Research challenges political assumptions and highlights widespread concern about wealthinequality
A new national study from Wellbeing Economy Alliance Scotland has found overwhelming concern about wealth inequality and strong backing for fairer taxation of wealth, including among people in higher-income households, challenging the common assumption that such reforms lack public support.
Key findings include:
• 85% support increasing taxes on the wealthy
• 90% say wealth inequality is more harmful than good for Scottish society
• 83% say the wealth gap is too large
• Two-thirds would prefer higher taxes to protect public services rather than cuts
Concern about inequality and backing for fairer taxation were consistent across income levels, age groups, and social backgrounds.
Participants described wealth inequality as damaging to people’s security, opportunities, and quality of life. Many said those with the greatest wealth should contribute more, particularly to support public services.
There is also strong public backing for specific reforms. Around 70% of people supported changes to ensure those with higher-value properties pay more council tax, reflecting broader support for progressive taxation.
Participants consistently linked their views on taxation to fairness and public benefit. Support was strongest where people believed the system was fair, transparent, and clearly linked to protecting public services such as healthcare, education, and local communities.
Lisa Hough-Stewart, Director, Wellbeing Economy Alliance Scotland and a member of the campaign Tax Justice Scotland, said: “This research shows clearly that people across Scotland are deeply concerned about wealth inequality and strongly support fairer taxation of wealth.
“For too long, political debate has assumed that taxing wealth is unpopular or politically impossible. Our findings show that this is not the case.
“Support comes from across society — including people who recognise they may need to contribute more.
“People recognise the role public services play in supporting everyone in society, and believe those with the greatest wealth should contribute more to sustain them.
“Public opinion is not the barrier to reform. The public is ready for change.”
The findings come at a time of continued pressure on public services and growing debate about inequality, taxation, and Scotland’s public finances. The Scottish Fiscal Commission has forecast a shortfall of £4.7 billion by 2029-30 even to fund existing spending commitments.
Support for tax reform was closely linked to fairness and trust. Participants emphasised the importance of ensuring that tax changes are proportionate, transparently implemented, and designed so those with the greatest wealth contribute their fair share.
The results add to mounting calls for a fairer tax system. Tax Justice Scotland – a campaign backed by more than 50 organisations, from anti-poverty and environment charities to social enterprise bodies, academics, policy think tanks and trade unions – is calling for fair tax reform at UK and Scotland levels.
Ahead of the Scottish election, it is urging every party to set out Tax Justice Plans to ensure national and local taxes in Scotland do more to help tackle inequality, poverty and the climate crisis while fairly generating additional money to invest in crucial public services.
Jamie Livingstone, Head of Oxfam Scotland and a member of Tax Justice Scotland, said: “People in Scotland are well ahead of the current political debate on inequality and tax. They can see too much wealth sitting in too few hands while children live in poverty and public services struggle and people know that’s not right.
“Most of us are willing to pay a bit more to support the services we all rely on but we expect the money to be spent wisely and those with the deepest pockets to contribute properly too. That it isn’t radical or complicated economics, it’s basic fairness.
“With the Scottish election fast approaching, every party should set out how they will help deliver a fairer tax system within the next Scottish Parliament.”
The study draws on nationally representative research conducted with more than 2,300 people across Scotland, alongside in-depth focus groups exploring attitudes to wealth inequality, taxation, and council tax reform.
Views are being sought on proposed changes to the Code of Practice for how Scotland’s police officers use stop and search powers.
The Code covers the conduct, recording and oversight of stop and search activity. The Scottish Government is legally required to periodically review the Code and has now published a consultation on a proposed update.
The revised Code aims to strengthen protections for children and vulnerable individuals, provide clearer guidance on the steps officers must take before, during and after a search, and introduce enhanced requirements on data recording, oversight and accountability.
Justice Secretary Angela Constance said the proposed changes would ensure the Code continues to support effective policing while maintaining public trust and confidence in the appropriate use of stop and search powers.
Ms Constance said: “Stop and search powers remain a vital tool for police to tackle crime and keep people safe, provided it is exercised lawfully, proportionately and with respect for an individual’s dignity and rights.
“The revised Code aims to improve clarity, transparency and safeguarding, while strengthening safeguards for children and vulnerable people, with clearer guidance on the steps officers should take before, during and after a search.
“The consultation is an opportunity to listen, reflect and to strengthen public trust. I encourage everyone with an interest in justice, equality and community safety to take part.
“Their views will help ensure the Code remains robust, fair and fit for the future – supporting effective policing while upholding the rights and freedoms that define our society.”
Scottish Government pledges to improve system following deaths in custody
Action to reform the Fatal Accident Inquiry system relating to deaths in custody will be taken following an independent review.
The review was commissioned by Justice Secretary Angela Constance, in consultation with the Lord Advocate, to examine how to improve the efficiency and effectiveness of investigations into deaths in custody and ensure those affected are treated in a trauma-informed way.
Retired Sheriff Principal Ian Abercrombie KC, who chaired the review, has now published his report. It contains 34 recommendations aimed at improving the process, timescales and communication of Fatal Accident Inquiries held in response to a death in custody.
Many of the review’s recommendations will require collaboration and legislative change, and the Scottish Government will set up a multi-agency working group to drive forward action, which will include the Scottish Prison Service, Police Scotland, the Crown Office and Procurator Fiscal Service, and other key partners.
Ms Constance said: “I am very grateful to Sheriff Principal Abercrombie and the advisory group for this forthright review. Their report’s thorough and wide-ranging recommendations set out the evident need to improve the Fatal Accident Inquiry system.
“The message from families who gave evidence to the review is clear, they feel let down and their experience of the system has added to their grief.
“This needs to change and families who have lost loved ones in custody cannot wait for a lengthy process to conclude before they see improvement.
