to care, lord darzi does point to this_ care, lord darzi does point to this and — care, lord darzi does point to this and say that 30% of hospital beds are taken out by patients— hospital beds are taken out by patients who need social care instead _ patients who need social care instead. the government isn't choosing _ instead. the government isn't choosing this moment to about its plans— choosing this moment to about its plans to social care. it has — its plans to social care. it has not _ its plans to social care. it has not come up with its own plans— has not come up with its own plans to _ has not come up with its own plans to put it in place and i think— plans to put it in place and i think it _ plans to put it in place and i think it will need to be seen in tandem of any planned changes. in tandem of any planned changes-_ in tandem of any planned changes. in tandem of any planned chances, , . changes. just a reminder, we are waiting — changes. just a reminder, we are waiting to _ changes. just a reminder, we are waiting to hear— changes. just a reminder, we are waiting to hear from - changes. just a reminder, we are waiting to hear from the l are waiting to hear from the prime minister. keir starmer is speaking any moment now so we will cross live to that as soon as it happens. just quickly, as they were saying, we're not going to the details soon. i think this is really

interesting. he has not been asked to set out the cure of the treatment. we have got some expectation... he is also going set out that there is a choice. we know about the three shifts. we know about the three shifts. we know about the three shifts. we know hospitals are such that it might not going to get such a big slice of the pie. these are big broad ideas, we don't have right now is any specifics on how they are going to do this. they are saying nhs need to reform or die.

they feel particularly pertinent to the first session this morning. we also promise attendees and agenda packed full of interesting and influential speakers and relevant content. i think we have delivered on that this morning. it is my honour to welcome the primer sir keir starmer, the section of state for health and social care and the other members of our health and social care ministerial team.

it absently steps out the challenges we face. we know that services are stretched to breaking point, staff are struggling and people are losing faith that support will be there when they are needed. the survey showed the lowest levels are such of the nhs ever recorded. as i and colleagues visit different places and part of our health and care system, we know of... we can't go on as

we know of... we can't go on as we are, we need change. we need bold, decisive action, not only to prove our nhs but for the wider health and social care system. ourvision wider health and social care system. our vision at the kings fund is at the best possible health and care. we know from our work that there is a huge desire to make care... the focus for money and for such that comes with it from acute care, to our communities, much closer to people's homes.

lord darzi does not report recognises the broader more poor state of the public health. i spent time with the mental health teams talking about the increasing number of people seeking their help. they reflected on the social context through some of this poor quality housing and employment, cited by lord darzi in his report, you are likely to... find it harder to access nhs services. one half of operation out reminded us yesterday here at the conference that a quarter of ten and ii—year—olds are

obese. it is a stat that always shocks me. obese. it is a stat that always shocks me. we obese. it is a stat that always shocks me. we need obese. it is a stat that always shocks me. we need to obese. it is a stat that always shocks me. we need to pay attention to our public health and help us all to our public health and help us all to live healthier lives. it is also impossible to consider the health of the nhs without acknowledging the deep challenges in social care. which is long overdue reform. at the king's fund we publish social care 360 every year to require a update on our care system. the bottom line is more people are requesting care and fewer people are able to access it, putting huge pressure on families and people in difficult situations. we need change. i am so pleased that lord darzi's report talks extensively about valuing our nhs and social star. here at the king's fund we worked on culture and leadership with leaders. we are here

every day —— we hear about the moral crisis that they face. it is increasingly hard to do so. we want to equip our staff effectively to do theirjobs that to equip our staff effectively to do their jobs that they to equip our staff effectively to do theirjobs that they come into the health service to do. the final theme of our conference is hope. we have over the past day had some brilliant and hopeful stories of staff doing great things. for example, to better integrate care, wrap it around people and patients. or to innovate with new treatments and technologies up and down the country. we have also heard from patients and communities who have really made their voices heard to improve services. most vividly this week in the work we have published on health care response to the crane fell fire. today is a day to reflect on the challenges we face and the change we need. we are hopeful that change we need. we are hopeful that change is coming and that by working

in partnership we can deliver a better health care system for all of us. one that is there in our most difficult and mostjoyful human moments. with that, i am delighted to welcome the prime minister to the state. thank you. applause thank you. thank you, sarah, for that— thank you. thank you, sarah, for that introduction. a really powerful introduction. really thought provoking as well with some of those statistics _ provoking as well with some of those statistics. thank you all for being here _ statistics. thank you all for being here. probably, ishould statistics. thank you all for being here. probably, i should say, thank you for— here. probably, i should say, thank you for letting me gate—crash your conference! it was your conference, it is me _ conference! it was your conference, it is me that— conference! it was your conference, it is me that has come along. i hear you had _ it is me that has come along. i hear you had a _ it is me that has come along. i hear you had a really good day yesterday and i you had a really good day yesterday and i hope — you had a really good day yesterday and i hope today isjust as good as that _ and i hope today isjust as good as that as _ and i hope today isjust as good as that as you — and i hope today isjust as good as that. as you heard today, what to lord _ that. as you heard today, what to lord darzi's— that. as you heard today, what to lord darzi's has published, his independent report on the state of

