over 8,500 more mental health professionals to support a million more people every year.

Every school will have specialist support.

Every community will have an open access mental health hub for young people.

Under Labour, spending on mental health will never be allowed to fall.

Stress, depression and anxiety account for 18 million workdays lost every year.

We know that the more secure people feel about their jobs the less likely they are to suffer from stress and be absent from work.

So we would expect employers to take wellbeing at work seriously.

Under Labour’s New Deal for Working People, people will have the security of knowing they have the right to paid leave for family emergencies.

Security and respect at work is good for workers.

It is good for families.

And a healthier workforce is good for the economy.

That is why I envisage a health service in the future which is under less strain because a healthier population needs it less.

Let me give you an example of prevention in action.

In the early 2000s, every pub you walked into was filled with smoke.

More than a quarter of all British adults smoked cigarettes.

Labour banned smoking indoors, as well as cigarette advertising.

Now just 14 per cent of adults smoke.

Reducing the number of smokers preventing countless people from needing treatment and it freed up beds in the NHS.

Just think of what more we could do.

We know that high blood pressure and cholesterol hit the poor hardest.

The consequences are cancers, heart failures, strokes.

Much of this can be prevented.

And usually the earlier you act, the better.

A community in which all are respected is itself a source of better health.

Because the connections we have in our communities are a form of security.

These bonds have been eroded over 12 years of Tory rule.

The social clubs, community centres, sports clubs, the green spaces, secure homes and safe streets.

These are all health policies.

There is a great example in Wigan.

Like most local authorities the Labour council in Wigan saw its budget slashed.

Its leadership responded with great imagination.

They decided to let the people decide the future of their own borough.

The people wrote the contract.

The Wigan Deal.

Which set out what both the people and the council would do.

Already, life expectancy in Wigan has increased.

On average, more than two years of good health have been added to people’s lives.

And early deaths from heart disease have fallen faster than elsewhere in the country.

This is what Labour in power can do.

This is, in fact, what Labour is doing in many councils all over the country.

And what the Labour government in Wales is doing too.

From Hospital To Home

I want the opportunity to add to this through central government.

Because the range of what we can do now is quite mind-boggling.

I was really struck by the power of progress recently.

Many years ago, my mum had her knees and her hips replaced, when she was in her 20s and 30s.

As was typical at the time, it took her six months to recover from the operation.

She couldn’t get out of bed for weeks.

By contrast, recently, a friend of mine had a hip operation, and he was on his feet the same day.

The improvement in care in our lifetimes has been amazing.

That’s what makes me optimistic about the NHS.

That’s why, for all the neglect of the Tories, and all the big challenges it faces I am still upbeat about its future.

We are still only beginning to explore what we might achieve.

There are technologies that can provide us with early warnings about the diseases we might be vulnerable to.

“Hospital at home” technologies allow patients to track and report their conditions with remote supervision.

We now have access to the most incredible array of information about ourselves.

Every day, algorithms are predicting our shopping choices.

Imagine how information like that could be gathered and the insights used for our health.

We can connect people with information and choices about their own health.

Which give people greater security and control of their health.

And that in turn makes us healthier, happier and more prosperous.

Conclusion: Only Labour

Sadly, the NHS is not getting better at the moment.

There is no plan.

No strategic thinking.

If the NHS is going to continue to look after us, then it has to change.

And only the Labour party has the permission to make that change.

We founded the NHS.

We understand it.

We have reason to be thankful for it.

I know I do.

We are not out of the woods yet.

The pandemic is by no means over.

But we should not make the mistake of thinking that once we get through Covid all will be well with the NHS.

It won’t.

We have a government that we cannot trust with a precious national resource.

Nearly three quarters of a century ago this party put into practice one of its cherished principles.

Health care, collectively provided, free at the point of use to embody the idea of equality.

It was a powerful idea then and it is a powerful idea now.

And every generation has to find its own way to carry the tradition on.

Because to prosper, we need the security of good health.

This is the health contract that we will sign with the British nation.

Item one, to tackle the immediate crisis to bring down waiting times by recruiting, training and retaining the staff we need.

Item two, to make mental health as important as physical health.

And item three, to shift the focus of health care to prevention as well as cure.

To build the communities that care for us.

To ensure that the NHS thrives.

To look after the NHS so it can look after us.