‘We’re in a right pickle’, Darzi concludes

Lord Darzi’s highly anticipated review of NHS performance finds that the NHS faces serious challenges that must be addressed in the fulness of time. It lays the blame squarely on the mistakes of the past and proposes that the NHS looks to the future for a lasting solution.

Professor Lord Darzi, known mainly for his conference appearances, impeccable dress and trustworthy hair, was asked by health and social care secretary Wes Streeting to conduct a critical review of the state of the NHS.

The appointment marks a welcome return to the pro-health policy arena for the former government minister and surgeon, whose 2008 review High Quality Care for All, the NHS Next Stage Review Final Report was widely praised for its elegance, its brevity – at just 92 pages – and for its wide-ranging aspirations.

Fresh approach

Mr Streeting said: “We need a completely fresh approach if we’re to avoid repeating the mistakes of the past. As the inventor of modern clinical practice, Lord Darzi was the obvious choice to lead an independent review of the NHS. I asked him to confirm my suspicion that the NHS is broken and to pin the blame on the Tories and that’s exactly what he delivered.”

The new review, entitled Oh Goodness, What a Pickle We’re In, concludes that:

• The NHS is in a bad way and things have got a lot worse recently
• Patients are fed up with having to wait for treatment
• NHS organisations must work better for more of the time
• There is an urgent need for more management and stronger leadership
• There are no easy solutions
• Something must be done about social care eventually, if not sooner
• Funding for landmark reviews by prominent public figures should be increased

Mr Streeting said that his previous claims that the Labour government would fix the NHS “within about five minutes of coming to power” may now need to be adjusted in light of Lord Darzi’s finding that it would take at least five years.

Meaningful first steps

The hard-hitting review was welcomed by NHS leaders.

One said: “This is the most significant moment since the last Darzi review. Many of the things he said then are even more relevant now, which is why it’s only right that he’s saying them again 16 years later.”

Matthew Taylor of the NHS Confederation said: “The NHS faces existential challenges and while this review may not solve the service’s problems overnight or indeed ever, it may prompt meaningful first steps towards the next stage of the journey. We call on the government urgently to consider how NHS membership organisations can play a part in the pre-implementation phase and to set out its vision for what good invoicing looks like.”

Privately, NHS leaders doubt that the government will listen to Lord Darzi’s pleas for more money and more managers for the NHS, as the health secretary is sceptical about the need for either.

Sir Chris Ham, a former think tank driver and long-time government advisor, said: “It’s vital for Lord Darzi to get these issues out in the open regardless of whether he really believes the government will do anything about them. He knows better than anyone that it’s better to have your ideas rejected than implemented, particularly if you want to maintain your reputation as a credible producer of independent policy reviews.”

Academic issue

Professor Sir Chris Ham added his hope that the Darzi review would be judged not merely on what it achieves but on its ability to highlight “the really critical issues of the day, such as the need for integration, community action, social cohesion and assemblies”.

A keen advocate of diversity, Sir Chris would like to see wider involvement of professors in health policy decision making and media coverage. He said he would be writing to Wes Streeting attaching a copy of his CV and a small invoice.

Responding to criticisms of the choice of Lord Darzi to lead the review, his agent Piers Booker of Whitehall Talent and Artistes said: “Who better than Prof Darzi to add a touch of class to any media event.”

Lord Darzi’s fees for personal appearances, after-dinner speaking and gravitas services can be found on the Whitehall Talent website.