our nhs _ independent report on the state of our nhs. it is an incredibly comprehensive analysis. some of you will have _ comprehensive analysis. some of you will have seen it, there are copies avaitabta — will have seen it, there are copies available. please read it. it is a raw and — available. please read it. it is a raw and honest assessment. that is what _ raw and honest assessment. that is what we _ raw and honest assessment. that is what we have asked for. that is why i what we have asked for. that is why i wanted _ what we have asked for. that is why i wanted to — what we have asked for. that is why i wanted to come here to the king's fund, _ i wanted to come here to the king's fund, home — i wanted to come here to the king's fund, home to many of our country's leading _ fund, home to many of our country's leading health experts. your contributions are going to be vital as we _ contributions are going to be vital as we get— contributions are going to be vital as we get this precious institution back on— as we get this precious institution back on its— as we get this precious institution back on its feet. and build an nhs which _ back on its feet. and build an nhs which is _ back on its feet. and build an nhs which is truly fit for the future. look, — which is truly fit for the future. look, i— which is truly fit for the future. look, iwas— which is truly fit for the future. look, i was starting point couldn't be further— look, i was starting point couldn't be further from that goal. public satisfaction in the nhs has fallen from _ satisfaction in the nhs has fallen from an— satisfaction in the nhs has fallen from an all—time high, when the last labout— from an all—time high, when the last labour government left office, to an alt-time _ labour government left office, to an all—time low today. think of the impact — all—time low today. think of the impact that has on the staff who on so much _ impact that has on the staff who on so much day in, day out. confidence is an— so much day in, day out. confidence is an alt-time — so much day in, day out. confidence is an all—time low. that is because,

as everybody— is an all—time low. that is because, as everybody in the country knows, the last _ as everybody in the country knows, the last government break the nhs. until this— the last government break the nhs. until this morning, we didn't know the futi— until this morning, we didn't know the full scale of the damage. which is laid _ the full scale of the damage. which is laid bare — the full scale of the damage. which is laid bare in the report. lord darzi. — is laid bare in the report. lord darzi. with— is laid bare in the report. lord darzi, with all his years of experience, is shocked by what is discovered — experience, is shocked by what is discovered. it is unforgivable. and people _ discovered. it is unforgivable. and people have every right to be angry. notiust_ people have every right to be angry. notjust because the nhs is so personal— notjust because the nhs is so personal to all of us, or because, when _ personal to all of us, or because, when people can't get the care they need, _ when people can't get the care they need. they— when people can't get the care they need, they are off where'd sick, with— need, they are off where'd sick, with a _ need, they are off where'd sick, with a huge cost to our economy... it is with a huge cost to our economy... it is because — with a huge cost to our economy... it is because some of these failings are, literally, life and death. take the waiting — are, literally, life and death. take the waiting times in a&e, more than 100,000 _ the waiting times in a&e, more than 100,000 infants waited more than six hours _ 100,000 infants waited more than six hours tast— 100,000 infants waited more than six hours last year. and nearly a tenth of all _ hours last year. and nearly a tenth of all patients are now waiting for 12 hours— of all patients are now waiting for 12 hours or— of all patients are now waiting for 12 hours or more. that is notjust a source _

12 hours or more. that is notjust a source of— 12 hours or more. that is notjust a source of fear and anxiety, it is leading to _ source of fear and anxiety, it is leading to thousands of avoidable deaths _ leading to thousands of avoidable deaths. that phrase, avoidable deaths. — deaths. that phrase, avoidable deaths, should always be chilling. that is _ deaths, should always be chilling. that is peoples loved ones. who could _ that is peoples loved ones. who could have — that is peoples loved ones. who could have been saved. doctors and nurses, _ could have been saved. doctors and nurses, whose whole vocation is to save _ nurses, whose whole vocation is to save thenr, — nurses, whose whole vocation is to save them, haven't been able to do so. save them, haven't been able to do so it— save them, haven't been able to do so it is— save them, haven't been able to do so. it is devastating, heartbreaking, infuriating. that is 'ust heartbreaking, infuriating. that is just scratching the surface. high risk of— just scratching the surface. high risk of heart attack patients waited too tong _ risk of heart attack patients waited too long for urgent treatment. cancer— too long for urgent treatment. cancer diagnosis, waiting too long. the cancer— cancer diagnosis, waiting too long. the cancer death rate higher than in other— the cancer death rate higher than in other countries. and when it comes to getting _ other countries. and when it comes to getting health for mental —— help for mentai— to getting health for mental —— help for mental health, 345,000 are waiting — for mental health, 345,000 are waiting over a year. that is roughly the entire — waiting over a year. that is roughly the entire population of leicester. look, _ the entire population of leicester. look, here — the entire population of leicester. look, here is the crucial point. the tories _ look, here is the crucial point. the

