‘Lofty ambition, little detail’: Readers react to Labour’s 10-year plan for the NHS

‘Lofty ambition, little detail’: Readers react to Labour’s 10-year plan for the NHS

Labour’s recently unveiled 10-year plan for the NHS has sparked a lively debate among Independent readers, many of whom are cautiously weighing its promises against the past.

The plan, unveiled last week by Sir Keir Starmer and Health Secretary Wes Streeting, includes ambitious goals such as “a doctor in your pocket” through a greatly enhanced NHS smartphone app, 24/7 health advice, easier online appointments, and a shift towards preventative medicine and neighbourhood health centres.

When we asked whether you thought Labour’s 10-year NHS plan could deliver real improvements, nearly half (47 per cent) of readers said no, citing a lack of funding, staff, and detail.

Another 28 per cent said the ambition is right, but delivery will be the real test, while 25 per cent believed it is the bold, long-term reform the NHS requires.

Many said the plans represent a welcome move towards modernising a service often criticised for being stuck in analogue times.

Yet, despite the optimism around the digital and structural reforms, several readers remained sceptical about whether the plan could deliver the improvements the NHS so desperately needs, with concerns focusing on funding, staffing shortages, and the lack of detailed delivery mechanisms.

With the NHS under constant pressure from an ageing population and rising demand, the question of how these reforms will be implemented was front and centre.

Here is what readers had to say about the plan’s prospects and challenges:

‘All just empty words and no delivery’

I can say that I am going to travel to the Moon and back – but if I don’t say how I intend to do it, how I intend to pay for it, and how anyone will know that I have done it, it is all just empty words and no delivery. The NHS has a huge recruitment/retention problem, and it is going to need tens of thousands of extra staff. In addition, Streeting has run away from Social Care, which is the one thing that will solve the NHS crisis. So like every other plan, it will not be resourced properly – but there will be lots of highly paid executives involved, working out of fancy offices, until the next plan comes along…

ListenVeryCarefully

‘Prevention is not a quick fix’

Prevention work is already undertaken by Public Health departments in local authorities, in collaboration with the NHS. This is absolutely nothing new. Councils spend millions on Public Health preventive work. The problem is that prevention can take years to show an effect or to realise savings for the NHS. Many people don’t seem to get that. Preventive work is not a quick fix. To be honest, I am sick of successive governments and highly funded think tanks producing report after report when we already know the answers.

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Flossie

‘They know the answers’

The announcement is very short on detail, particularly on how they will help prevent ill health. Successive governments have commissioned reports on diet, exercise, and active travel for years – they know the answers. Why the reluctance to announce them and any sort of delivery plan?

Holly

‘Like a nurse reorganising the Houses of Parliament’

Again, the government is seduced into reorganising the organisers and office teams. Non-clinical people always do this, and it makes no difference – it’s like a nurse reorganising the Houses of Parliament. Plain hopeless. Emperor’s new clothes.

Having been through five of these restructures, I can say they never change or improve anything. As always, they want less clinical activity and more admin…

Diane1234

‘We can’t afford an NHS that fixes everything’

The biggest problem with the NHS is that we want it to fix every ailment – from cuts and scrapes to organ transplants. Sooner or later, we have to face up to the fact that we can’t afford an NHS that tries to fix everything, including things we should take responsibility for, such as obesity.

Issuing painkillers to just about every patient who has a procedure is also ludicrous, as paracetamol or ibuprofen costs about 39p a pack in a no-frills supermarket.

Using the NHS should be limited to “must do” and “could do” – not “it would be nice if I could use it because I’m too idle to sort out my minor problem myself”.

We are nearing the point where we will need to pay a small charge for all the high blood pressure pills and statins issued to the older population. They’re all on them.

onmyown

‘Primary prevention works – but it’s never been prioritised’

Primary prevention has always been the Cinderella service within our health system, because it is not “sexy” and requires hard graft to change attitudes and promote health. But quite simply, it works.

As a retired health visitor with more than 40 years in practice, I can categorically state that if you invest in taking health into the community, it will work.

For too long, resources have been directed into much more expensive tertiary care. I really hope this time they mean it.

HappilyRetiredWoman

‘Nothing new’

This is nothing new – we’ve been trying to transfer care from hospitals to communities for years (since Thatcher and “care in the community”). This appears to be a blueprint to shut down more hospitals or reduce funding. This isn’t what’s needed – just the opposite.

Community services are already stretched. Doctors’ surgeries are reducing services, and waiting times are too long. Pharmacies are closing down and being sold due to a lack of funding.

This 10-year plan is just the usual political BS that won’t get to grips with the real problems.

ChrisMatthews

‘This is the future – and it’s already happening’

A very good idea. Not far from where I live, there are two modern NHS clinics where diagnostic procedures are performed without the need to travel miles to the general hospital.

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This is the future, and this is what has already been done in many more advanced European countries.

Pomerol95

‘Abolish the CQC – there’s £50m saved’

I recently changed my GP because I was unhappy with the service. The contrast between the two services is stark, and I wondered how it could be that there is such inconsistency at such a basic level.

