Policy commitments and actions are needed urgently
A policy statement from Keep Our NHS Public By Co Chairs Tony O’Sullivan and John Puntis
A new Labour leadership has an opportunity to reset the public conversation on the NHS and care.
The NHS should not be presented as broken beyond repair. It has been seriously damaged by underinvestment, fragmentation, workforce pressure and loss of capacity, but it can recover if there is a clear commitment to public service values, staff, safety and long-term investment.
At present, the public debate is too narrow. There is overemphasis on headline waiting list figures, technology, AI and private sector partnership, while the public continue to experience serious problems in urgent and emergency care, GP access, dentistry, mental health, maternity services and social care. Staff morale has been damaged, public confidence has weakened and many people do not yet feel that services are improving in their day-to-day lives.
A new leadership can do better by offering a confident public service renewal agenda: rebuild trust, back staff, restore capacity and ethical standards, and make visible progress on social care before the next General Election.
1. Recommit to the NHS as a publicly funded, publicly provided and publicly accountable service
Context
Labour’s historic relationship with the NHS remains a major political strength, but it cannot be taken for granted. Public disappointment and staff demoralisation have grown because many people do not yet see significant improvement in the services they rely on.
The NHS model itself remains one of Labour’s strongest assets. The problem is not that the NHS is beyond repair, but that it has been damaged by underinvestment, fragmentation, outsourcing and pressure on staff. A new leadership should make clear that recovery will be rooted in public provision, public accountability and rebuilding the NHS team.
Policy position
Recognise that to reduce the demand on health services requires the social determinants of health to be addressed. Make a clear public commitment to the NHS as a universal, publicly funded, publicly provided and publicly accountable service.
This should include public thanks to NHS staff – including outsourced staff who are part of the wider NHS team – and a commitment to rebuild capacity, reduce reliance on agency staffing and bring services and staff back into the NHS.
Benefit
This would reassure patients and staff that NHS recovery will not mean managed decline, further fragmentation or a further shift away from public provision. It would give NHS staff a visible signal of respect and help rebuild confidence from within.
2. Treat public services as national investment, not a drain on public finances
Context
The current debate too often presents public services as a cost pressure rather than a foundation of national prosperity. This weakens the case for the long-term investment needed to restore NHS, care and education services.
A functioning health service is essential economic infrastructure. When people cannot access timely care, more people are pushed out of work, families and carers are placed under pressure, and employers lose skills, experience and productivity. If health services fail, the economy feels the consequences.
Policy position
Frame investment in the NHS, education and care as investment in the country’s health, productivity, skills and economic resilience.
A new leadership should make the case that government investment in public assets, including NHS buildings and health infrastructure, is different from day-to-day spending and can create long-term public value.
Benefit
This would shift the debate from short-term cost control to national renewal. It would allow a leadership candidate to argue for investment from a position of economic competence, not simply moral urgency.
3. Address urgent and emergency care as a national safety priority
Context
Waiting lists matter, but they are not the whole story. The most acute visible crisis is in urgent and emergency care, where corridor care, delayed admission and unsafe waits are causing large-scale avoidable deaths, harm and undermining public confidence.
This crisis reflects wider system failure: too few beds, delayed discharge, insufficient social care, staff shortages and years of lost capacity. It is also linked to pressure in other parts of the system, including general practice, dentistry, maternity, mental health and community care.
Policy position
Recognise corridor care, delayed admission, avoidable mortality and harm, and unsafe waits as a national safety priority requiring system-wide action.
This should include investment in NHS capacity, more staffed beds where needed, better discharge support, stronger social care provision, improved access to general practice and technology that supports staff rather than replacing them.
Benefit
This would show that a new leadership is focused on patient safety, dignity and lived experience, not only headline performance targets. It would also give the public and staff confidence that the scale of harm is being recognised and addressed.
4. Set a new ethical standard for public contracts and private sector involvement
Context
Public trust has been weakened by repeated concerns about outsourcing, private finance, procurement, data contracts and revolving-door relationships between private interests and government.
The issue is not simply whether the private sector is ever involved. The issue is whether public money, NHS capacity, staff, services and data are governed in the public interest. Poor-value contracts, profit extraction from NHS-funded services and opaque decision-making all risk further undermining trust.
Policy position
Commit to transparent, ethical and evidence-based public contracting, with clear tests for value for money, public accountability, data ethics, workforce standards and conflicts of interest.
A new leadership should also commit to reviewing outsourced services and private contracts against public interest tests, especially where contracts undermine NHS capacity or fail to deliver value.
Benefit
This would create clear distance from past (and recent) failures and show that public money, NHS data and public services will be protected by higher ethical standards. It would help rebuild public trust by showing that the public interest comes before private influence or profit extraction.
5. Commit to visible progress on social care before the next General Election
Context
Social care reform has been promised for more than a generation. The public has heard repeated commitments, but too little visible change. The result is human distress, pressure on unpaid carers, avoidable loss of independence and serious consequences for the NHS.
Without reliable social care, people stay in hospital when they no longer need to be there, families are forced to fill gaps in care, and urgent and emergency services face avoidable pressure. Social care must not be seen as a separate issue but central to NHS recovery.