tories would — look, here is the crucial point. the tories would have you believe that all of _ tories would have you believe that all of this— tories would have you believe that all of this is because of a once in all of this is because of a once in a generation pandemic. but today's report— a generation pandemic. but today's report clearly shows that this is 'ust report clearly shows that this is just not— report clearly shows that this is just not true. covid hit our nhs harder— just not true. covid hit our nhs harder than health care systems in other— harder than health care systems in other countries. the nhs delayed, cancetted — other countries. the nhs delayed, cancelled or postponed far more routine — cancelled or postponed far more routine care during the pandemic than _ routine care during the pandemic than any— routine care during the pandemic than any comparable health system. why? _ than any comparable health system. why? because our nhs went into the pandemic— why? because our nhs went into the pandemic in a much more fragile state~ _ pandemic in a much more fragile state. fewer doctors, fewer nurses, fewer— state. fewer doctors, fewer nurses, fewer beds — state. fewer doctors, fewer nurses, fewer beds. than most other high income _ fewer beds. than most other high income health systems. and let's be realty— income health systems. and let's be really clear _ income health systems. and let's be really clear about what caused that. but i ideologically driven, top—down, organisation of 2012. from the former— top—down, organisation of 2012. from the former health secretary, andrew lanstey. _ the former health secretary, andrew lansley, hopelessly... cost a fortune. _ lansley, hopelessly... cost a fortune, and then all had to be

reversed _ fortune, and then all had to be reversed. lord darzi describes it as a calamity— reversed. lord darzi describes it as a calamity without international precedent. a scorched earth approach to health _ precedent. a scorched earth approach to health reform, the effects of which _ to health reform, the effects of which are — to health reform, the effects of which are still being felt today. and at— which are still being felt today. and at the same time, they inflicted what the _ and at the same time, they inflicted what the report describes as the most _ what the report describes as the most austere decade in which the nhs was founded. crumbling buildings, decrepit— was founded. crumbling buildings, decrepit portakabins, mental health patients— decrepit portakabins, mental health patients in victoria era cell is infested _ patients in victoria era cell is infested with vermin. when we say they break— infested with vermin. when we say they break the nhs, that is not performative, just look at it. a lost _ performative, just look at it. a lost decade for our nhs, in which the conservatives left it unable to be there — the conservatives left it unable to be there for patients today and totally — be there for patients today and totally unprepared for the challenges and opportunities of tomorrow. it is notjust the state of our— tomorrow. it is notjust the state of our national health service in crisis _ of our national health service in crisis it— of our national health service in crisis it is— of our national health service in crisis. it is also the state of our national— crisis. it is also the state of our

national health. we are becoming a sick society. spending more of our lives _ sick society. spending more of our lives in _ sick society. spending more of our lives in our— sick society. spending more of our lives in our house than ten years ago _ lives in our house than ten years ago -- — lives in our house than ten years ago -- more— lives in our house than ten years ago. —— more of our lives in ill health — ago. —— more of our lives in ill health. inactive because of long—term sickness. as today's report — long—term sickness. as today's report makes clear, the nhs is not contributing to national prosperity as it could. getting people back to health— as it could. getting people back to health and — as it could. getting people back to health and work, would not only reduce _ health and work, would not only reduce tb— health and work, would not only reduce tb costs —— the costs on the nhs, _ reduce tb costs —— the costs on the nhs, it— reduce tb costs —— the costs on the nhs, it would help fund public services — nhs, it would help fund public services. lord darzi, says fewer children— services. lord darzi, says fewer children are getting vaccinated, white _ children are getting vaccinated, while those from the most deprived backgrounds are twice as likely to be obese — backgrounds are twice as likely to be obese by reception age. twice as likely _ be obese by reception age. twice as likely. much of this is a direct

