September 12th 2024

By Ailsa Colquhoun

Darzi report raises questions about GP contractor model

Prime Minister Kier Starmer will today pledge the ‘biggest reimagining of our NHS since its birth’, following the publication of the 2024 Darzi investigation of NHS performance.

Following a two-month study, the former Labour government health minister and academic surgeon, Lord Darzi, has set out three areas of reform, including to shift more care into the community from hospitals.

Sources close to health secretary Wes Streeting say this could include a move away from the contractor GP model, which under current legislation, will prohibit dispensing. The aim would be to incentivise investment in GP. 

The DDA has responded to that position in a think-piece.

Other key areas of focus include digital transformation and greater focus on preventative care.

Key findings from Lord Darzi’s 142-page report include:

• Deterioration: The health of the nation has deteriorated over the past 15 years, with a substantial increase in the number of people living with multiple long-term conditions. 
• Spending: Too great a share of the NHS budget is being spent in hospitals, too little in the community, and productivity is too low.
• Waiting times: Waiting lists have swelled and waiting times have surged, with A&E queues more than doubling from an average of just under 40 people on a typical evening in April 2009 to over 100 in April 2024. One in 10 patients are now waiting for 12 hours or more.
• Cancer care: The UK has appreciably higher cancer mortality rates than other countries, with no progress whatsoever made in diagnosing cancer at stage one and two between 2013 and 2021.
• Lasting damage: The Health and Social Care Act of 2012 did lasting damage to the management capacity and capability of the NHS. It took 10 years to return to a sensible structure, and the effects continue to be felt to this day.   
• Productivity: Too many resources have been being poured into hospitals where productivity had substantially fallen, while too little has been spent in the community.