My Lords, I thank the noble Lord, Lord Darzi, for introducing so beautifully this important debate. In an age where some view suggestions of NHS reform as heretical, I welcome the opportunity to put down ideological swords and approach the NHS and the issue of social care with the clarity of debate that our healthcare system so desperately needs.
Lots of people, including my family and close friends, rightly testify to the wonderful care that they have received from the NHS. I do not yet have grandchildren and congratulate the noble Lord, Lord Winston, and my noble friend Lady Morris on their recent arrivals, but St Mary’s in Paddington looked after me very well when I had both my children on the NHS, so I understand the emotional attachment that we have to the noble ideal of the NHS and the numerous examples of superlative care experienced.
However, although we are often told that the NHS is the envy of the world, it is not the envy of the developed world. The UK healthcare system consistently receives mediocre rankings in international reports. Even the Commonwealth Fund report ranked us last but one for healthcare outcomes. We need outcome-driven improvements to our National Health Service, as those matter most to patients.
There have been and will be many important contributions today from those with direct experience of the NHS. I shall therefore limit myself to three short observations. We must invest in early diagnosis. The UK has lower cancer survival rates than comparable health systems. The cost of late diagnosis can be up to four times that of early diagnosis, which in turn dramatically improves the chance of cure and survival.
Secondly, we need to help to transform a culture in the NHS that can be resistant to innovation. Without this, reform will prove ineffective. Healthcare professionals must absolutely be able to speak up for the benefit of patients without the risk of victimisation. The national guardian, Dr Henrietta Hughes, is leading a positive culture change by publishing case reviews to support the proper treatment of whistleblowers. Our remarkable NHS staff are our greatest asset and a rich source of knowledge. They must be empowered to identify concerns and provide solutions.
Finally, we must have a proper debate about the funding of the NHS. It is simply wrong to perpetuate the myth that any alternative to the current system is a malicious attempt at privatisation. It is not a binary choice. We all agree that healthcare in this country should be universally accessible. This was the original and great gift when the NHS was created. Although every developed economy now provides its citizens with universal access to healthcare, none has copied the UK model. Other healthcare systems—in Germany, the Netherlands and Switzerland—offer feasible alternatives that deliver not only better value for money but better outcomes for patients. We know that the NHS needs more money, but we should not presume to know how to get it.
I welcome the proposal of a cross-party commission, but if we seek a sustainable future, we must keep an open mind, fairly evaluate alternative regimes and resist the narrow dogma that hampers rather than protects the NHS.