result— likely. much of this is a direct result of— likely. much of this is a direct result of white in socialjustices, poor— result of white in socialjustices, poor quality housing, lower incomes. all of— poor quality housing, lower incomes. all of it. _ poor quality housing, lower incomes. all of it. not — poor quality housing, lower incomes. all of it, notjust damaging the health— all of it, notjust damaging the health of— all of it, notjust damaging the health of our nation, it is piling up health of our nation, it is piling up the — health of our nation, it is piling up the pressure is on our nhs. so that is— up the pressure is on our nhs. so that is the — up the pressure is on our nhs. so that is the report. look, i haven't come here — that is the report. look, i haven't come here just to set out this in potting — come here just to set out this in potting -- — come here just to set out this in polling —— appalling inheritance. it is important we know and understand it in detait~ _ is important we know and understand it in detail. my government was elected — it in detail. my government was elected on a mandate for change. i am also _ elected on a mandate for change. i am also here to talk about how together— am also here to talk about how together we can fix it. i feel very profoundly— together we can fix it. i feel very profoundly a responsibility for this — profoundly a responsibility for this the _ profoundly a responsibility for this. the nhs may be broken but it is not _ this. the nhs may be broken but it is not beaten. the report says the nhs may— is not beaten. the report says the nhs may be in a critical condition but its _ nhs may be in a critical condition but its vital — nhs may be in a critical condition but its vital signs are strong. and we need — but its vital signs are strong. and we need to— but its vital signs are strong. and we need to have the courage to

deliver— we need to have the courage to deliver long—term reform. major surgery. — deliver long—term reform. major surgery, not sticking plasters. we have _ surgery, not sticking plasters. we have got— surgery, not sticking plasters. we have got to face up to the challenges. look at our asian society~ — challenges. look at our asian society. the higher burden of disease _ society. the higher burden of disease. the nhs is at a fork in the road _ disease. the nhs is at a fork in the road we _ disease. the nhs is at a fork in the road. we have a choice. we have a choice _ road. we have a choice. we have a choice about — road. we have a choice. we have a choice about how it should meet those _ choice about how it should meet those demands. don't act and leave it to die? _ those demands. don't act and leave it to die? raise taxes on working people? — it to die? raise taxes on working people? 0r— it to die? raise taxes on working people? 0r reform to secure its future? — people? 0r reform to secure its future? working people can't afford to pay— future? working people can't afford to pay more. so it is reform or die. let me _ to pay more. so it is reform or die. let me be — to pay more. so it is reform or die. let me be clear from the outset, what _ let me be clear from the outset, what reform does not do. first, it does _ what reform does not do. first, it does not — what reform does not do. first, it does not mean abandoning those ideas of a public— does not mean abandoning those ideas of a public service, publicly funded, _ of a public service, publicly funded, free at the point of use. the basic— funded, free at the point of use. the basic principle of dignity.

inspired _ the basic principle of dignity. inspired by bevan, that when you fall inspired by bevan, that when you fail itt, _ inspired by bevan, that when you fail itt, you — inspired by bevan, that when you fall ill, you should never have to worry— fall ill, you should never have to worry about the bill. that is as true _ worry about the bill. that is as true today— worry about the bill. that is as true today as when the nhs was founded — true today as when the nhs was founded 76 years ago. i believe in that very— founded 76 years ago. i believe in that very deeply. some of you will know, _ that very deeply. some of you will know. my— that very deeply. some of you will know, my mum and my sister both worked _ know, my mum and my sister both worked in — know, my mum and my sister both worked in the nhs. my wife works in the nhs _ worked in the nhs. my wife works in the nhs. and the nhs cared for my mum _ the nhs. and the nhs cared for my mum throughout what was a very long ittness _ mum throughout what was a very long illness the _ mum throughout what was a very long illness. the nhs runs through my family— illness. the nhs runs through my family tike — illness. the nhs runs through my family like a stick of rock. you know. — family like a stick of rock. you know. this _ family like a stick of rock. you know, this isn'tjust about emotion. it is know, this isn'tjust about emotion. it is about— know, this isn'tjust about emotion. it is about hard facts as well. the nhs is _ it is about hard facts as well. the nhs is uniquely placed for the opportunities of big data and predictive and preventative... the problem _ predictive and preventative... the problem isn't that the nhs is the wrong _ problem isn't that the nhs is the wrong model, it is the right model,