My old GP had a CQC rating of “good”, but it was far from that. I dug around a bit and found that the last time the CQC had assessed the practice was in 2016 – nearly a decade ago.

The problem with such rating systems, beloved of the competition-obsessed Tories, is that they’re actually worse than useless. They create an illusion of competence where it doesn’t exist.

Plainly, it isn’t practical for one organisation to continuously monitor standards throughout the healthcare system, so it should be blindingly obvious that this is not an appropriate way to ensure consistency of service.

Abolish the CQC – there’s £50m a year saved.

RickC

‘District hospitals and prevention – let’s hope it happens’

Moving frontline services to community care centres would be a very positive move. Re-establishing the district hospital would be very popular.

Shifting the emphasis to the prevention of illness and the improvement of public health systems is also a laudable aim. Let’s hope this can be achieved in 10 years!

PaleHorse

‘Lofty ambition, very little detail’

I cannot see anything concrete in this statement – plenty of lofty ambition, but very little detail.

I like the idea of local health centres providing access to diagnostic services. If they are allowed to invest in new equipment, it will speed up the move to digital services.

Moonraker2025

‘Dangerous to cut cure before prevention pays off’

Prevention vs cure is logically all very well – but do we know how to reliably prevent sickness that might put people in hospital? For many conditions, effective systems for prevention might take more than a decade to have much effect.

So, no money is saved through needing less for cure for 10 years or more. It is very dangerous to run down curative services until we see the new investment in prevention paying dividends.

I suppose Streeting will require the NHS to blame the unwell for not following prevention guidelines – as a sort of “not our responsibility: you did this to yourself”.

Simplesimon

‘So… it won’t happen’

It would take a lot of cash; the NHS doesn’t have it because the Treasury doesn’t have it…

It would require the UK economy to improve dramatically… It won’t.

Or they could increase taxes, particularly for the wealthy, but they won’t do that, as it would upset their donors – and higher taxes aren’t why the donors put them in power…

So… it won’t happen.

ScoobytheDog

‘Nothing really new here’

After spending nearly fifty years working in the NHS, I think this all seems to have been said before. So nothing really new here, but the sentiment is a good one. How to deliver it will be the real test.

Sparrow

‘Remember Blair’s polyclinics?’

If Labour don’t put in the funding and increase the staffing, this latest NHS plan will fail.

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Remember Blair’s polyclinics, anyone?

rcourt130864

‘No understanding of cause and effect’

There seems to be no vision at all. No understanding of cause and effect. For example, the “food” industry, peddling its processed junk, has made people ill and obese. But rather than tackle the cause, expensive weight-loss drug injections are prescribed. Likewise, the alcohol industry. Either a lack of vision, or the government has been ‘bought off’ by wealthy pressure groups.

Heisenberg97

‘The NHS is a public service, not a business’

It can work – the basic problem has always been that the NHS was never intended to be a business and cannot be run as one. It is a public service. Before the advent of business management techniques (plied by business consultants), it was the envy of the world as a health service, not measured by being a profitable public company-style business.

I worked on this well over 20 years ago. Clinical and non-clinical should be treated separately. Fixed assets should be NHS-owned (not government-owned), giving them control over expansion, upgrades etc.

Build a model based on the production side and the service side. The production side is more predictable and can be proactive. In the NHS, you could represent this by likening it to a catalogue of products: tests, scans, standard operations (hip, knee replacements etc.), and all post-operative support can be included as ‘products’.

The supplier or deliverer of the individual products does not have to be the NHS, but coordination should be through an NHS functional system. The NHS could rent on-site space to a service provider who would, for example, equip an area where scans, x-rays etc. are provided to patients on referral from an NHS-approved doctor on an agreed service contract.

I challenge the view that to outsource these services is ‘selling off’ the NHS.

The service side of any operation, on the other hand, is always more reactive (as in any business) and needs skilled resources with the flexibility, training, and tools to provide support to the patient.

They need the best resources to handle unclassified ‘breakdowns’ and set in motion a recovery plan that covers not just fixing the problem, but getting the patient back to normal (or a new normal).

This is the NHS’s core function and is the public service that we all expect.

ArcticFox

‘Not a plan, just a wish list’

First, it almost certainly isn’t a “plan” in the sense that anyone in business would recognise. I bet it is just a wish list of things they want to happen, much like the recently published “Modern Industrial Strategy”, lacking any detail as to how it’s actually going to be delivered, what the key milestones are, who is going to be responsible, what resourcing and cash is going to be dedicated towards it, and what the measures of success will be. Equally, I doubt there is any delivery structure in place, or transformation programme governance, or anything like that.

Second, Labour is going to be out of office come 2028 or 2029 for the next 30 years, and whoever takes over from them will almost certainly tear this plan up. They don’t have ten years, and they must know that by now. So honestly, what’s the point in publishing a “ten-year plan”? It’s just performative at this stage.

sj99

Some of the comments have been edited for this article for brevity and clarity. You can read the full discussion in the comments section of the original article here.

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