“Responsibility for acting on the recommendations sits with a range of justice partners, which is why I am setting up a multi-agency group to drive forward reforms.
“The group will consider the review’s recommendations and develop a shared action plan to improve the system of fatal accident inquiries for deaths in custody, with an emphasis on implementing reform as a priority.”
HOME SECRETARY UPDATES WESTMINSTER FOLLOWING SUMMER RECESS
Home Secretary Yvette Cooper made a statement in parliament yesterday on actions the government is taking with France to strengthen border security and reforms to the asylum system:
Mr Speaker, with your permission, I will update the House on the actions we are taking with France to strengthen our border security and the next steps on our reforms to the asylum system.
Now to be aware when we came into the government, we found an asylum and immigration system in chaos.
Small boat gangs for 7 years had been allowed to embed their criminal trade along the French coast. The asylum backlog was soaring. Illegal working was being ignored.
It is little wonder that people right across the country lost confidence in the system and demanded to know why they were paying the price of a system that was so out of control.
But that does not mean people rejected the long and proud history of Britain doing our bit to help those fleeing persecution or conflict – including in the past decade families from Ukraine, Syria and Hong Kong.
It is the British way, to do our bit alongside other countries to help those who need sanctuary.
But the system has to be controlled and managed, based on fair and properly enforced rules, not chaos and exploitation driven by criminal smuggler gangs.
It is exactly because of that important tradition, that substantial reforms are needed now.
In our first year, we have taken immediate action, laying the foundations for more fundamental reform.
We have restored asylum decision making and then rapidly increased the rate of decisions.
Instead, we removed 35,000 people with no right to be here, including a 28% increase in returns of failed asylum seekers and a 14% increase in removals of foreign criminals.
We have increased raids and arrests on illegal working by 50%, and we cut the annual hotel bill by almost a billion pounds in the last financial year. We are rolling out digital ID and biometric kits so immigration enforcement can check on the spot whether someone has a right to work or a right to be in the UK.
And on Channel crossings and organised immigration crime we are putting in place new powers, new structures and new international agreements to help dismantle the criminal industry behind small boats.
I want to update the House on the further steps we are now taking.
In August I signed the new treaty with France allowing us for the first time to directly return those who arrive on small boats.
The first detentions took place the next day – of people immediately on arrival at Dover.
We expect the first returns to begin later this month.
Applications have also been opened for the reciprocal legal route, with the first cases under consideration, subject to the strict security checks.
We have made clear this is a pilot scheme – the more that we prove the concept at the outset, the better we will be able to develop and grow it.
But the principles it embodies are crucial.
Because no one should be making these dangerous or illegal journeys on small boats.
And if they do, we want to see them swiftly returned.
But in return, we believe in doing our bit alongside other countries to help those who have fled persecution through managed and controlled legal programmes.
This summer we have also taken further action to strengthen enforcement against the smuggling gangs.
France has reviewed its maritime approach to allow for the interception of taxi boats in French waters, and we will continue to work with them to implement this change as soon as possible.
In the last year, the NCA has led 347 disruptions of immigration crime networks – their highest level on record and a 40% increase in a year.
Over the summer, we announced a £100 million uplift in funding for border security and up to 300 more personnel in the NCA focussing on targeting gangs.
The Border Security Bill will give them stronger powers. Counter terrorism powers against smuggler gangs and powers to seize and download mobile phones of small boat arrivals.
And the power to ban sex offenders from the asylum system altogether.
Those powers could be in place within months, making our country safer and more secure. (Political content redacted)
Let me turn now to the major reforms that are needed to fix the broken asylum system we inherited.
Although we have increased decision making and increased returns the overall system remains outdated, sclerotic and unfair.
So, as we set out in the Immigration White Paper, we will shortly set out radical reforms to modernise the asylum system and boost our border security.
Tackling the pull factors. Strengthening enforcement. Making sure people are treated fairly. Reforming the way that the ECHR is interpreted here at home. Speeding up the system, cutting numbers and ending the use of hotels. And developing controlled and managed routes for genuine refugees.
At the heart of these reforms will be a complete overhaul of the appeals system.
The biggest obstacle to reducing the size of the asylum system and ending hotel use.
Tens of thousands of people in asylum accommodation are currently waiting for appeals and under the current system that figure is set to grow, with an average wait time of 54 weeks.
We have already funded thousands of additional sitting days this year.
And the Border Security Bill will introduce a statutory timeframe of 24 weeks.
But we need to go further. So, we will introduce a new independent body to deal with immigration and asylum appeals fully independent of government, staffed by professionally trained adjudicators, with safeguards to ensure high standards but able to surge capacity as needed and accelerate and prioritise cases, alongside new procedures to tackle repeat applications and unnecessary delays.
We are also increasing detention and returns capacity – including a 1,000-bed expansion at Campsfield and Haslar, with the first tranche of additional beds coming online within months to support many thousands more enforced removals each year.
Our reforms will also address the overly complex system for family migration, including changes to the way Article 8 of the ECHR is interpreted.
We should be clear that international law is important – it is because other countries know we abide by it that we have been able to do new agreements with France to return people who arrive on small boats, to make new agreements with Germany to stop the warehousing of small boats by criminal gangs and to explore return hubs partnerships with other European countries.
But we also need the interpretation of international law to keep up with the realities and challenges of today’s world.
But there is one area where we also need to make more immediate changes.
The current rules for family reunion for refugees were designed many years ago to help families separated by war, conflict and persecution.
But the way they are being used now has changed.
Even just before the pandemic, refugees who applied to bring family to the UK did so on average more than 1 or 2 years after they were granted protection.
Long enough for them to get jobs, find housing and be able to provide their family with some support.
In Denmark and Switzerland, currently those granted humanitarian protection are not able to apply to bring family for at least 2 years after protection has been granted.
