the Lord Darzi Rapid Review on the state of the English NHS

Ara Darzi’s independent review into the performance of National Health Service (NHS) England, 1 commissioned soon after the Labour election victory in July, was published on 12 September. The report has been well received as an honest appraisal of the current state of the NHS.

The fact that the NHS is in serious trouble will be no surprise to anyone working there. Darzi offers a stark view, exposing ballooning waits in primary and secondary care and evidence that the nation’s health is deteriorating. Too much of the budget is being spent in secondary care. And all of this is exacerbated by insufficient capital funding and unhelpful and damaging reorganisations. Furthermore, too many staff members are disengaged, and the patients’ voices are not loud enough.

Yet, despite all this, once patients’ get into the system’, they receive good care. Darzi concludes that ‘despite the challenges, the NHS’s vital signs remain strong’.

While specifically tasked not to look at solutions, Darzi gives some helpful pointers. He suggests re-engaging staff and empowering patients, shifting care closer to home, simplifying and innovating care delivery, improving hospital productivity, and tilting towards technology.

What can we say as Christians? We got together several Christian healthcare leaders recently and asked them just that. We felt our response should be underpinned by servant-heartedness, serving the sick and not ourselves. The honesty about the state of the NHS is refreshing and welcome, with truth such a foundational Christian principle. In recent years, the absence of truth in some of the dialogue around health policy has caused harm and got in the way of solutions.

The ‘how’ of taking things forward is all important. Along with patients and other health professionals, Christians working in the NHS must have a voice in policymaking and implementation and be convinced that God’s voice, through us, is valid and essential. We care about patients and the effect of new policies on staff. We want to serve both, to empower both, and to care for both. We have a whole-life faith. We see our patients and colleagues as more than a diagnosis or a skill set but as whole people with a life beyond the hospital or surgery, all of which are important to true health. We can help empower and re-engage our colleagues, supporting those who have just given up. Speaking up for and championing the care of our colleagues is vital to improving staff retention, without which failure looms.

Sir Keir Starmer said the NHS must ‘reform or die’. There is a fundamental tension between this desire for radical change and an inevitable cynicism.

Jesus taught a radical gospel, where the first are last and the last first, 2 where rulers are brought low, and the lowest is raised high. 3 This good news remains relevant to this day, perhaps increasingly so. Christians can be confident in our radical Saviour as we embrace change. Ultimately, God is in charge, and we can take confidence in that. That, in turn, makes a difference to who we are and how we are, so that we can be a non–anxious presence at work amid change.

The culture we practise and live in has changed enormously over the 76 years since the NHS began, but the Christian voice is as vital as ever. We need to speak the truth confidently and boldly wherever we work and have influence.