Unlock the Editor’s Digest for free
Roula Khalaf, Editor of the FT, selects her favourite stories in this weekly newsletter.
England has spent almost £40bn less than peer countries on health assets and infrastructure since the 2010s, stunting NHS modernisation and exacerbating care backlogs, an official review into the health service will say this week.
Lord Ara Darzi will note in his government-commissioned report that had England matched Germany, France, Australia and other comparable countries over the past 15 years, it would have allotted an extra £37bn of capital expenditure to land, buildings and equipment, said people close to the surgeon and former health minister.
The report, due to be published on Thursday, will argue that this spending could have modernised technology such as MRI machines and CAT scanners and significantly cut waiting lists for routine care, the people said.
The money could have “paid for the 40 new hospitals that were promised but which have yet to materialise”, the report will say, referring to a pledge by then prime minister Boris Johnson, and could have “rebuilt or refurbished every GP practice”.
“Instead, we have crumbling buildings, mental health patients being accommodated in Victorian-era cells . . . and parts of the NHS operating in decrepit portacabins,” Darzi will add.
The previous Conservative government, in power between 2010 and 2024, raided budgets allocated to capital outlays over successive years as it prioritised boosting day-to-day spending, and responding to crises during winter months, over long-term investment.
Since taking office in July, health secretary Wes Streeting has repeatedly said the NHS is “broken” and in need of reform, as well as promising to tackle waiting lists for non-urgent treatment, which stood at 7.6mn in May.
But senior health figures warned the new Labour government, which asked Darzi to assess the state of the health service, not to follow a similar playbook to the Tories after it said in July that it would pause investment in the long-awaited new hospitals programme.
Set out by the Johnson government in 2020, the NHP aimed to build or expand 40 hospitals by 2030. Last year the UK public spending watchdog said funding cuts and problems with planning and staffing meant only 32 would be completed by the deadline.
Darzi’s findings echo research by the Health Foundation think-tank, which said in 2022 that Britain’s capital health spending on buildings, technology and equipment lagged its European neighbours.
However, his report will note that in terms of overall health spending as a share of gross domestic product, England has been roughly in line with peer countries, at 10.9 per cent compared with the OECD average of 9.1 per cent in 2023.
The report is expected to blame performance problems in the NHS on the Covid-19 pandemic, along with the upheaval caused by a big round of Tory health reforms in 2012 and a decade of austerity from 2010.
Backlogs in the NHS have more recently been exacerbated by a wave of strikes over pay between 2022 and this year, which are estimated to have led to the cancellation of roughly 1.5mn appointments and operations.
However, two people familiar with the report’s contents said Brexit would not be named as a contributor to performance problems — a decision that is likely to raise eyebrows across the health sector, which has struggled to recruit staff since the UK left the EU and stricter visa rules took effect.
The Department of Health and Social Care said Darzi’s report would “make clear that the challenges facing the NHS aren’t about money alone, but how money is often not spent effectively”.
“We can’t undo the mistakes of the past, nor can we ignore the £22bn black hole in the public finances. And we will make clear that reform is crucial to make taxpayers’ money go further,” the department added.
Read the full article here