Here in the UK now however those applications now come in on average within 1 month, even before a newly granted refugee has left asylum accommodation. As a consequence, refugee families who arrive are far more likely to seek homelessness assistance.
Some councils are finding that more than a quarter of their family homelessness applications are linked to refugee family reunion. That is not sustainable.
Currently there are also no conditions on family reunion for refugee sponsors unlike those in place if the sponsor is a British citizen or a long-term UK resident. That is not fair.
Finally, the proportion of migrants who have arrived on small boats and who then apply to bring family has also increased sharply in recent years.
With signs that smuggler gangs are now able to use the promise of family reunion to promote dangerous boat journeys to the UK.
Mr Speaker, we continue to believe that families staying together is important. It is why we will seek to prioritise family groups among the applicants to come to Britain under our new deal with France.
But reforms are needed. In our asylum policy statement later this year, we will set out a new system for family migration.
Including contribution requirements, longer periods before newly granted refugees can apply, and dedicated control arrangements for unaccompanied children, and for those fleeing persecution who have family in the UK. We aim to have some of those changes in place for the spring.
In the meantime, we need do to address the immediate pressures on local authorities.
And the risks from criminal gangs using family reunion as a pull factor to encourage more people onto boats.
Therefore, we are bringing forward new Immigration Rules this week to temporarily suspend new applications under the existing dedicated Refugee Family Reunion route. Until the new framework is introduced, refugees will be covered by the same Family Migration rules and conditions as everyone else.
Mr Speaker, let me turn next to the action we are taking to ensure that every asylum hotel will be closed for good under this government.
Not just by shifting individuals from hotels to other sites, but by driving down the numbers in supported accommodation overall.
Not in a chaotic way, through piecemeal court judgements, but through a controlled, managed and orderly programme, driving down inflow into the asylum system, clearing the appeals backlog which is crucial, and continuing to increase returns.
Within the asylum estate, we are reconfiguring sites, increasing room-sharing, tightening the test for accommodation and working at pace to identify alternative cheaper and more appropriate accommodation with other government departments and with local authorities.
And we are increasing standards and security and joint public safety cooperation between the police, accommodation providers and the Home Office to ensure that laws and rules are enforced.
Mr Speaker, I understand and agree with local councils and communities who want the asylum hotels in their communities closed.
Because we need to close all asylum hotels, and we need to do so for good.
But that must be done in a controlled and orderly manner, (…) that led to the opening of hotels in the first place.
Finally, Mr Speaker, let me update the House on the continued legal and controlled support we will provide for those facing conflict and persecution.
We will continue to do our bit to support Ukraine – extending the Ukraine Permission Extension scheme by a further 24 months, with further details to be set out in due course.
We are also taking immediate action to rescue children who have been seriously injured in the horrendous onslaught on civilians in Gaza so they can get the urgent health treatment they need.
The Foreign Secretary will update the House shortly on the progress to get those children out.
I can confirm the Home Office has put in place systems to issue expedited visas, with biometric checks conducted prior to arrival for children and their immediate accompanying family members.
We have done the same for all the Chevening scholars and are in the process of doing so now for the next group of students who have been awarded fully funded scholarships and places at UK universities so they can start their studies in Autumn this year.
Later this year, we will set out our plans to establish a permanent framework for refugee students to come study in the UK so that we can help talented young people fleeing war and persecution to find a better future. Alongside capped and managed ways for refugees to work here in the UK.
Mr Speaker, this is a government determined to fix every aspect of the broken system we inherited and restore the confidence of the British people.
What we will never do is seek to stir up chaos, division or hate.
That is not who we are as a country. That is not what Britain stands for.
A practical plan to strengthen our border security, to fix the asylum chaos and to rebuild confidence in an asylum and immigration system that serves our national interest, protects our national security, and reflects our national values.
Because, when we wave the Union Flag, when we wave the St George’s Flag, when we sing God Save The King, and celebrate everything that is great about Britain and about our country.
We do so with pride because of the values that our flags, our King, and our country represent.
Togetherness, Fairness and Decency.
Respect for each other, and respect for the Rule of Law.
That is what our country stands for.
That is the British way to fix the problems we face.
NHS Scotland’s governance arrangements need to be strengthened to deliver the scale of reform needed across the health service.
NHS Scotland comprises 22 NHS boards, with oversight provided by the Scottish Government. A range of governance groups are in place across NHS Scotland but there are weaknesses within the scrutiny and assurance processes at the Scottish Government level. This risk could be reduced by making greater use of non-executive directors to provide more challenge.
The planning and governance of healthcare in Scotland is becoming more complex, and this limits NHS boards’ ability to drive reform. The mix of local, regional, and national partners makes decision making and accountability difficult.
A new planning framework has been introduced by the Scottish Government and new national strategies for reform are due in 2025. Dealing with this change will be challenging for boards, but it should give them more clarity and help them to work more collaboratively to deliver reform.
NHS boards use a blueprint for good governance that was produced in partnership with the Scottish Government. The blueprint has been well received but there is scope for it to be strengthened to more clearly set out how board governance should be adapted to deliver reform.
NHS Scotland’s governance arrangements need to be strengthened to deliver the scale of reform needed across the health service.
Stephen Boyle, Auditor General for Scotland, said: “The delivery of NHS services must be reformed for Scotland’s health service to remain affordable and sustainable.
“NHS Scotland’s governance arrangements are key to delivering that reform, but they need to be strengthened.
“The planning of healthcare in Scotland is becoming more complex and the Scottish Government needs to ensure lines of accountability and decision-making are clear.”
The British Dental Association has warned that reforms to NHS dentistry cannot be the end of the road for the struggling service, and that recent hikes in National Insurance may undo this progress.
