July 3 2025 - 5:00pm
Overshadowed by the welfare reform failures of the last few days, the NHS 10 Year Plan has finally arrived. Keir Starmer claims it will “fundamentally rewire” the way the UK’s health service will operate. It is focused on three guiding principles of transition: hospital to community, analog to digital, and sickness to prevention. Yet the plan is overly ambitious, setting the government up for failure. It also lacks the detail needed to convince staff and patients it can fix the healthcare crisis.
The plan to shift care from hospitals to communities is an admirable one. Hospitals are overwhelmed, and discharging patients — especially the elderly — remains a major challenge. Reducing hospital spending is risky without a corresponding boost to social care funding, which needs urgent reform, and not a review deferred until 2028. The danger is that if hospital funding is cut to support community care, it may no longer cope with rising admissions from an aging population.
Another key part of the plan is the introduction of neighborhood health centers. In theory these could lead to better access for patients without stepping foot into a hospital. However, the only concrete detail is that more money will be diverted to the community. How will they be funded and where will they be built? The plan claims they will be open “12 hours a day, 6 days a week”. If the NHS staffing crisis continues, one thinks not.
Current analysis shows spending plans will merely maintain the status quo. But for such a radical shift in the NHS, more money will be needed.
The digitalization of the NHS, through the NHS app, is what the Health Secretary believes will be a panacea to patient woes. Increased autonomy for our healthcare is needed, and if this works, it could help patients feel less lost in the maze of their care. For elderly patients though, who will increasingly make up a larger proportion of patients, many already feel lost with the current shifts to online services. For example, as a doctor, I’ve had consultations where the first 10 minutes are spent dealing with concerns around booking online appointments and how complicated it all is. That said, AI scribes and better IT systems to reduce bureaucracy would be welcome. But again, we wait for details on funding.
Much will depend on which companies the government chooses to deliver the new technology. It will most likely be Palantir and United Healthcare’s subsidiary Optum, both of which have questionable records. When these systems were implemented in the US, they didn’t work well, staff were disciplined for prioritizing patient safety, and in a service already plagued by cover-ups, scandals, and ignored patients, it’s hard to see how this will work without causing further problems in the long run.
The most important part of the plan, and the most difficult, is the shift from sickness to prevention. For decades health leaders have cited this as the way to create a sustainable health service, but almost none of them have been able to implement adequate policies. In the decade prior to the pandemic, public health funding was decimated, and initiatives to improve people’s health fell by the wayside.
The plan offers some ideas to make the country healthier: restricting junk food for children, tackling the problems of vapes and tobacco products and expanding the rollout of weight-loss drugs. In a time of increased vaccine skepticism, it also aims to increase the uptake of the game-changing HPV vaccine to prevent certain cancers. These are positive steps, but somewhat predictable and, like much else, lacking in substance.
The British people won’t see results in the near future. Tony Blair’s health secretary Alan Milburn — who is currently acting as a consigliere of sorts to Wes Streeting — once said: “The best political trick I pulled off was to publish a 10-year plan. Why? Because it basically bought time.” It would be uncharitable to assume Streeting is trying to merely buy time. Big fixes do take a long time. But voters will need to see things improving well before the halfway point for Labour to have a shot at a second term.