it isiust _ wrong model, it is the right model, it isiust not — wrong model, it is the right model, it isjust not taking advantage of the opportunities in front of it. and that — the opportunities in front of it. and that is what we need to change. second. _ and that is what we need to change. second, reform does not meanjust putting _ second, reform does not meanjust putting more money in. of course, even _ putting more money in. of course, even in _ putting more money in. of course, even in difficult financial circumstances a labour government will always — circumstances a labour government will always make the investment in our nhs _ will always make the investment in our nhs that is needed. always. but we have _ our nhs that is needed. always. but we have to _ our nhs that is needed. always. but we have to fix the plumbing before turning _ we have to fix the plumbing before turning on— we have to fix the plumbing before turning on the taps. hear me when i say this, _ turning on the taps. hear me when i say this, no— turning on the taps. hear me when i say this, no more money without reform~ — say this, no more money without reform~ i— say this, no more money without reform~ i am _ say this, no more money without reform. iam not say this, no more money without reform. i am not prepared to see even _ reform. i am not prepared to see even more — reform. i am not prepared to see even more of your money spent on agency— even more of your money spent on agency staff who cost £5,000 a shift _ agency staff who cost £5,000 a shift 0n— agency staff who cost £5,000 a shift. 0n appointment letters which arrive _ shift. 0n appointment letters which arrive after— shift. 0n appointment letters which arrive after the appointment. 0r on paying _ arrive after the appointment. 0r on paying for— arrive after the appointment. 0r on paying for people to be stuck in hospital— paying for people to be stuck in hospitaljust because they cannot -et hospitaljust because they cannot get the _ hospitaljust because they cannot get the care they need in the community. tonight there will be

12.000 _ community. tonight there will be 12,000 patients in that very position~ _ 12,000 patients in that very position. that is enough to fill 28 hospitals — position. that is enough to fill 28 hospitals. we cannot go on like this _ hospitals. we cannot go on like this as — hospitals. we cannot go on like this. as lord darzi said, nhs staff are working harder than ever but productivity has fallen. because patients— productivity has fallen. because patients cannot be discharged. clinicians — patients cannot be discharged. clinicians are spending time trying to find _ clinicians are spending time trying to find beds rather than treating more _ to find beds rather than treating more patients. that is notjust sotved — more patients. that is notjust solved by— more patients. that is notjust solved by more money, it is solved by reform~ — solved by more money, it is solved by reform. third. reform does not mean _ by reform. third. reform does not mean trying — by reform. third. reform does not mean trying to fix everything from whitehall. it really doesn't. lord darzi _ whitehall. it really doesn't. lord darzi says— whitehall. it really doesn't. lord darzi says there are vital signs of the nhs — darzi says there are vital signs of the nhs and they are strong, he is talking _ the nhs and they are strong, he is talking about the talents and passions of our nhs workforce. he is talking _ passions of our nhs workforce. he is talking about the breadth and depth of clinical— talking about the breadth and depth of clinical talent. the extraordinary passion and care of our nhs — extraordinary passion and care of our nhs staff. if we are going to build _ our nhs staff. if we are going to build an— our nhs staff. if we are going to build an nhs fit for the future, i

tell you. — build an nhs fit for the future, i tell you, we are going to do it with our nhs _ tell you, we are going to do it with our nhs staff. and with our patients as wett _ our nhs staff. and with our patients as wett we — our nhs staff. and with our patients as well. we are going to change it together — as well. we are going to change it together. that starts with the first steps _ together. that starts with the first steps for — together. that starts with the first steps for 40,000 extra appointments every week. but we have also got to do the _ every week. but we have also got to do the hard — every week. but we have also got to do the hard yards of long—term reform~ — do the hard yards of long—term reform. this government is working at pace _ reform. this government is working at pace to— reform. this government is working at pace to build a ten year plan. something so different from anything that has— something so different from anything that has gone before. this plan will be framed — that has gone before. this plan will be framed around three big shifts. three _ be framed around three big shifts. three fundamental reforms. which are rooted _ three fundamental reforms. which are rooted in _ three fundamental reforms. which are rooted in what lord darzi has set out today — rooted in what lord darzi has set out today. first, moving from an analog _ out today. first, moving from an analog to — out today. first, moving from an analog to a — out today. first, moving from an analog to a digital nhs. we can already— analog to a digital nhs. we can already see glimpses of the extraordinary potential for technology. like the world's first