Policy position
Set out a clear statement of intent for a National Care Service, with publicly provided care services at its heart, and accelerate the timetable for implementation following the Casey Commission.
The first visible step should be practical and deliverable: expand community care capacity through local authorities, reduce delayed discharge and begin rebuilding publicly provided care services.
Benefit
This would give the public a sense that long-promised reform is finally moving from review to delivery. It would also help relieve pressure on hospitals, support independence, value care workers and show that a new leadership is serious about one of the country’s biggest unresolved public service challenges.
Early policy actions
The five proposed umbrella policy commitments from a new Labour leadership on the NHS and social care outlined above would inform key practical early actions that would demonstrate that a new leadership is serious about moving from review and rhetoric to delivery.
End corridor care and relieve pressure on hospital beds
Fund local authorities to create 8,000 additional community care places, in line with the Royal College of Emergency Medicine’s recommendation. This would help reduce the number of hospital beds occupied by patients who are medically ready for discharge, relieve pressure on urgent and emergency care, and act as an achievable first step towards a publicly funded and publicly provided National Care Service.
This should sit alongside investment in more hospital beds and the staff needed to provide safe care.
Stop new outsourcing of clinical work
Introduce a moratorium on new outsourcing of clinical work to the private sector, alongside a statement of intent to review and end poor-value contracts where possible.
The case should be made on value, quality and public interest: outsourcing can weaken integrated NHS care, divert funding into profit, undermine NHS services and reduce the money available to rebuild NHS capacity.
Reject private finance for NHS buildings and infrastructure
Rule out a return to private finance for building new hospitals, health centres and NHS estate refurbishment. Public borrowing to invest in state-owned NHS buildings should be framed as positive, cheaper and responsible because it creates long-term public assets rather than long-term private liabilities.
Rebuild NHS capacity, with technology used to support staff
Focus on expanding NHS capacity to address waiting lists and unmet need, including the needs of nearly three million people out of the workforce for health reasons.
AI and improved IT should be treated as long-term tools to support staff, improve systems and reduce unnecessary pressure. They should not be presented as substitutes for the workforce, beds, buildings and services the NHS needs.
Invest in general practice
Improve GP funding per patient and fund the increase in GPs needed to restore access and continuity of care.
This would allow unemployed and locum GPs to join primary care with greater security, support earlier intervention, reduce pressure elsewhere in the NHS and rebuild general practice as a cornerstone of public healthcare.
Review the Palantir contract break clause and end the contract
Use the February 2027 break clause in the Palantir contract as an opportunity to demonstrate a new ethical standard for NHS data and public contracting.
A decision to end or fundamentally reset the contract would signal that a new leadership is serious about transparency, public trust, evidence-based practice and the protection of NHS data.
Make social care reform visible immediately
Use the creation of 8,000 additional community care places as the first practical step towards wider social care reform.
This would connect urgent action on hospital discharge with a longer-term commitment to a National Care Service, showing that social care reform is moving from repeated promise to visible delivery.
About the contributors
This contribution is made by Dr Tony O’Sullivan and Dr John Puntis, co-chairs of Keep Our NHS Public.
Dr Tony O’Sullivan is a retired consultant paediatrician in child development and disability. He was Director of Children and Young People’s Services at Lewisham and Greenwich NHS Trust and played a key role in the successful campaign that overturned Jeremy Hunt’s decision to close Lewisham Hospital in 2013. He specialised in childhood disability and established Kaleidoscope, the multi-agency centre for children and young people in Lewisham, as well as a multidisciplinary autism service in 2005.
Dr John Puntis is a retired consultant paediatrician who worked at Leeds General Infirmary. He was Director of Neonatal Intensive Care for West Yorkshire, general paediatrician and developed a regional specialist service in gastroenterology and nutrition. He is a published researcher, Associate Editor for Archives of Disease in Childhood, a regular correspondent to The BMJ, chair of Leeds Keep Our NHS Public and works with unions and campaign organisations across Yorkshire.
Keep Our NHS Public (KONP) was established in 2005 in response to policies promoting private finance and private sector provision within the NHS. Its purpose is to restore the NHS as a publicly provided, publicly funded and publicly accountable service. It also supports the call for a national care, support and independent living service. Keep Our NHS Public:
- Works collaboratively with campaign organisations, unions, MPs, councillors and local communities.
- Regularly delivers interviews and briefings for media and journalists on a range of issues related to the NHS and social care.
- Regularly provides briefings for MPs, unions and elected councillors, and seeks to influence NHS Trusts, Integrated Care Boards and local authorities. It works with MPs across parties where there is support for progressive policy on the NHS, social care and health inequality.
- Helped establish the SOS NHS alliance in 2022, which is supported by more than 50 organisations, including 18 national unions. The alliance has briefed MPs and campaigned publicly on urgent issues, including avoidable deaths linked to delays in emergency care.
- Organised the People’s Covid Inquiry in 2021, chaired by Michael Mansfield KC. Its final report was used by Covid-19 Bereaved Families for Justice, the BMA, the TUC and legal teams involved in the UK Covid Inquiry.
- Helped establish the End Social Care Disgrace campaign, working with service users, family carers, care workers and partner organisations.
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