Keir Starmer says UK’s NHS needs to ‘reform or die’

In the nuclear medicine department of London’s University College Hospital, patients pass through polished corridors to airy rooms decorated with green-leaf stencils, where they are scanned and treated, particularly for cancer, with cutting-edge technology that uses radioactive tracers. The facility is a showcase for Prime Minister Keir Starmer’s bid to revitalise Britain’s National Health Service that should boost employment, as well as helping to counter the growing popularity of Nigel Farage’s party, Reform UK, members of Starmer’s team say. Starmer has visited to advertise his “reform or die” agenda for the health service.

His team sees the NHS in England as one area where it can offer people tangible improvements soon, a member of his team said.

So it’s in hospital corridors such as these, where political rhetoric meets practical reality, that votes for Starmer’s Labour Party could be won or lost as his health reform agenda is tested in local elections in parts of England on May 1. Before last year’s national election, public satisfaction with Britain’s run-down and overburdened health service had slumped to its lowest on record. The service was founded by Labour in 1948; nearly half the party’s supporters told pollsters that improving it was their number one concern. In its October budget, Labour injected almost 26 billion pounds ($34 billion) into the system over two years, calling that the largest boost in day-to-day NHS spending since 2010. But it is cutting Britain’s welfare bill to try to meet its fiscal rules. It said the NHS must start reducing waiting times and took steps to cut bureaucracy and red tape, including scrapping NHS England, an organisation that manages health services. Among targets, Starmer set a goal of doubling the number of scanners in England to help reduce the more than 6 million people waiting for treatment and provide more than 2 million extra appointments every year. The government said in February the NHS had met its appointments target between July and November 2024 and was chipping away at the list.

How sustainable such steps prove to be — and particularly, whether they show up in the less affluent regions where Brexit campaigner Farage is gaining ground — will be an acid test. “When you ask those who switched to Labour at the last election, it was very clear that the NHS and the economy were the two key tests as to whether Labour have delivered on their promise,” said Luke Tryl, executive director of think tank More in Common UK.

Farage, whose party has rivalled the popularity of Britain’s two main parties in recent weeks, hopes to win votes in central and northern England and the nation’s increasingly deprived coastal areas, where dissatisfaction with the NHS runs deep. Reform UK did not respond to a request for comment for this story but has argued it could eradicate waiting lists by reducing NHS managers, boosting the workforce and offering private healthcare vouchers.

Health Minister Wes Streeting, who said in January that improving the health service would be a “potent antidote” to populism, says this shows Farage does not believe in the NHS’s mandate of “a universal service free at the point of use” — which Farage rejects.

For one health expert, Starmer’s strategy is a gamble because it will take longer than May for the benefits of Labour’s extra spending to be noticed by voters. “The problem with investment in health is that it is notoriously quite sticky, it takes a while to see noticeable benefits,” said Luke Munford, senior lecturer in health economics at The University of Manchester. A spokesperson for the Department of Health and Social Care said: “We have hit the ground running.”

Besides delivering the extra appointments, the spokesperson said the government had invested in family doctors to shift care out of hospitals and diagnostic equipment to get patients answers sooner. Labour plans three major shifts for health: to move care from hospitals to the community, switch treatment and administration technology to digital methods, and work on methods of prevention rather than just treatment - hence the publicity focus on scanners.

But even in the London hospital, staff say the challenges are many. Some scanners cost around a million pounds each. Demand, as elsewhere across Europe, is surging as post-war Baby Boomers age and sicken. And skilled staff are hard to come by.

Geoff Bellingan, medical director for cancer and surgery at the trust that runs the hospital, said it was seeing a “significant rise” in some referrals “and those patients all need diagnostics”.

The hospital said the nuclear medicine department has already increased its rate of some scans by nearly one-fifth, is allowing family doctors more direct access to its imaging services, and trying to push more patients through by streamlining procedures.

But it lacks space for new machines and cannot recruit enough radiographers from within the UK, because not enough are trained there.