Sector Responds to Devastating Darzi Report
Industry leaders have responded to the release of a devastating report which reveals that a decade of austerity has left the NHS in “critical condition”
A rapid review of the health service, completed in just nine weeks, has revealed that many of its staff are “disengaged” and that there are “distressingly high levels of sickness absence”.
Ara Darzi, the report’s author and a surgeon and an independent peer, blamed choices made by the last government for the damage to the health service and said it would take more than five years to fix.
Sir Keir Starmer is expected to respond to the findings today [September 12] making clear that the NHS must “reform or die”.
In response sector leaders say:
ICG Chair, Mike Padgham said:
“We are pleased that Lord Darzi’s report acknowledges the crisis in adult social care due to under-resourcing and the human and economic consequences this has had.
“But we are dismayed that adult social care was not included in the remit of the report in the first place. That is a serious omission and makes something of a nonsense of the whole process. It is like getting a surveyor’s report on the crumbling foundations of a house but ignoring the holes in the roof – the building is going to collapse anyway!
“For politicians to keep talking about reform of the NHS without including reform of social care at the same time, beggars belief.”
“You can’t fix the NHS unless you fix social care,” Mr Padgham added. “We currently have 1.6m people who cannot get the care they need and a shortage within the social care workforce of 131,000 staff. If you address those issues, and the chronic under-funding of social care for the past 30 years, you will begin to take the pressure off the NHS and significantly help its reform.
“We need to switch resources from the NHS into social care so providers can recruit the staff they need to provide more care, ultimately saving money for the NHS.
“The health secretary, Wes Streeting, has identified cutting waiting lists as his top priority and includes more care in the community and more preventative care, as levers towards achieving that.
“That means tackling the crisis in social care so that it can provide that community care and that preventative care, keep people out of hospital and help cut waiting lists.
“But at the moment, all the focus is on the NHS without any attention on social care reform. Unless you fix social care, you will be wasting your time. The social care sector has the answers, and we urge the Government to engage with us as a matter of urgency.”
Sarah Woolnough, Chief Executive of The King’s Fund said:
‘This is an authoritative and sobering articulation of what patients have been telling us for some time – services are stretched to breaking point and people are losing faith that support will be there when they need it.”
‘The report is more than a gloomy assessment of how long it will take to recover services, it is a mandate for government to take bold, decisive action.”
‘The biggest improvements to health and care in our country will come from prioritising services outside of hospital. That means greater investment in the primary and community services that support people before they end up needing hospital treatment. It means political focus on public health strategies that keep people healthy and preventing illness in the first place. And it means finally getting to grips with the much-needed reform of adult social care.”
‘Lord Darzi’s report also underscores the need to move beyond past lazy criticism of the value of NHS managers and instead recognise that implementing major improvement of the health service requires investment in high quality leaders. “
‘Ministers now face tough trade-offs between tackling immediate NHS pressures, or prioritising reform of the root causes of the crisis. Today’s report makes clear that incremental improvement will not do – radical change is needed.”
‘The task is not simply to prop the NHS back up, it is to create a new approach to health and care in this country.’
Emily Holzhausen CBE, Director of Policy and Public Affairs at Carers UK, said:
“The Darzi review is a hugely important report demonstrating the role and the value of the NHS not just to patients, unpaid carers, staff, but also to the wider economy and the health of the nation.”
“We know from the the 4.7 million unpaid carers in England, 1.4 million of whom provide more than 50 hours of care per week, that they are much more likely to be in ill-health as well as struggling to plug the gaps left by a struggling NHS and underfunded social care system. The impacts on unpaid carers are huge.”
“In our State of Caring 2023 survey, 30% of respondents, most of whom were providing substantial unpaid care for disabled, ill or older relatives or friends, had been waiting for specialist treatment for over year. Unpaid carers told us that this was affecting their own ability to care, their health and wellbeing and employment opportunities. Many then face poverty as a result of poor health and inability to work.”
“Despite having clear rights to be consulted at the point of hospital discharge before they take on care, 60% of carers providing substantial care told us that they were not involved in that discharge, and yet they were the ones who would be taking on the care of someone with considerable needs.”
“This review recognises that this lack of engagement and support leads to poorer outcomes not just for carers, but for patients, too.”
“We are delighted that the Darzi review has recognised carers’ role and has recommended ‘a fresh approach’ which regards unpaid carers both as people with their own needs where caring is a significant factor in their lives, but also as a provider of care who should be treated as an equal partner. We and our members who are unpaid carers, look forward to working with the.”
Nuffield Trust Chief Executive Thea Stein said:
“Lord Darzi’s damning report underlines the stark realities experienced across almost every corner of the health service. Wide-ranging problems have been growing in plain sight for years and Darzi’s impressively comprehensive assessment will be familiar to anyone who has studied or experienced the slow deterioration of health care provision in England.
