No social insurance model for NHS under Labour reforms, Starmer indicates


abour would not move to a social insurance model as part of sweeping changes it is proposing for the health service, the party’s leader has indicated.

Sir Keir Starmer said he had commissioned his shadow cabinet to come up with long-term reforms to improve NHS standards, childcare provision and help get over-50s back into work as part of a blueprint for government.

In an article for The Sunday Telegraph, the Opposition leader backed changes proposed by shadow health secretary Wes Streeting, including bringing GPs on to the NHS payroll.

But Sir Keir said those changes would not reach as far as bringing in a social insurance model, as seen in other European nations.

I think if we don’t reform the health service, we will be in managed decline

In classic social insurance models, members – usually employees – contribute a proportion of their salary to a fund to help pay for their healthcare.

The funding is often matched by employers.

Sir Keir appeared to rule out switching from the current NHS funding model, which is fed financially via national insurance contributions, to a social insurance system when interviewed on the BBC’s Sunday With Laura Kuenssberg programme.

Asked whether Labour would look at such a model, he said: “Look, free at the point of use is the founding principle of the NHS and it is absolutely fundamental for me.”

The former civil servant said his party wanted to “look at all sorts of reform” for the NHS.

“The reason I want to reform the health service is I want to preserve it,” he told the BBC.

“I think if we don’t reform the health service, we will be in managed decline.

“The health service is in the worst position it has been in its entire history under the Tories.”

Prime Minister Rishi Sunak admitted in the Commons last week that, while he was registered with an NHS GP, he had paid for private healthcare in the past.

Sir Keir denied ever doing the same.

Separately, shadow Northern Ireland secretary Peter Kyle accused the Tories of turning the NHS into a “parasite” by failing to train homegrown doctors.

He told Sky News’ Sophy Ridge On Sunday programme the NHS was “not the envy of the world” and had a troubled global reputation because it was “now recruiting more doctors from abroad than we are actually producing through training back home”.

“That means that the Government has turned our NHS and our country into a parasite,” said Mr Kyle.

In his article for The Sunday Telegraph, Sir Keir outlined a series of reforms that a future Labour government would embark upon.

They included getting rid of “bureaucratic nonsense” to allow patients to bypass GPs and self-refer themselves to specialists.

He also backed gradually “phasing in a new system” for GPs, turning family doctors into direct NHS employees.

The current model sees self-employed GPs run their own practices under contracts awarded by the NHS.

But the Opposition leader said it was time to accept that the system needed overhauling, with the pressure on GP surgeries causing more people to resort to attending hospital instead.

The pledges have echoes of New Labour’s 1997 promises, when Sir Tony Blair swept into power on the back of a manifesto vowing to slash NHS waiting times and make the service more patient-focused.

Labour’s proposals come against a backdrop of winter pressures on the NHS and industrial action by nurses and ambulance workers.

Last week, figures showed the proportion of patients seen within four hours in England’s A&Es fell to a record low of 65% in December.

Meanwhile, shadow education secretary Bridget Phillipson said Labour wanted to reform childcare to offer much wider support for parents and families.

Speaking to The Sunday Times, she said Westminster needed to “completely rethink how we deliver childcare”.

She told the newspaper she was inspired by a trip last year to Estonia, where a place at nursery is guaranteed by law and childcare provision does not end until a pupil finishes primary school.

Mrs Phillipson said Labour wanted to “move towards a modern system that runs from the end of parental leave right through to the end of primary school”.

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