The National Health Service (NHS) in the United Kingdom is facing an unprecedented crisis, with a former top official warning that the system is “drinking in the last-chance saloon”. Alan Milburn, who served as health secretary under Prime Minister Tony Blair, is sounding the alarm as he prepares to take on a senior role in the current health department.
“Million Times Worse” Than Before
In a paywalled interview, Milburn pulled no punches in assessing the dire state of the NHS. “The NHS is in the worst state I’ve ever seen and I’ve been around health policy now for 30 years,” he said, adding that the current crisis is “a million times worse” than when he was in office. This stark assessment underscores the magnitude of the challenges facing the health service.
Call for Cultural Change and Major Reforms
To address the crisis, Milburn is calling for a fundamental shift in mindset and approach within the NHS. He argues that “people have got to stop thinking that the answer to the NHS problem is simply more and more money.” Instead, he advocates for “cultural change” and asserts that “big reforms will be needed to make it fit for the future”.
“The NHS has got to be weaned off the ‘more, more, more’ culture, and it’s got to recognise that if you’re going to do big dollops of resources, then that has got to be matched by a massive dose of reform.”
– Alan Milburn, former UK health secretary
Milburn’s comments come as the NHS is set to receive an additional £22.6 billion in funding, announced in the recent budget. However, he stresses that simply pouring more money into the system is not enough. “When you put that amount of money in, you better make sure that every pound of it is working to produce better outcomes for patients,” Milburn said.
Government Faces “Acid Test” on NHS Reform
The former health secretary believes that the current government, led by Prime Minister Keir Starmer, is committed to pursuing significant reforms in the NHS. He noted that Starmer “has got religion on public-service reform” and that current Health Secretary Wes Streeting would go “further and faster” than the Blair government did in implementing changes.
Milburn emphasized that delivering on NHS reform is “the acid test for this government”. With the health service unlocking billions in additional funding, the pressure is on to ensure that the money is used effectively and leads to tangible improvements in patient care and outcomes.
A Different Fiscal Climate Demands Bold Action
Compared to his time as health secretary between 1999 and 2003, Milburn acknowledges that the current fiscal climate is markedly different. With relatively less resources available, he argues that the need for reform is even more pressing. “If you’ve broadly got less resourcing than then, you’ve got to do more reforming than then,” he said.
Milburn warns that failure to embrace reform and move away from the “more, more, more” mentality could have dire consequences for the NHS. “If you’re going to do big dollops of resources, then that has got to be matched by a massive dose of reform,” he said, adding that this approach is “the only game in town, because otherwise in the end what will happen is we’ll end up breaking the NHS.”
Labour’s Vision for an “NHS Fit for the Future”
The Labour government has made building “an NHS fit for the future” one of its five key missions outlined in its election manifesto. The party has promised a range of measures to improve the health service, including:
- Cutting waiting times by offering 40,000 more appointments every week
- Doubling the number of cancer scanners
- Employing 8,500 additional mental health staff
- Implementing a new “dentistry rescue” plan
- Bringing back the concept of the “family doctor”
As Milburn takes on his new role in the health department, all eyes will be on how he and the government navigate the delicate balance between increasing resources and driving the reforms needed to modernize the NHS and make it sustainable for the long term. The stakes could not be higher, with the very future of the nation’s most cherished institution hanging in the balance.