According to survey evidence from 195 NHS dentists in Scotland:
69% of respondents agree that Payment Reform, which launched in November 2023, represents an improvement over the system that proceeded it. However, dentists say it has not met the Scottish Government’s stated objectives. Only 1 in 5 (21%) agree that the reformed system reduces bureaucracy, little over 1 in 4 (26%) say it increases clinical freedom. Only 7% believe it enhances access for NHS patients, and only 3% says it supports a reduction in oral health inequality.
With practices facing higher costs as a result of the most recent UK Budget, 45% estimated their practices will struggle to remain financially sustainable. Over half (53%) warned it will accelerate the move to the private sector. 65% stressed these costs must be covered by either the UK or Scottish Government.
Only 10% could describe the NHS as an attractive place to build and maintain a career. 91% felt their job was stressful, with 71% saying they felt burnt out by it.
86% identified higher needs patients requiring more clinical time as a challenge affecting their practice. 83% cited not being able to accommodate all the patients who contact them. Recruitment and retention of dentists was flagged by 72%, for dental nurses by 78%.
These headlines were presented to the Conference of Scottish Local Dental Committees in Stirling yesterday the single largest gathering of NHS dentists in Scotland.
Gillian Lennox, Chair of the BDA’s Scottish Dental Practice Committee, said:“Dentists on the frontline say payment reform is clearly an improvement on what preceded it.
“But in terms of sustainability, bureaucracy, prevention, access and inequality there is still so much more to do.
“The simple fact is that 9 out of 10 of my colleagues wouldn’t describe the NHS as an attractive place for dentists to build and maintain a career. We can’t go on like this.
“It’s the practices with vacancies they can’t fill. The NHS colleagues on the brink reporting high levels of stress and burnout.
“As dentists we believe in prevention, and that principle needs to be applied to the pressures we’re under. Broken systems have a very human cost, for colleagues and the millions we treat.”
Neither the UK nor Scottish Government have arrived at any tangible mitigations to the threat presented by National Insurance and National Minimum Wage hikes.
Gillian Lennox added: “The National Insurance hike risks taking a wrecking ball to already struggling practices, undoing the progress we’ve secured with payment reform.
“We do have sympathy with Holyrood, this mess is not of their making.
“However, what remains clear is that one Government – North or South of the border – is going to have to fix it.”
Chancellor pledges to work with regulators to develop ambitious reforms.
Today’s summit marks the first in a series of meetings with the regulators ahead of publishing action plan.
Reeves welcomes initial ideas from regulators to boost innovation and investment, but pushes for more ambition.
The CEOs of key regulators were urged to ‘tear down regulatory barriers’ that hold back economic growth at a summit in the Treasury yesterday.
In a meeting hosted by the Chancellor of the Exchequer and Secretary of State for Business and Trade, chief executives at watchdogs covering sectors including railways, water, energy, aviation were told that economic growth is the absolute top priority for the government, as part of the Plan for Change for put more money in people’s pockets.
The meeting was the first in a series following a joint letter from the Prime Minister, Chancellor and Secretary of State for Business and Trade in December, in which the government asked the regulators to each propose five reforms to support growth in the coming year. Over the coming weeks, 17 regulators will be called in to have their proposals scrutinised as the government leaves no stone unturned to deliver growth.
At yesterday’s meeting, the Chancellor told the regulators that they would have a key role to play in delivering growth by helping to create a regulatory environment that unlocks innovation and investment, supports businesses to thrive and allows much needed infrastructure to be built.
The regulators agreed with the Chancellor that they have a role to play in driving growth but highlighted that there are some barriers, including the need to balance growth with their other legal responsibilities.
The Chancellor noted that the regulators’ responsibilities had accumulated over time and said she was open to hearing about where this was preventing them from taking clear, consistent and balance actions to drive growth.
She emphasised the importance of leadership to deliver a mindset shift on regulation, calling on each of the CEOs in the room to institute cultural change based on helping to deliver growth instead of excessively focusing on risk.
The Chancellor also promised that the government would work with them to develop and deliver important reforms by playing its part, including by making time for legislation where it is needed or using the upcoming Spending Review, and noted the Prime Minister’s promise to rip up regulation that blocks investment to make the regulatory regime fit for the modern age.
The Chancellor was clear that while some of the proposals already put forward were promising, she wanted to see greater ambition and urgency to drive economic growth. She emphasised that fresh ideas were needed and noted that the Government will also ask industry to come forward with their own ideas to deliver a more growth supportive regulatory environment.
She highlighted some specific and promising ideas she had heard from the regulators today. These included: driving greater responsiveness to business demands, particularly on planning and license applications; grant funding administered by Ofwat to drive innovation in the water sector supply chain; energy tariff reform; increasing access to rail operator efficiency data and innovative drone solutions which would unlock growth in the public sector.
The regulators agreed to continue working with the government on their proposals reform ahead of publishing an action plan in Spring, and welcomed today’s strategic discussion.
The Chancellor finished the meeting by reiterating that leadership matters, noting that every regulator would have to play their part to improve living standards across the country.
Following the meeting, Chancellor of the Exchequer Rachel Reeves said: “There’s no substitute for growth. It’s the only way to create more jobs and put more money in people’s pockets, which is why it’s at the heart of our Plan for Change.
“Every regulator, no matter what sector, has a part to play by tearing down the regulatory barriers that hold back growth. I want to see this mission woven into the very fabric of our regulators through a cultural shift from excessively focusing on risk to helping drive growth.”
Health Secretary calls on entire nation (i.e. ENGLAND) to shape the government’s plans to overhaul the NHS
Public, clinicians and experts urged to submit ideas for its future as new online platform Change.NHS.uk goes live today – putting staff and patients in driving seat of reform
Responses will shape government’s 10 Year Health Plan to fix broken health service and deliver government mission to build an NHS fit for the future
The biggest national conversation about the future of the NHS since its birth is set to be launched today (Monday 21 October), as the entire country is called upon to share their experiences of our health service and help shape the government’s 10 Year Health Plan.
