THE Labour Party, as it exists now under Keir Starmer and Health Secretary Wes Streeting, is not the party to save the NHS — and this is not a new phenomenon.

In fact, Starmer and Streeting appear to be barely interested in going through the motions of even pretending to want to save it in any meaningful form. Last September, Streeting, who has even raised “self-care” by patients as a measure to be considered for the NHS, went as far as saying he was prepared to let the NHS “die” if it failed to adapt to his “reforms,” which amount to further privatisation, the closure of hospitals and cutting costs, while also mandating prescriptive and even coercive use of drugs on the general population to keep them out of hospital, and pushing the perversely incentivised “integrated care” model even harder than previous Tory governments, under the economically illiterate threat that the NHS will “go bankrupt” if the “reforms” are not imposed.

This plan was crystallised even further in the report Streeting commissioned by Lord Darzi, an ardent advocate of Tory NHS “reform” who oversaw much of Tony Blair’s marketisation of the NHS, to write last autumn on the future of the NHS.

Darzi trod a razor’s edge, both gushing with praise for Tory changes to the NHS while blaming the Tories for its collapse — and then prescribing “more of the same” as a supposed cure for what those policies caused.

And Streeting has signalled his determination to push through Darzi’s (and his) bleak vision for the NHS by appointing Tom Kibasi as his special adviser for the so-called NHS “10-year plan.” Kibasi worked for more than a decade for McKinsey, the giant US corporation that Tony Blair put “at the heart of the NHS” and which has encouraged NHS management, in a hard-to-find paper for the NHS in Northern Ireland, to look at the end of the NHS as a service that is “free at the point of delivery,” turning it into one that requires “co-payment” or outright payment for access to accident and emergency or even to hospital treatment generally.

Kibasi, who was a partner at McKinsey with a focus on “integrated care,” has said that he played the leading role in the creation of Darzi’s report, which frames NHS reform in terms of “superior return on investment” and the massive extension of “integrated care” with its hospital closures and rationing and seems written to provide Starmer’s government with the excuses it needs in order to carry out that agenda.

He has now been appointed to oversee the detailed plan for accomplishing those ends over at least the next decade, essentially writing the “end-of-life” prescription for the NHS that he and his new boss have decided is the way to “save” it — profitably, of course.

Also “at the heart” of the NHS, after its acquisition of NHS software services provider EMIS, is UnitedHealth. The US health insurance giant, which has been slammed for the huge percentage of policyholders whose claims are turned down by its AI-driven management software and has been both fined and sued for corruption in its claim decisions — the number doubled between 2020 and 2022 — is reported to be involved in Streeting’s plans to use AI to make the NHS more efficient.

To avoid the cognitive dissonance of thinking that a Labour government must be better for the NHS than the Tories simply because it’s a Labour government, it’s important to understand that none of this is new for what Labour has been for the last four decades with only some reprieve under the leadership of Jeremy Corbyn.

Phil Whitaker, writing in the New Statesman 10 years ago next month, described Tony Blair’s mass escalation of for-profit “competition” in the NHS as “an extraordinary spectacle of a Labour government adopting a policy direction not even the Tories had dared to explore,” one which Tory or Tory-led governments from 2010 onwards were eager to exploit and extend.

Starmer, who has been described as “Tony Blair, minus the optimism,” seems determined to differentiate himself only by taking Blairism — and the Thatcherism it embraced and Starmer has praised — further than either. In Streeting, he has an instrument who seems perfectly eager to help him carry out that aim.

So much for the Starmer government’s intent for the NHS, a kind of perverse homeopathy: more of what is killing it will supposedly cure it. In practical terms, Streeting’s immediate tactic — apart from appointing Kibasi to plan the implementation of Darzi’s report — seems to be a focus on the “downskilling” of NHS care through the massive expansion of the use of physician associates (PAs) in place of fully qualified doctors.

He even went as far, last week, as to attack the NHS for using “foreign” doctors — an attack that served both as a dog-whistle to the “racist voters” Labour seems determined to court, and as an opening to push for more use of British-trained “clinicians” who are not actually doctors, given the many years’ training required to become a doctor.

The Starmer government is committed to the expanded use of physician associates, who can have as little as two years’ training and do not have medical qualifications, despite the Department of Health and Social Care’s own analysis finding that their use poses “high risk” to patients in many settings and warning explicitly that wider use of PAs means greater danger. A Health Education England report on these dangers concluded that “[t]he proposed increase in the PA workforce will also mean an increase in the scale of the risk of harm.”

The General Medical Council (GMC), which has been heavily criticised for co-operating with the government in this expansion by agreeing to regulate PAs when previously it only regulated fully qualified doctors, has also slapped down attempts by fully qualified doctors to ensure that the way trusts use PAs should be mandated to ensure patient safety and access to fully qualified care.

When the Royal College of Anaesthetists (RCA), for example, told the GMC that the scope for NHS trusts’ scope for using associates needed to be more carefully controlled to keep patients safe, the GMC’s chief executive Charlie Massey criticised the RCA for being “insufficiently flexible” and said that any framework must allow “for an increase in scope over time” and that the RCA was “go[ing] beyond [its] remit” by “seeking to place requirements on employers.”

The use of PAs is part of the push by successive governments, under “integrated care,” to cut costs so that corporate providers can maximise profits, regardless of the consequences for patients and for the NHS workforce that serves them.

The foxes are not only in charge of the NHS chicken coop but have been deeply embedded in it for decades under both Labour and Tory governments. Those who care about our nation’s greatest achievement must realise that Streeting and Starmer and their plans for the NHS, whether in data, medical qualifications, the closure-plan dressed as ‘pushing care out of hospitals’ or anything else, are to be called out and resisted.

Claudia Webbe is the former member of Parliament for Leicester East (2019-24). You can follow her at www.facebook.com/claudiaforLE and twitter.com/ClaudiaWebbe.