ever noninvasive knife less surgery for kidney— ever noninvasive knife less surgery for kidney transplant. imagine that, pioneered _ for kidney transplant. imagine that, pioneered by leeds teaching hospitals. precision cancer scanners _ hospitals. precision cancer scanners. i saw some of them yesterday~ _ scanners. i saw some of them yesterday. 0r scanners. i saw some of them yesterday. or simply transforming how we _ yesterday. or simply transforming how we manage a condition. we went to kings— how we manage a condition. we went to kings mill hospital earlier this year and — to kings mill hospital earlier this year and bet a 12—year—old girl called — year and bet a 12—year—old girl called molly. she is using her smartphone to monitor her glucose levels _ smartphone to monitor her glucose levels. instead of being forced to repeatedly prick her fingers. it made — repeatedly prick her fingers. it made such a difference to her daily life. made such a difference to her daily life it _ made such a difference to her daily life it gave — made such a difference to her daily life. it gave great reassurance to her mum — life. it gave great reassurance to her mum who could remotely check on the settings _ her mum who could remotely check on the settings and the findings. we have got— the settings and the findings. we have got to make these opportunities available _ have got to make these opportunities available to everyone. we have got to use _ available to everyone. we have got to use technology to empower patients — to use technology to empower patients and give them much greater control— patients and give them much greater control over their health care. take an innovation like the nhs app. this could _ an innovation like the nhs app. this could be _ an innovation like the nhs app. this could be a _ an innovation like the nhs app. this could be a whole digital front door

to the _ could be a whole digital front door to the nhs. appointments, self referrat. — to the nhs. appointments, self referral, reminders for checkups and screenings — referral, reminders for checkups and screenings. patients in control of their— screenings. patients in control of their own — screenings. patients in control of their own data. health care so much more _ their own data. health care so much more transparent. so you will always know _ more transparent. so you will always know your _ more transparent. so you will always know your options and the standards that she _ know your options and the standards that she should expect. you know, earlier— that she should expect. you know, earlier this — that she should expect. you know, earlier this year i went to... hospitat _ earlier this year i went to... hospital. a fantastic hospital where they carry— hospital. a fantastic hospital where they carry out heart surgery on infants — they carry out heart surgery on infants. really humbling to see. i met the _ infants. really humbling to see. i met the parents of a two—year—old of that -- _ met the parents of a two—year—old of that -- who — met the parents of a two—year—old of that —— who had had complicated heart _ that —— who had had complicated heart surgery. tiny infants. incredible surgery. i asked the parents — incredible surgery. i asked the parents about their child's history and conditions. what was the story about— and conditions. what was the story about it. _ and conditions. what was the story about it, the history. as they told me, about it, the history. as they told me. i_ about it, the history. as they told me. icoutd — about it, the history. as they told me, i could see them welling up as they went — me, i could see them welling up as they went through the history, the conditions. — they went through the history, the conditions, all of that. and then they— conditions, all of that. and then they told — conditions, all of that. and then they told me that every time they

went to _ they told me that every time they went to a — they told me that every time they went to a different hospital, they had to— went to a different hospital, they had to go— went to a different hospital, they had to go through all of that over and over— had to go through all of that over and overagain. had to go through all of that over and over again. they really struggle to tell— and over again. they really struggle to tell the _ and over again. they really struggle to tell the story and they had to do it every— to tell the story and they had to do it every single time. because the records _ it every single time. because the records weren't held electronically. so we _ records weren't held electronically. so we have — records weren't held electronically. so we have got to have fully digitatty— so we have got to have fully digitally available record so that cruciat _ digitally available record so that crucial information is there for you when _ crucial information is there for you when you — crucial information is there for you when you go to the nhs. while i am on technology, we are going to throw the futi— on technology, we are going to throw the full weight of the british government behind our world leading life sciences. second, sarah mentioned this, we have got to shift more _ mentioned this, we have got to shift more care _ mentioned this, we have got to shift more care from hospitals to communities. the king's fund has lon- communities. the king's fund has tong catted — communities. the king's fund has long called for this. successive governments have repeatedly promised it. governments have repeatedly promised it but _ governments have repeatedly promised it. but what has happened? the opposite — it. but what has happened? the opposite. the share of the nhs budget— opposite. the share of the nhs budget spent on hospitals has actually— budget spent on hospitals has actually increased. this ten year plan _ actually increased. this ten year plan has — actually increased. this ten year plan has to— actually increased. this ten year plan has to be the moment that we change _ plan has to be the moment that we change that. the moment we begin to