Members of the public, as well as NHS staff and experts will be invited to share their experiences views and ideas for fixing the NHS via the online platform, change.nhs.uk, which will be live until the start of next year, and available via the NHS App.
The public engagement exercise will help shape the Westminster government’s 10 Year Health Plan which will be published in spring 2025 and will be underlined by three big shifts in healthcare – hospital to community, analogue to digital, and sickness to prevention.
As part of the first shift “from hospital to community”, the UK government wants to deliver plans for new neighbourhood health centres, which will be closer to homes and communities. Patients will be able to see family doctors, district nurses, care workers, physiotherapists, health visitors, or mental health specialists, all under the same roof.
In transforming the NHS from analogue to digital, the government will create a more modern NHS by bringing together a single patient record, summarising patient health information, test results, and letters in one place, through the NHS App.
It will put patients in control of their own medical history, meaning they don’t have to repeat it at every appointment, and that staff have the full picture of patients’ health.
New laws are set to be introduced to make NHS patient health records available across all NHS trusts, GP surgeries and ambulance services in England – speeding up patient care, reducing repeat medical tests, and minimising medication errors.
Systems will be able to share data more easily, saving NHS staff an estimated 140,000 hours of NHS staffs’ time every year, because staff will have quicker access to patient data, saving time that can then be spent face-to-face with patients who need it most and potentially saving lives.
By moving from sickness to prevention, government wants to shorten the amount of time people spend in-ill health and prevent illnesses before they happen. As an example, the 10 Year Health Plan will explore the opportunities smart watches and other wearable tech may offer patients with diabetes or high blood pressure, so they can monitor their own health from the comfort of their own home.
The launch of the new online platform will take place at a health centre in East London, where the Secretary of State will meet with the Chief Executive of the London Ambulance Service before the first engagement event involving NHS staff from across the healthcare system as a start to the national conversation.
Prime Minister Keir Starmer said: My mum worked for the NHS, my sister worked for the NHS and my wife still works for the NHS – so I know first-hand how difficult it has been for staff, and for patients battling against a broken system for over a decade. But it’s time to roll up our sleeves and fix it.
“We have a clear plan to fix the health service, but it’s only right that we hear from the people who rely on the NHS every day to have their say and shape our plan as we deliver it. Together we can build a healthcare system that puts patients first and delivers the care that everyone deserves.
“We have a huge opportunity to put the NHS back on its feet. So, let’s be the generation that took the NHS from the worst crisis in its history and made it fit for the future.”
Health and Social Care Secretary Wes Streeting said: “When I was diagnosed with kidney cancer, the NHS saved my life, as it has for so many people across our country. We all owe the NHS a debt of gratitude for a moment in our lives when it was there for us, when we needed it. Now we have a chance to repay that debt.
“Today the NHS is going through the worst crisis in its history. But while the NHS is broken, it’s not beaten. Together, we can fix it.
“Whether you use the NHS or work in it, you see first-hand what’s great, but also what isn’t working. We need your ideas to help turn the NHS around.
“In order to save the things we love about the NHS, we need to change it. Our 10 Year Health Plan will transform the NHS to make it fit for the future, and it will have patients’ and staff’s fingerprints all over it.
“I urge everyone to go to Change.NHS.uk today and help us build a health service fit for the future.“
Investment alone won’t be enough to tackle the problems facing the NHS, why is why it must go hand in hand with fundamental reform.
The three big shifts will be our key principles for reform and will revolutionise the way people manage their health and access care. Our reforms will also shift the NHS away from late diagnosis and treatment to a model where more services are delivered in local communities and illnesses are prevented in the first place.
It is vital the government hears from patients, experts and the NHS workforce to make sure we get this right and preserve the things people value about the health service.
NHS England Chief Executive Amanda Pritchard said: “NHS staff are facing an unprecedented number of challenges – with record demand for care, alongside growing pressures from an ageing population, rising levels of multiple long-term illnesses and patients with more complex needs. And they are often hampered by working in crumbling buildings with outdated tech, meaning too many patients are waiting too long for care they need.
“So, it is vital the health service innovates and adapts – as it has always done throughout its 76-year history – to design and deliver an NHS fit for the future.
“The 10 Year Health Plan is a chance to make the best practice, normal practice across the country. So, we will be carrying out the largest ever staff engagement exercise in NHS history and leaving no stone unturned as we seek to harness frontline views, alongside those of patients and the public, to ensure this happens.
“It is your experiences – good, bad, and sometimes frustrating – that we need to help shape this once in a generation opportunity, so please get involved!”
Bold ambitions for the NHS can only be achieved by listening to the expertise and knowledge of its 1.54 million strong workforce. Their understanding of what’s holding them back from performing at their best will help us bring down waiting times and provide the world class care the public deserve.
The government has already taken immediate action to address challenges in the health service and deliver an NHS fit for the future. Whether that’s agreeing a deal with resident doctors within weeks, securing a funding increase for GP practices to manage rising pressures or hiring an extra 1,000 GPs into the NHS by the end of this year, there are both short- and long-term reforms working hand in hand.
Lord Ara Darzi said: “As my recent Investigation found, the NHS is in need of urgent and fundamental reform. The 10 Year Health Plan comes at a crucial moment—and by describing the ultimate destination for the health service, it will help improve decision-making in the here and now.”
The start of this national conversation on the future of the NHS follows on from Lord Darzi’s independent report into the health service that diagnosed its condition. Lord Darzi concluded the NHS is in a ‘critical condition’ with surging waiting lists and a deterioration in the nation’s underlying health, identifying serious and widespread problems for people accessing services.
