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The Guardian - UK
The Guardian - UK
Politics
Andrew Gregory Health editor

‘A proper diagnosis’: Prof Lord Darzi, keyhole pioneer asked to unpick NHS

Prof Lord Darzi in 2014
Prof Lord Darzi has previously spotlighted general practice as being a key area that needs life-saving surgery. Photograph: Chris Radburn/PA

The world-renowned surgeon Prof Lord Darzi has been appointed by ministers to lead an independent investigation into the performance of the NHS.

Wes Streeting, the health secretary, said the review would be aimed at “diagnosing the problem” so ministers could “write the prescription”. Charged with assessing the evidence that could help reshape the NHS, the task presents an opportunity for an innovator who relishes a challenge.

Born in Baghdad, an early brush with death as a five-year-old Armenian refugee sparked Ara Darzi’s lifelong passion for the power to heal. He was hospitalised with meningitis weeks after starting school and his family feared the worst but he survived. Doctors teased him by suggesting he should join the business of saving lives when he grew up.

Darzi did not need further encouragement. He moved to Ireland aged 17 to study medicine, finished his training in England, and became a consultant. He later won the nickname “Robo Doc” for spearheading the use of keyhole surgery and pioneering robotics in operating theatres.

Labour have asked him for help with the NHS before. Darzi was “gobsmacked” when Gordon Brown invited him to become a health minister in 2007. Reluctant to quit surgery, Darzi agreed on the condition he could still operate – which he likes to do with Pink Floyd playing in the background – on Fridays and Saturdays.

In 2008, he led a review of the NHS that recommended a relentless focus on quality of care. It also called for a shift away from the political command and control of processes, and towards professional responsibility for clinical outcomes.

Improving quality of care is highly likely to feature again in Darzi’s 2024 review. However, the NHS he is assessing today is in a far worse state than it was 16 years ago. An estimated 7.6m treatments were waiting to be carried out at the end of May, relating to 6.38 million patients, according to NHS England data published on Thursday.

Beyond hospitals, mental health services, especially for children, are in disarray amid record demand. Community services and ambulance services – two areas often overlooked by ministers – also require emergency treatment.

Darzi has previously suggested general practice needs life-saving surgery. Writing for the Financial Times last year, he said the last Labour government “concentrated on reforms to hospitals” while the subsequent Conservative administration focused on the financing of care. “There has been relatively limited attention paid to care outside hospitals,” he added.

That looks set to change. The Guardian revealed this week how ministers planned to divert billions of pounds from hospitals to GPs to “fix the front door to the NHS”. The government is also warming to the idea there should be a much bigger focus on preventing ill health in the first place, according to sources.

But first, the NHS will have its own appointment with a doctor, and scans to establish the scale of the surgery it may require.

“As every clinician and every patient knows, the first step to addressing any health problem is a proper diagnosis,” Darzi said after his appointment was announced on Thursday.

Critics claim the investigation is a delaying tactic from Streeting, designed to buy him more time before he can be judged on NHS performance.

They also say the review will not uncover anything new. The Guardian has previously exposed the extent of the crisis engulfing the NHS, and revealed the impact on staff and patients.

But Darzi says the review will be critical. “My work will analyse the evidence to understand where we are today – and how we got to here – so that the health service can move forward. This is an important step to re-establishing quality of care as the organising principle of the NHS.”

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