“While not surprising, the report’s findings are deeply troubling. As our research work has repeatedly shown, too often the NHS is not able to provide people with the timely care they need, despite steadfast public commitment to the core principles of the health service. The impacts of this are not felt equally: people in the poorest areas are particularly struggling to access healthcare.
“Rightly, the report repeatedly references the interrelated, compounding pressures of the desperate state of social care and cuts to public health provision. But by design it does not dig into those issues. In future, we hope to see serious work by the government to address those broader societal issues that determine population health and impact health care access.
“Ultimately, the Lord Darzi’s diagnostic report sets out important aspirations to be delivered in the forthcoming 10-year plan to treat – and fix – the NHS. But the improvements we all hope for – and that patients desperately need – will take time, commitment and major financial, practical and system-wide support. There will be no quick fixes.”
NHS Confederation chief executive Matthew Taylor, who was asked by Lord Darzi to lead one of review’s engagement sessions, said:
“This report paints a bleak picture of the state of an NHS which, despite working harder than ever before, has been struggling in the face of rising demand, a decade of underinvestment and the impact of the pandemic. NHS leaders will recognise Lord Darzi’s diagnosis of the NHS’ problems and will work with the government to help address them.
“The review has rightly identified many of the root causes, not least how we invest much less in our buildings, technology and equipment than many comparable countries. And how the ill-fated NHS reforms of the early 2010s were an unnecessary distraction and stripped out vital management capacity that has harmed efforts to make services more productive. We would add the parlous state of social care to that list, which successive governments have failed to address.
“The government has taken the first necessary step in diagnosing the problem, and the task now is to move to identifying the prescription. Ministers will need to work on two fronts. First, to help the NHS avoid a winter crisis given the financial crisis that is engulfing the service. NHS leaders are already having to make tough choices about what services and staff they can afford at a time when they actually want to be preparing to ramp up capacity to meet the usual spike in demand over winter. Emergency funding will be needed in the Autumn Budget, not least to boost staff and capacity in social care. We also cannot repeat the mistakes of the past by raiding already overstretched capital budgets to plug holes in day to day spending.
“In parallel, the government needs to prepare for the long term through its planned 10 year strategy. We know this is far from easy given the perilous state of the public finances. But the fact remains that unless we restore the NHS to the long term average funding increases it needs, accompanied with changes to the way that local services are delivered, then we will never bring down waiting lists to the levels required as well as preventing more illness from occurring in the first place.”
Dr Sarah Hughes, Chief Executive of Mind, said:
“This is a dark day for mental health. Lord Darzi’s findings showing many people in mental health crisis are being held in rooms constructed for a Victorian asylum are disturbing, shameful, but ultimately unsurprising. This comes in the same week as the opening of the country’s largest inquiry into mental health inpatient services, looking at the deaths of thousands of people. And shortly we expect NHS figures showing too many are sectioned under the Mental Health Act. How many more reports and inquiries will it take before we see meaningful action to end what is a national scandal?
“The desperate state of mental health services is not a secret. People who have spent time in mental health hospitals tell Mind they are ‘holding places’, ‘cold’ and even ‘prison-like’. Elsewhere in community and primary care services, millions of people are on a waiting list for mental health support. Without the help they need to prevent reaching crisis point, people are becoming more unwell.
“Today must be a turning point. It is a chance for the new government to make real change to the lives of people with mental health problems. Passing an ambitious and compassionate Mental Health Bill, that truly brings the Mental Health Act into the twenty-first century, is an essential first step. People with mental health problems deserve better than derelict wards, racial inequalities and coercive treatment. It is time to end this needless trauma and deliver a new deal for mental health.”
Kathryn Smith, Chief Executive of the Social Care Institute for Excellence, said:
“Although focused on the problems facing the NHS, the Darzi Review strengthens the case for acting on social care reform sooner rather than later. The Review lays bare the critical and long-standing issues facing both the NHS and the social care system, from service fragmentation and underfunding to inefficiencies and an ageing population. To resolve the NHS’s long waiting times and improve healthcare outcomes, we need to consider patient pathways across health and social care systems as a whole.
“Lord Darzi’s analysis recognises that health and social care cannot function effectively in silos; they are inter-dependent. Enabling people of all ages, not just older people, to live independently, manage long-term conditions and relieve the pressure on finite NHS and emergency services are goals of both systems. Without a coordinated approach, people will continue to face under-met and unmet care needs, and family carers will remain overstretched.
“Waiting for government action and investment on social care may prove to be a false economy. Social care must be treated as an equal partner to the NHS, and we must leverage opportunities now for upstream prevention, new models of community care and digital innovation. The NHS 10-year Plan has an important role to play in reimagining both our future national health system and social care.
“This is a vital moment for the future of care in the UK—one we cannot afford to miss. We look forward to working closely with government, health and care partners as future plans for the NHS and a National Care System take shape.”