The launch of the engagement exercise for the 10 Year Health Plan will build on these findings and is the next step to delivering the Government’s mission to fix the NHS and deliver a health service fit for the future.
Rachel Power, Chief Executive of The Patients Association, said: “We warmly welcome this ambitious initiative to engage with patients, staff, and the public on the future of our NHS.
“For far too long, many patients have felt their voices weren’t fully heard in shaping health services. This national conversation, initiated by the government, marks a significant step towards genuine patient partnership and puts patients at the heart of the NHS’s evolution.
“Through our work as an independent charity, we speak directly with thousands of patients living with various health conditions each year. This gives us valuable insights into diverse experiences across the health and care system, from widely shared patient needs to unique challenges faced by underrepresented groups.
“We’re eager to contribute these wide-ranging perspectives to help shape a health service that truly meets the needs of everyone it serves.”
Louise Ansari, Chief Executive of Healthwatch England said: “We know people appreciate the hard work of NHS staff, but they are all too aware that the NHS faces many challenges that need fixing. The 10-year plan provides the opportunity to do this.
“We urge everyone to have their say on how the NHS should deliver better care to people where and when it is needed, more support to help people stay well, and a culture of listening to and acting on the views of patients.
“All too often, people face unequal access to care, with disabled people and those on lower incomes being particularly at risk. The NHS belongs to us all, so you must speak up and help create a health service that is fit for the future – equal and inclusive for everyone.”
Cllr Louise Gittins, Chair of the Local Government Association said: “The NHS rightly holds a place in our nation’s heart, being there for us at moments of great joy, deep sadness, and everything in between. It is also one of local government’s most important partners. What each side does can impact the other.
“Every one of us is unique, complex and carries different ambitions. The NHS plays a key role in helping us to live the life we want to lead, but it cannot do it alone. Through social care and wider wellbeing activity, councils play an essential role in supporting people to do what matters most to them and live a meaningful life.
“This exercise is therefore crucial for the future of health, social care and wellbeing.”
Caroline Abrahams, Charity Director at Age UK said: “We are delighted to see this first, essential part of developing the 10-year plan getting going.
“With our rapidly ageing population it’s important that the plan takes fully into account the needs of tomorrow’s older people as well as today’s and helps all of us to age confidently and well. We encourage everyone to get involved and have their say – it’s almost certainly a once in a generation opportunity to do so.”
The Deputy Chief Executive of NHS Providers, Saffron Cordery said: “This will be a landmark moment for the NHS.
“Trust leaders are ready and willing to work with the government to tackle the many challenges the NHS currently faces to create a ‘next generation’ NHS fit for the future.”
Jacob Lant, Chief Executive of National Voices said: “We are encouraged by the ambitious approach the Government is taking to involve patients and organisations from across the sector in shaping the 10 Year Plan.
“We are excited to play our part in this, and will be working with our members to ensure that people from marginalised and minoritised communities are able to shape the discussions and big decisions ahead.
“Closing the gap in healthy life expectancy is a shared ambition of this Government and the National Voices coalition, and we will work tirelessly to ensure no groups are left behind.”
Matthew Taylor, Chief Executive of the NHS Confederation said: “Following more than a decade of underinvestment and in the face of some serious challenges we are reaching a turning point for the NHS.
“The 10-year plan will set the service on a path towards being put on sustainable footing so that it can best serve our population. No one working in the NHS will argue that it works perfectly – its staff have been crying out for change and we hope the ten-year plan will deliver for them and their communities, including by listening to the reality of their experiences and by incorporating the many examples of best practice and innovation that are taking place across the country.”
Helen Walker, Chief Executive of Carers UK said: “We are excited to see this first engagement phase of the NHS 10 Year Plan, a process which will include unpaid carers and ask for their views about the kind of health service they want to see in the future.
“We wholeheartedly agree with the recommendations from the Darzi review which suggested there should be a “fresh approach to supporting unpaid carers”. Unpaid carers are critical to the NHS and the NHS is a critical service for them, but it’s not always set up to help carers and can make their lives harder.
“England’s 4.7 million unpaid carers provide the bulk of support for older, ill and disabled relatives, helping millions to live in local communities where they want to be. Their support is valued at £152 billion, the equivalent of a second NHS, but they also face greater health inequalities and poorer health outcomes.
“With one in three NHS staff also juggling work and care, there’s a real opportunity to create a service which truly supports families who provide unpaid care. We see this as a win:win situation – helping families and building an NHS which is fit for the future; delivering better outcomes for everyone.”
Cancer Research UK’s chief executive, Michelle Mitchell, said: “We welcome the UK Government’s move to start a public conversation about the future of the NHS in England.
“Despite the best efforts of its hard-working staff, the NHS is under extreme pressure. This exercise is another important step in the process towards developing a 10-Year-Plan that should ensure all cancer patients across the UK get the care they deserve.”
NO mention of Scotland?Health is a devolved issue, but I’m sure our suggestions will be welcomed, too! – Ed.
PM to pledge ‘the biggest reimagining of our NHS since its birth’
PM to set out plan for long term, fundamental reform to fix broken NHS
Lord Darzi’s independent investigation concludes NHS is in ‘critical condition’
Findings provide a diagnosis of the challenges facing the health service, which will inform government’s 10 year plan to reform the NHS
The PM will pledge the ‘biggest reimagining of our NHS since its birth’ in a speech this morning [12 September 2024], following the publication today of a full and independent investigation into the state of the NHS.
Lord Ara Darzi’s probe has concluded the service is in a ‘critical condition’ amidst surging waiting lists and a deterioration in the nation’s underlying health, identifying serious and widespread problems for people accessing services.
