The speech made by Keir Starmer, the Prime Minister, at the South West London Elective Orthopaedic Centre, Epsom on 6 January 2025.
A happy new year to you all!
I hope you had a refreshing Christmas break.
I do recognise and realise that for so many people in the NHS, those words ‘Christmas’ and ‘break’ don’t very often go well together.
So before I say anything else – can I just say to all of you, and through you to all of your colleagues who work in the NHS. Thank you.
Thank you for the service to our country. And for the countless lives that you save and change – every single day. A massive thank you to you.
Now, this year of course is the 80th anniversaries of VE and VJ day.
And on the 8th of May and the 15th of August we will come together to celebrate the greatest victory of this country and the greatest generation that achieved it.
It will be a wonderful moment – and we intend to do them proud.
But what that generation knew is that the strength and prosperity of a nation rests on the security of working people.
And that the fundamental job of government is to deliver that security so working people can realise their aspirations and drive a country forward.
And so for this Government that is what this year is about, what next year is about, what every waking moment is about.
The goal of our Plan for Change. And this year – we will deliver.
And let me tell you there is no institution more important for the security of our country than the National Health Service built by that generation eight decades ago now.
It’s the embodiment of British values and humanity.
Fairness and equal respect.
But look at it now. And I’m looking at the staff here.
Because the feeling of record dissatisfaction.
Millions of people – waiting, waiting, waiting on waiting lists.
Their lives on hold.
The potential of the country, if you like – blocked.
So 2025 is about rebuilding Britain.
And rebuilding our NHS is the cornerstone of that.
We will protect the principles we all cherish and that you all work to every day.
Care – free at the point of use.
Treatment according to need. Key principles.
But to catapult the service into the future.
We need an NHS reformed, from top to bottom.
Millions of extra appointments signed, sealed and delivered with the plan we are launching today.
National renewal in action.
You know, people have long said we couldn’t do this.
The wallowing in a fatalism about the potential of this country.
The change we can deliver for working people.
Well – this plan is a comprehensive rebuttal of that mindset.
A National Health Service that treats patients more quickly. That is closer to their lives.
Gives them a level of convenience that they take for granted in nearly every other service they use every day.
Just think about, every day, with just few swipes of their phone millions of people buy food or clothes for their family. They book holidays. They even find love!
There’s no good reason why a public, free at the point of use, NHS can’t deliver that kind of convenience.
In fact – it must.
And we talked about some of these this morning. We need an NHS hungry for innovation as you are at this centre.
That is the only way to face up to the challenges of the future.
The wonder of us living longer and longer.
And with that hunger – together we will save countless lives.
Improve care from where it is now, beyond belief.
Do not doubt this can be done.
A system like ours with vast amounts of patient data, with scale, with the extraordinary resilience of our NHS staff.
We are well-placed for the AI revolution in healthcare.
Trust me – that is coming.
And Britain is a world leader.
So we can do this.
But first – we must confront the reality of what is needed.
Because the NHS can’t become the national money pit.
Productivity can’t bump along 11% lower than it was before the pandemic.
Working people can’t be expected to subsidise the current level of care with ever rising taxes.
That is the price of ducking reform – and I won’t stand for it.
I believe in public service, I believe in the NHS, I will fight for it – day and night. But I will never stand for that.
And look as many of you will know, and as we talked about this morning – my wife, my sister, my mum.
They all worked or work for the NHS. And as you know nobody works in the NHS for an easy life – you know that and I know that.
Indeed, I’ve said many, many times before – I wouldn’t be standing here in front of you today if it wasn’t for the NHS.
Because my Mum had Still’s disease – she was diagnosed when she was eleven. And one of the things she was told was that she would never have children.
Well the NHS never gave up on her. And that’s why I’m standing here today, so thank you to the NHS – as every family has a story like that to thank the NHS for.
And every day, in this hospital and throughout the service NHS staff give their all to save lives and look after the families of other people.
And then just get up the next day and just to do it all again. Every single day.
So when I think about what they’ve been through over fourteen years.
It makes me angry.
I am angry – that you are working harder and harder yet the system just isn’t delivering results that we need for patients or for staff.
That is the cut and dry argument for reform.
And it’s not just about money.
At the budget we invested over £25 billion in the National Health Service.
