Make or break? First concrete move to reshape health service

Since Labour won power last July, Keir Starmer has repeatedly affirmed his deep affection for the NHS, close family ties to it, and his determination to reform it.

- Denis Campbell

Since Labour won power last July, Keir Starmer has repeatedly affirmed his deep affection for the NHS, close family ties to it, and his determination to reform it. In a speech last September, he said the health service in England was in such dire straits that it must "reform or die", and his government's plans to overhaul how it worked "could amount to the biggest reimagining of our NHS since its birth" in 1948.

Wes Streeting, his health secretary, echoed that same message in his address to Labour's party conference two weeks later. The choice facing the country's most vital service was "reform or die - we choose reform", he said.

Beyond that bold rhetoric, however, Starmer and Streeting have, until now, given little in the way of concrete detail about exactly what that reform will entail. The detail will be set out in a 10-year health plan, due in late May, which is being drawn up by Streeting and a coterie of advisers.

It will put flesh on the bones of the "three big shifts" in how healthcare is provided that both have promised: from analogue to digital, from hospital care to care based in the community and from treating people's illness to preventing them from getting sick in the first place.