The PM will say that the scale of the damage done to the NHS revealed by the report is “unforgivable”, recognising the tragic consequences for too many patients and their families: “People have every right to be angry. It’s not just because the NHS is so personal to all of us – it’s because some of these failings are life and death.
“Take the waiting times in A&E. That’s not just a source of fear and anxiety – it’s leading to avoidable deaths.
“People’s loved ones who could have been saved. Doctors and nurses whose whole vocation is to save them – hampered from doing so. It’s devastating.
He will also address the causes behind the state of the NHS, including the long term impacts of the 2012 Health and Social Care Act which is described in the report as “a calamity without international precedent” which “proved disastrous”, as well as the far reaching consequences of underinvestment throughout the 2010s.
The PM is expected to say: “Our NHS went into the pandemic in a much more fragile state.
“We had higher bed-occupancy rates, fewer doctors, fewer nurses and fewer beds than most other high income health systems in the world.
“And let’s be clear about what caused that…a “scorched earth” approach to health reform, the effects of which are still felt to this day.
“Lord Darzi describes [the 2010s] as “the most austere decade since the NHS was founded”. Crumbling buildings, decrepit portacabins, mental health patients accommodated in Victorian-era cells infested with vermin.
“The 2010s were a lost decade for our NHS…which left the NHS unable to be there for patients today, and totally unprepared for the challenges and opportunities of tomorrow.”
As well as recognising the cost to people’s health, the PM will also address the inextricable link between the state of the NHS and the nation’s economy: It’s not just the state of our National Health Service in crisis – it’s also the state of our national health.
“There are 2.8 million people economically inactive due to long term sickness, and more than half of those on the current waiting lists for inpatient treatment are working age adults.
“Getting people back to health and work will not only reduce the costs on the NHS, it will drive economic growth – in turn creating more tax receipts to fund public services.
In the face of these dire findings and the growing pressures on the NHS from an ageing society and preventable illnesses, the PM will set out his belief in the ‘profound responsibility’ of government to do the hard work necessary to tackle them: “What we need is the courage to deliver long-term reform – major surgery not sticking plaster solutions.
“The NHS is at a fork in the road, and we have a choice about how it should meet these rising demands.
“Raise taxes on working people to meet the ever-higher costs of aging population – or reform to secure its future.
“We know working people can’t afford to pay more, so it’s reform or die.”
Rooted in Lord Darzi’s diagnoses of the challenges facing the NHS, the Prime Minister will outline three fundamental areas of reform and the imperative to work with staff and patients throughout this process.He is expected to say: “”This government is working at pace to build a Ten-Year Plan. Something so different from anything that has come before.
“Instead of the top-down approach of the past, this plan is going to have the fingerprints of NHS staff and patients all over it.
“And as we build it together, I want to frame this plan around three big shifts – first, moving from an analogue to a digital NHS. A tomorrow service not just a today service.
“Second, we’ve got to shift more care from hospitals to communities… And third, we’ve got to be much bolder in moving from sickness to prevention.
“Only fundamental reform and a plan for the long term can turn around the NHS and build a healthy society. It won’t be easy or quick. But I know we can do it.
“The challenge is clear before us; the change could amount to the biggest reimagining of our NHS since its birth.”
Lord Darzi is an independent peer and practising surgeon with 30 years’ experience in the NHS. He examined over 600 pieces of analysis from DHSC, NHS England and external organisations during his investigation. His report will inform the government’s 10-year plan to reform the health service.
Lord Darzi said: “Although I have worked in the NHS for more than 30 years, I have been shocked by what I have found during this investigation – not just in the health service but in the state of the nation’s health.
“We want to deliver high quality care for all but far too many people are waiting for too long and in too many clinical areas, quality of care has gone backwards.
“My colleagues in the NHS are working harder than ever but our productivity has fallen.
“We get caught up frantically trying to find beds that have been axed or using IT that is outdated or trying to work out how to get things done because operational processes are overwhelmed. It sucks the joy from our work – we became clinicians to help patients get better, not to go into battle with a broken system.
“We need to rebalance the system towards care in the community rather than adding more and more staff to hospitals. And we need a more honest conversation about performance – the NHS is now an open book.
“In the last 15 years, the NHS was hit by three shocks – austerity and starvation of investment, confusion caused by top-down reorganisation, and then the pandemic which came with resilience at an all-time low. Two out of three of those shocks were choices made in Westminster.
“It took more than a decade for the NHS to fall into disrepair so it’s going to take time to fix it. But we in the NHS have turned things around before, and I’m confident we will do it again.”
Despite the damning analysis, Lord Darzi insists the NHS’s vital signs ‘remain strong’ and he praised staff for their ‘shared passion and determination to make the NHS better for our patients’.
In carrying out the review, Lord Darzi brought more than 70 organisations together in an Expert Reference Group and sought input from NHS staff and patients through focus groups and frontline visits.
Responding to the report, Secretary of State Wes Streeting said: “I asked Lord Darzi to tell hard truths about the state of the NHS. He has produced an honest, expert, comprehensive report on the appalling state our health service is in.
“Today’s findings will inform our 10-year plan to radically reform the NHS and get patients treated on time again.
“The damage done to the NHS has been more than a decade in the making. We clearly have a long road ahead. But while the NHS is broken, it’s not beaten. We will turn the NHS around so it is there for you when you need it, once again.”
Today’s report has been welcomed by NHS England and health organisations who have pledged to work closely with the government on its mission to rebuild the NHS.
Amanda Pritchard, NHS England Chief Executive, said: “As this report sets out, staff are the beating heart of the NHS with a shared passion and determination for making the NHS better for patients – but it is also clear they are facing unprecedented challenges.
“Our staff are treating record numbers of patients every day despite ageing equipment and crumbling buildings, a surge in multiple long-term illnesses, and managing the long-lasting effects of the pandemic.
