Marking its 75th anniversary, Sir Tony said there is no future for the NHS without “fully embracing the tech revolution”.
And he called for the service to make much more use of private healthcare providers to cut waiting times. Sir Tony’s suggestions included that patients should be allowed to pay to speed up access to healthcare.
His intervention comes the day after former health secretary Sajid Javid, who has suggested patients should be charged to see a GP, called for a royal commission into the model of the NHS. He said the NHS was “frozen in time” and an inquiry was needed to compare it with models used in comparable countries.
And the ex-Labour leader, in a report by his Tony Blair Institute think tank, said: “The NHS now requires fundamental reform or, eventually, support for it will diminish. As in the 1990s, the NHS must either change or decline.”
He said that despite “pockets of excellence”, the NHS is falling behind the healthcare systems in other countries, as many services remain “slow and unresponsive to digital transformation”.
Embracing the private sector would open the NHS to providers where the “incentives of funding and accountability are designed to encourage innovation”, he added.
Sir Tony said the NHS App has opened the door to partnership with the private sector in “ways that were not possible before”, creating “opportunities for greater choice and competition”.
In the foreword to his report, which suggests reforms to make the NHS fit for the future, Sir Tony backs expanding the role of the private sector on six occasions.
Sir Tony said: “Change is never easy and requires brave political leadership. If we do not act, the NHS will continue down a path of decline, to the detriment of our people and our economy.”
Labour’s Wes Streeting said he “does not agree” with Sir Tony’s suggestion that some people should be able to pay to use NHS services.
The shadow health secretary said the UK “already has a two-tier system”, adding that “people who can afford it are paying to go private and those who can’t are being left behind”.
But he added to warnings around the future of the health service, claiming the NHS will die without “the necessary investment and reform” to change and modernise.
“At the moment the NHS is in jeopardy. I’m anxious about the future of the NHS, as I think the rest of the country is,” he told Sky News.
“Unless it changes, it will die. And yet the NHS’s founding principles – public service, free at the point of use, there for us when we need it – is absolutely possible for the next 75 years, but it needs the right leadership.”
Mr Streeting blasted what he called the “absurd spectacle” of “ministers celebrating the 75th anniversary of an institution that they have broken”.
And health secretary Steve Barclay has insisted the NHS can prosper without a dramatic overhaul, insisting it needs “constant evolution, not a big bang moment”.
He brushed off calls from Mr Javid and Sir Tony to consider a fundamental shakeup of the model of the NHS.
And Mr Barclay said the NHS being free at the point of use is “a source of national pride”, adding that the government is “fully committed to these founding principles”.
Writing in The Times, the health secretary said: “Clearly, there are pressures on services, particularly following the pandemic, and as a result of changing demographics and health needs.
“It is important the NHS changes and adapts in response to this, and improving technology and medical advancements, but this requires constant evolution – not a big bang moment.”
And he added that, under the government’s plans, the NHS “will be fit to deliver the best care to patients for another 75 years”.
But it came as health minister Maria Caulfield admitted record-long NHS waiting lists could increase further.
Some 7.4 million people are on the NHS waiting list and that figure could get worse despite Rishi Sunak's promise to cut it, MS Caulfield said. “To patients, what matters is how long they’re waiting. They’re not really worried about who else is on the waiting list,” she told Sky News.
And a leading group of think tanks warned on Wednesday that the NHS will not reach its 100th anniversary without investment.
The King’s Fund, the Health Foundation and the Nuffield Trust said the NHS is the “jewel in the country's crown” but the organisations warned that the service faces “huge challenges”.
In a letter to Rishi Sunak, Labour leader Sir Keir Starmer and Liberal Democrat leader Sir Ed Davey, the organisations said the NHS has “endured a decade of underinvestment” and criticised politicians for an “addiction to short-termism and eye-catching initiatives” which will not help the service in the long run.
“Unachievable and unrealistic” fast improvements without long-term planning will “doom the service to failure”, they said.
Without action the service will face “managed decline that gradually erodes the guarantee of safety... it was designed to create”.
The think tanks also called for investment in the service, reform in the social care sector and action to address the “fraying health of the UK population”.
The letter states: “Seventy-five years after its creation, the National Health Service is in critical condition.
“Pressures on services are extreme and public satisfaction is at its lowest since it first began to be tracked 40 years ago.
“Despite this, public support for the NHS as an institution is rock solid – it still tops surveys about what makes people most proud to be British, and the public are unwavering in their support for its founding principles: free at the point of use, comprehensive and available to all.”
The letter adds: “We urge you to make the next election a decisive break point by ending years of short-termism in NHS policy-making... promising unachievable, unrealistically fast improvements without a long-term plan to address the underlying causes of the current crisis is a strategy doomed to failure.”
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