turn our— change that. the moment we begin to turn our national health service into a _ turn our national health service into a neighbourhood health service. that means — into a neighbourhood health service. that means more tests, scans, health to be much bolder in moving from sickness to more itioi�*i. to be much bolder in moving from care offered _ sickness to more tests, health that means more tests, scans, health care offered _ that means more tests, scans, health care offered on high streets and that means more tests, scans, health care offered on high streets and town— care offered on high streets and town— care offered on high streets and town centres. improve gp access, town centres. improve gp access, bring — bring — town centres. improve gp access, bring back— town centres. improve gp access, bring back the family doctor, offer town centres. improve gp access, bring back— town centres. improve gp access, bring back the family doctor, offer digital— bring back the family doctor, offer digital consultations for those that digital— bring back the family doctor, offer digital consultations for those that want them. virtual wards, want them. virtual wards, digital consultations for those that digital consultations for those that want them. virtualwards, and more want them. virtualwards, and more patients— want them. virtualwards, and more patients safely looked after in patients— want them. virtualwards, and more patients safely looked after in their— patients safely looked after in their own homes, where we can deal their— patients safely looked after in their own homes, where we can deal with problems early, before people with problems early, before people are off _ with problems early, before people are off work sick, and before they are off _ with problems early, before people are off work sick, and before they need _ are off work sick, and before they need _ are off work sick, and before they need to— are off work sick, and before they need to go— are off work sick, and before they need to go to hospital. we have to need to— are off work sick, and before they need to go— are off work sick, and before they need to go to hospital. we have to sickness to prevention. make _ need to go to hospital. we have to make good — make _ need to go to hospital. we have to make good — need to go to hospital. we have to make good of the integration of need to go to hospital. we have to make good of the integration of health— make good of the integration of health and social care. so we can health— make good of the integration of health and social care. so we can discharge — health and social care. so we can discharge those 26 hospital worth of discharge — health and social care. so we can discharge those 26 hospital worth of patient _ discharge those 26 hospital worth of patient saving money, reducing the patient _ discharge those 26 hospital worth of patient saving money, reducing the strain— strain— patient saving money, reducing the strain on— patient saving money, reducing the strain on our nhs and giving people patient saving money, reducing the strain on— patient saving money, reducing the strain on our nhs and giving people better— strain on our nhs and giving people better— strain on our nhs and giving people better treatment. and third, in better treatment. and third, in terms — better treatment. and third, in terms of— better treatment. and third, in terms — better treatment. and third, in terms of— better treatment. and third, in terms of their shifts, we have got terms of their shifts, we have got to be _ terms of their shifts, we have got to be much— terms of their shifts, we have got to be much bolder in moving from to be _ terms of their shifts, we have got to be much— terms of their shifts, we have got to be much bolder in moving from sickness _ to be much bolder in moving from sickness _ to be much bolder in moving from sickness to— to be much bolder in moving from sickness to— to be much bolder in moving from

sickness to prevention. we have already— sickness to prevention. we have already announced nhs health checks in workplaces, blood pressure checks at dentists _ in workplaces, blood pressure checks at dentists and opticians,

politicians say they are shocked too often, _ politicians say they are shocked too often, but — politicians say they are shocked too often, but i — politicians say they are shocked too often, but i was really shocked. the single _ often, but i was really shocked. the single biggest cause of six to ten—year—olds, owing to hospital, having _ ten—year—olds, owing to hospital, having your — ten—year—olds, owing to hospital, having your teeth taken out? can you think of— having your teeth taken out? can you think of anything more soul destroying? that brilliant nhs team who want _ destroying? that brilliant nhs team who want to use their talents to save _ who want to use their talents to save lives, _ who want to use their talents to save lives, spending their time taking — save lives, spending their time taking out— save lives, spending their time taking out rotting teeth. something that could so easily have been prevented. i know some prevention measures— prevented. i know some prevention measures will be controversial, but i am prepared to be bold even in the place _ i am prepared to be bold even in the place of— i am prepared to be bold even in the place of loud opposition. some of our changes won't be universally poputar. — our changes won't be universally popular, we know that. but i will do the right— popular, we know that. but i will do the right thing for our nhs, our economy— the right thing for our nhs, our economy and our children. the task before _ economy and our children. the task before us— economy and our children. the task before us is— economy and our children. the task before us is the work of our generation. we have already hit the ground _ generation. we have already hit the ground running. negotiating an end