“While teams are working hard to get services back on track, it is clear waiting times across many services are unacceptable and we need to address the underlying issues outlined in Lord Darzi’s report so we can deliver the care we all want for patients.
“As Lord Darzi rightly points out, many of the solutions can be found in parts of the NHS today. That is why we are fully committed to working with government to create a 10-year plan for healthcare to ensure the NHS recovers from Covid, strengthens its foundations and continues to reform so it is fit for future generations”
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. 1 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.
Responding to the publication of Professor Lord Darzi’s Independent Investigation of the National Health Service in England, Nuffield Trust Chief Executive Thea Stein said:“Lord Darzi’s damning report underlines the stark realities experienced across almost every corner of the health service.
“Wide-ranging problems have been growing in plain sight for years and Darzi’s impressively comprehensive assessment will be familiar to anyone who has studied or experienced the slow deterioration of health care provision in England.
“While not surprising, the report’s findings are deeply troubling. As our research work has repeatedly shown, too often the NHS is not able to provide people with the timely care they need, despite steadfast public commitment to the core principles of the health service. The impacts of this are not felt equally: people in the poorest areas are particularly struggling to access healthcare.
“The big question now is what happens next.
“The Government has an early opportunity to make good on long-argued points on dysfunctional NHS funding in its first Budget next month. The health service is staring down the barrel of a significant shortfall in funding this current year [2] and the Chancellor will need to set out clear plans to tackle this, ahead of a longer-term funding settlement.
“Rightly, the report repeatedly references the interrelated, compounding pressures of the desperate state of social care and cuts to public health provision. But by design it does not dig into those issues. In future, we hope to see serious work by the government to address those broader societal issues that determine population health and impact health care access.
“Ultimately, the Lord Darzi’s diagnostic report sets out important aspirations to be delivered in the forthcoming 10-year plan to treat – and fix – the NHS. But the improvements we all hope for – and that patients desperately need – will take time, commitment and major financial, practical and system-wide support. There will be no quick fixes.”
Reforms will help reunite thousands of lost or stolen animals every year and deter pet theft
Lost or stolen pets will be reunited with their owners more quickly under reforms to the pet microchipping system announced today (29 March).
With over nine million pet dogs and nine million pet cats in England, it is devasting for owners when they are lost or stolen. Microchipping is the most effective and quickest way of identifying pets, with microchipped dogs more than twice as likely to be reunited with their owner.
Reforms set out today will help reunite stray pets by making microchip records easier to access, improving the accuracy of microchip information, and standardising database operator processes.
The new measures will help deter pet theft by creating more opportunities for suspicious activity to be flagged. This will include requiring database operators to provide a field indicating whether the pet has been reported as ‘missing’, strengthening the process for transferring keepership of a pet by ensuring the current keeper has 28 days to object, and preventing the creation of duplicate records.
The changes also include the creation of a central portal that approved users – including vets, local authorities, and police – can use to search microchip records rather than having to contact separate databases individually, which can delay the time taken for pets to be returned home.
Animal Welfare Minister Lord Douglas Miller said: ““Pets are treasured members of the family so it can be devasting for owners when they are lost or stolen.
“These vital reforms will simplify the microchipping system to make it quicker for vets, local authorities and police to access important information when they need it, helping to safeguard pets from theft and increase the likelihood of lost pets being returned home.”
Michael Webb, Battersea’s Head of Policy & Public Affairs, said: “Battersea is incredibly pleased with these reforms to the microchipping system, which will improve services for owners, enforcers and rescues alike.
“We see dogs and cats arrive at our centres every day with out-of-date microchips, or sadly no microchip at all, making it near impossible for our staff to reunite people with their pets.
“These reforms, which we have been calling for for some time, will not only help rescues like Battersea reunite more pets in less time, but also hopefully better protect dogs and cats from theft.
“With only several weeks to go until the law requires millions of cats to be microchipped, it is vital that the country’s microchipping system is as effective and robust possible and we will continue to work with Defra and other organisations to ensure that this is the case.”
RSPCA Chief Executive Chris Sherwood said: “Microchipping our pets is so important and provides reassurance and security, should they go missing, that they’ll be able to be identified and returned home quickly.
“A centralised portal with more accurate records will ensure that animals who end up with vets, local authorities and charities, like the RSPCA, can be traced back to their owners as quickly as possible, minimising the stress and anxiety they may feel being away from everything they know.”
British Veterinary Association President Anna Judson said: “Microchipping is a vital tool for vets working to identify lost pets and to successfully reunite them with their owners. The British Veterinary Association has been pressing for action to address issues with the current database system, which have been a source of ongoing frustration.
“These new measures are a positive step forwards and the new portal should help vet teams to check multiple databases quickly, identify and reunite cats and dogs with their owners and provide prompt treatment where needed.”
Today’s announcement follows a government consultation on the issue in which over 96% of respondents expressed support for the measures, and progresses an Action Plan for Animal Welfare pledge and key recommendations from the Pet Theft Taskforce.
It also builds upon wider work to make it easier for lost, stray, or stolen pets to be returned home safely, including making it compulsory to microchip all pet cats in England by 10 June 2024.
Westminster is also clamping down on pet theft by taking forward key recommendations from the Pet Theft Task Force, and have recently confirmed Government support for the Pet Abduction Bill.
These commitments are part of a wider Government effort to build on our existing world-leading animal welfare standards.
Since publishing the Action Plan for Animal Welfare in 2021, Westminster has brought in new laws to recognise animal sentience, introduced tougher penalties for animal cruelty offences; announced an extension of the ivory ban to cover other ivory bearing species; supported legislation to ban glue traps, the import of detached shark fins and measures to ban the advertising and offering for sale of low welfare activities abroad.