A record amount, and rightly so over £1.8 billion since July on cutting waiting times – alone.
And that’s investment that will deliver 40,000 extra appointments every single week, picking up on some of the techniques that you are using here.
And that’s an outcome that is wanted by everyone. Wished for by everyone. But it’s only possible because of the difficult choices we confronted.
But let me be crystal clear that money will not be used, not as it has been in the past just to paper over cracks.
That’s the definition of the sticking plaster politics that we were elected to change.
No, this is the year we roll up our sleeves and reform the NHS.
A new era of convenience in care. Faster treatment – at your fingertips. Patients in control. An NHS fit for the future.
It’s not just about giving patients greater flexibility over appointments or leveraging the power of the NHS App.
And we are doing to do that.
But there’s a bigger principle here.
It’s about unlocking the huge untapped potential if we organise services around patient control.
And you see it with Martha’s Rule which was really important.
It’s about a shift in the balance of power away from a passive deference to doctors and towards patients being able to get that second opinion.
Play a greater role in deciding their care and treatment.
And the early results of Martha’s Rule are in.
Lives of some of the sickest patients in our care:
Transformed, extended, saved.
And so it’s a rule that’s now being recognised as a potentially groundbreaking innovation.
So look – across the NHS we will put patients in control of their care.
And to meet that demand we will also move care closer to their lives.
Shift treatment away from hospitals and centres.
And deliver more care at their GPs, in their community, in their home.
And you gave me some brilliant examples of what a difference that makes – shifting care towards people’s communities and their homes this morning when we were walking through what you do right here.
Because as you know – this will make a massive difference to waiting times.
If we can get more GPs consulting immediately with specialists. Diagnosing even more quickly than that will avoid an extra 800,000 unnecessary referrals and appointments – every single year.
Another game-changer – community diagnostic centres.
We will open them, more of them – and they will be seven days a week, twelve hours a day.
So that if you need a scan or an X-ray, you get it done much more quickly – and at your convenience.
That alone – will deliver 440,000 extra tests and scans every year.
We’ll also let patients with long-term conditions monitor themselves at home. Give them the technology to do that.
That will cut another half a million unnecessary appointments.
We’ll also reform funding incentives.
Focus our investment on what will actually cut waiting times.
Far too much money is wasted on inefficient care. That has to stop. Because we can’t afford it.
Artificial Intelligence will help us here as well.
I’ve seen it in action at the hospital I was at the tail end of last year.
AI-enhanced stethoscopes that can tell, literally in a heartbeat whether you’re at risk of cardiac failure.
And just think about that.
A patient saved, in an instant.
From a possible future that they may have had, where they collapse, possibly more than once.
Rushed, on trolleys, into acute services in a hospital. All of that avoided because AI was able to pick it up much earlier.
Think of the impact not just on the individual patient, the person that might happen to, and of course their families, but also on the NHS.
Artificial intelligence is a technology with almost unlimited power to cut waste, speed things up and save lives. And with this plan – the NHS will harness it properly.
And finally – to cut waiting times as dramatically as possible our approach must be totally unburdened by dogma.
Working people would expect nothing less.
So today – I welcome a new agreement that will expand the relationship between the NHS and the private healthcare sector.
Make the spaces, facilities and resources of private hospitals more readily available to the NHS.
That’s more beds, more operations, more care – available to the NHS. Treating patients – free at the point of use. Targeted – at where we need them most.
A partnership – in the national interest. Cutting waiting times, working for you. Delivering our plan for change.
I know some people won’t like this, but I make no apologies.
Change is urgent.
I’m not interested in putting ideology before patients and I’m not interested in moving at the pace of excuses.
All through this project that we have been involved in people have been saying – slow down…
“You won’t win in every nation in Britain…”
“You won’t deliver that plan…”
They’ll say it again this year – I have no doubt about that.
It’s that anthem of decline.
But they’ve been wrong at every stage so far and they’ll be wrong again.
Because this year – we will show that Britain can. We can change our country.
Politics can be a force for good.
We can unite the NHS behind a plan for reform.
An NHS that is faster, easier and more convenient with waiting times – cut.
Patients in control.
Technology – at your service.
And outstanding care in your community.
That is the change we will deliver.
Another step along the road to a country and a people…
Strong, secure, confident.
That the future will be better for their children.
Thank you.