to the _ ground running. negotiating an end to the strikes which the tories refused — to the strikes which the tories refused to do. these strikes were costing _ refused to do. these strikes were costing us— refused to do. these strikes were costing us a — refused to do. these strikes were costing us a fortune. we inherited 1000 _ costing us a fortune. we inherited 1000 trainee gps who were set to graduate — 1000 trainee gps who were set to graduate into unemployment. instead, we have _ graduate into unemployment. instead, we have hired them. but only fundamental reform and a plan for the tong _ fundamental reform and a plan for the long term can turn around the nhs and — the long term can turn around the nhs and build a healthy society. it won't _ nhs and build a healthy society. it won't be _ nhs and build a healthy society. it won't be quick, it will take a ten year— won't be quick, it will take a ten year plan, — won't be quick, it will take a ten year plan, notjust won't be quick, it will take a ten year plan, not just the work of one partiament — year plan, not just the work of one parliament. but i know we can do it. because _ parliament. but i know we can do it. because we — parliament. but i know we can do it. because we have done reform before. the tast— because we have done reform before. the last labour government reform to the nhs _ the last labour government reform to the nhs to— the last labour government reform to the nhs to deliver better outcomes for patients, better value for taxpayers. conservative governments undid _ taxpayers. conservative governments undid that — taxpayers. conservative governments undid that good work. this only goes to prove. _ undid that good work. this only goes to prove, once again, that only a labour— to prove, once again, that only a labour government can reform the nhs _ labour government can reform the nhs my— labour government can reform the nhs. my labour government has a huge mandate _ nhs. my labour government has a huge mandate for— nhs. my labour government has a huge

mandate for change. we are mission driven~ _ mandate for change. we are mission driven~ i_ mandate for change. we are mission driven. i think the themes of this conference — driven. i think the themes of this conference today are fitting for this moment. challenge, change and hope _ this moment. challenge, change and hope. because the challenge is clear before _ hope. because the challenge is clear before us _ hope. because the challenge is clear before us. the change could amount to the _ before us. the change could amount to the biggest reimagining of the nhs since its birth. and the hope, well, _ nhs since its birth. and the hope, welt, that— nhs since its birth. and the hope, well, that is what is really exciting _ well, that is what is really exciting and galvanising about this moment — exciting and galvanising about this moment. if we get this right, people can took— moment. if we get this right, people can look back and say, this was the generation— can look back and say, this was the generation that took the nhs from the worst— generation that took the nhs from the worst crisis in its history, got it back— the worst crisis in its history, got it back on — the worst crisis in its history, got it back on its _ the worst crisis in its history, got it back on its feet, and made it fit for the _ it back on its feet, and made it fit for the future. thank you very much for the future. thank you very much for listening — for listening. applause

thank you very much. i applause thank ouve much. . ., ., thank you very much. i am going to take a number— thank you very much. i am going to take a number of media _ thank you very much. i am going to take a number of media questions, | thank you very much. i am going to i take a number of media questions, so bear with— take a number of media questions, so bear with me — take a number of media questions, so bearwith me. i take a number of media questions, so bear with me. i have got bbc first. thank— bear with me. i have got bbc first. thank you — bear with me. i have got bbc first. thank you. you talk about shifting resources into community health care, improving technology and prevention of ill health. these ideas have been talked about for some time. some progress has been made. what is new and different about your ideas? brute made. what is new and different about your ideas?— made. what is new and different about your ideas? we have a raw and honest assessment _ about your ideas? we have a raw and honest assessment of _ about your ideas? we have a raw and honest assessment of where - about your ideas? we have a raw and | honest assessment of where we really are. honest assessment of where we really are we _ honest assessment of where we really are we are _ honest assessment of where we really are. we are clear eyed about this meaning — are. we are clear eyed about this meaning. we need a ten year plan not a short-term — meaning. we need a ten year plan not a short—term set of decisions and we have the _ a short—term set of decisions and we have the mandate for change to carry this through. what has happened in the past _ this through. what has happened in the past is — this through. what has happened in the past is that we talk about change. _ the past is that we talk about change, sometimes step towards change _ change, sometimes step towards change and then back again. but not what i _ change and then back again. but not what i would talk about mission driven, — what i would talk about mission driven, this driving sense of purpose _ driven, this driving sense of purpose to get the nhs not just

driven, this driving sense of purpose to get the nhs notjust on its feet— purpose to get the nhs notjust on its feet but fit for the future. what — its feet but fit for the future. what drives that is this sense of the future _ what drives that is this sense of the future. in the labour party, we look the future. in the labour party, we took back— the future. in the labour party, we took back so— the future. in the labour party, we look back so proudly at what we did 76 years _ look back so proudly at what we did 76 years ago. i want people in generations to look back so proudly at what _ generations to look back so proudly at what this labour government 2024 did. at what this labour government 2024 did it _ at what this labour government 2024 did it is _ at what this labour government 2024 did. it is that determination, drive, — did. it is that determination, drive, my— did. it is that determination, drive, my personal ambition and wes streeting's _ drive, my personal ambition and wes streeting's decision. lord darzi's conclusion is that there is no quick fix of the nhs. it is going to cost time and money that is going to cost time and money that is money you don't have and it is time, sick and suffering patients can't afford. if you were to speak to one single patient who has been suffering in agony for so long, what would you say to him or her about you are going to fix the nhs and make them better in the short term?

i am going to say we