Make your voice heard: 10-year NHS plan consultation

What is ONE REFORM the government must make in our NHS over the next 10 years?

The government is drafting plans on how to run our NHS for the next 10 years - and they want to hear from you.

After 14 years of systematic privatisation, they must end outsourcing and return our NHS to working for people, not profit.

We've prepared a standard response below to make responding as simple as possible. You can send it as it is or edit it before sending.

Director General of the 10-year health plan

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Unfortunately, the public cannot respond to the 10-year NHS consultation without creating yet another account online. This is preventing people from taking part in what Health Secretary Wes Streeting says is a “national conversation about the future of our NHS”.
I am writing to you directly to provide you with my thoughts on what I believe is one of the most important challenges facing our NHS and the reform that you should implement to deal with it over the next 10 years.
Among other things, Lord Darzi identified two causes of the crisis in our NHS: (1) A decade of underfunding of the NHS, and (2) The reforms created by the 2012 Health and Social Care Act.
I believe that most of what is wrong with our NHS derives from these two politically motivated decisions.
It seems obvious how underfunding is a major problem. Under the last government, the NHS invested £40 billion less per year than France, and £73 billion less per year than Germany according to an analysis by the Health Foundation. [1] The 10-year plan needs to make provision for proper funding of the health services over the next decade.
My response will mainly focus on the impact of the Health and Social Care Act 2012, which Lord Darzi’s review called the Health and Social Care Act “a disaster without precedent”.
While Darzi is right about this law overall, he failed to mention that one of its main reforms was that it required competitive tendering for the provision of NHS services, which opened the door to the rapid growth of the role of the private sector within the NHS between 2012 and 2020.
Recent research by We Own It looked at 72,000 outsourcing contracts signed between January 2012 and May 2024, worth a total of over £130 billion. [2] Their analysis found that private firms providing NHS services make £10 million a week in profits from their NHS contracts. 
Furthermore, research from the University of Oxford has linked outsourcing of NHS services to hundreds of treatable deaths. [3]
Wes Streeting’s three big proposed shifts are welcome, but it is important that there is a fourth big shift to govern them: from private to public. 
In other words, to ensure that all of the funding put into the health service is going toward treating patients, and not toward private profit, we need a shift from outsourcing toward public provision in the NHS.
Key figures in government and Labour’s policy document adopted by their conference in 2023 have demonstrated an understanding of the need for this shift:
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Rachel Reeves: “Under Keir Starmer’s Labour government we will see the biggest wave of insourcing of public services for a generation”. [4]
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Wes Streeting: “Rachel Reeves talks a lot about radical insourcing and I’d like to see some of that because I think we are paying over the odds for some services, including in the NHS” [5]
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The Labour Party’s 2023 National Policy Forum document: “We will make the NHS the preferred provider of commissioned healthcare services and will end the reliance on outsourcing and cronyism that saw our public services weakened in the face of the Covid-19 pandemic.” [6]
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In sum, I am asking for two specific reforms to our NHS in the 10-year plan:
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Bring all currently outsourced services back into the NHS at the end of their current contracts, just like Labour is doing in the railway. We Own It research shows that 94% of contracts for outsourced NHS services are expiring within this parliament. [7]
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Ban all new outsourcing of NHS services, and support NHS bodies, such as NHS Trusts and Foundation Trusts, to build up their in-house capacity to take on currently outsourced services when their contracts end.
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Thank you very much for your time and consideration.
Sources:
1. "How much does the UK spend on health care compared to Europe?", The Health Foundation, June 27, 2024
2. “ANALYSIS: The NHS has lost £10 million a week to private profits since 2012”, We Own It. June 17, 2024
3. Goodair, B & Reeves A 2022, Outsourcing health-care services to the private sector and treatable mortality rates in England, 2013–20: an observational study of NHS privatisation, in The Lancet Public Health, Volume 7, No 7
4. “Rachel Reeves: It’s time to take back control of public services”, Labour List. February 8, 2021
5. “Wes Streeting: NHS privatisation could not be further from my aims”, New Statesman. March 7, 2023
<div>6. National Policy Forum - Final Policy Documents, 2023.</div>
7. “RESEARCH: Labour's historic opportunity to reverse NHS outsourcing in the first term”, We Own It. June 3, 2024

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