From the NHS to ‘spreading opportunity’: Here’s what should be in Keir Starmer’s ‘plan for change’

Prime minister Keir Starmer will unveil his so-called “plan for change” today (December 5).

The strategy – which the Labour leader described as the “the most ambitious yet honest delivery plan in a generation” – will reveal what the government intends to prioritise over the next five years.

It will include numerical targets for his government’s five ‘missions’: boosting economic growth, making the UK a green energy superpower, cutting crime, fixing the NHS and spreading opportunity.

“It is the most ambitious yet honest delivery plan in a generation,” Starmer wrote in The Sun on Sunday. “That means doing things a different way, and launching new, measurable milestones so the ­public can track our progress.

“Because when I said this was a ­government in the service of working people, I meant it.”

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The plan for change – which Number 10 have declined to call a ‘reset’ – follows a difficult few months for the government. But, politicking aside, it is undeniably a significant moment. It will reveal where the government’s priorities lie, and, by extension, what manifesto promises are likely to fall by the wayside.

So what could – and should – be in it? Big Issue spoke to experts in each of the five ‘mission’ policy areas to find out.

What are Keir Starmer’s five missions in his plan for change?

Boosting economic growth

Before the election, Keir Starmer pledged to make the UK the fastest growing economy in the G7. However, he will reportedly sideline this goal, instead promising to increase real disposable income.

Zoë Billingham, director of IPPR North, has welcomed this shift. GDP growth is an accurate measure of an economy’s overall performance – but it is less good at reflecting a population’s welfare.

“I think the living standards pledge is the most exciting [target],” she explained. “Targeting economic growth is necessary and right, but in terms of how people feel, how the economy actually impacts their day-to-day life – It’s got to be about the cash they have in their pockets.”

Governments who fail to make meaningful progress on these metrics tend to be punished at the ballot box. For example, US economy is faring much better than most of its counterparts. But grocery prices are up 20% – a key factor cited by Donald Trump voters at the November election.

Starmer is aware of these dynamics, says Billingham, and a focus on living standards in his plan for change should pervade the other five targets, too.

“The essential costs – housing costs and energy costs are two of the biggest things that make up personal budgets,” she said. “ And then on the on the other side the equation, of course, is income. How much people are earning? How much is universal credit and the safety net for people? These things all matter… they are related to ‘growth’ but they cannot be reduced to ‘growth’.”

Making the UK a green energy superpower

The government has pledged to create a clean electricity system by 2030.

In a report released earlier this month, the National Energy System Operator declared that the path clean power will depend on the “mass deployment of offshore wind, with onshore wind and solar”. NESO expects onshore wind to double and solar farms to triple from today’s capacity.

The government’s numerical target may well revolve around renewable infrastructure. Such an overarching goal for energy is a good start, says Louise Marix Evans, an environmental consultant based in the North of England – but there are other improvements that are just as important.

“I would add the target: for every X we spend on the grid development, we spend an equal or similar proportion on local level improvements. Warm, insulated, affordable, homes, clean air, investment in public transport, investing in cycle networks,” she said.

“For every pound you spend on new generation – the same amount should be spent on energy efficiency.”

When it comes to decarbonising the grid, the local power plan – Labour’s policy to develop community-owned renewable energy projects – will be crucial. The aim is to generate up to eight gigawatts (GW) of clean energy – enough to power 4.35 million homes. This needs to happen through engagement on a “municipal, council and community level.

“We need to ask: what can GB Energy do to really drive through local power?” Marix Evans added.

For example, the environmental consultant is working on a scheme with Rossendale Valley Energy – a community owned energy group in East Lancashire. She is working with the council to retrofit 14,000 terraced houses.

“We’re looking there at a system where you’ve got shared solar panels across the houses, boreholes with the shared loop ground source heat pump loops and little ground source heat pumps inside people’s houses, and enough retrofits to the house to keep it warm and cozy with a small heat pump,” she explained

“And you’re doing it like a co-op. You’re doing it collectively in a community. This sort of thing will be key when it comes to looking to the future.”

Fixing the NHS

The waiting list for routine hospital treatment is currently 7.57 million.

There will be one NHS target – to lower these waiting lists. The prime minister is expected to set a target for 92% of routine operations and appointments in England to be carried out within 18 weeks by March 2029 – a goal that has not been achieved in almost a decade.

Hospital leaders are sceptical about the possibility of meaningful progress. A recent survey by the hospitals body NHS Providers found that 71% of trust leaders thought it unlikely that they could make such progress that quickly. This rises to 100% of those who run acute and ambulance trusts.

Earlier this year, Lord Darzi published a report suggesting that the “awful state” of A&E causes an additional 14,000 deaths a year. Nearly a tenth of all patients waiting 12 hours or more. 

Dr Jahangir Alom is an emergency medicine physician in North East London. An elective waiting list reduction is “of course” important, he told Big Issue. But it cannot be the government’s singular focus.

“The most common thing I say to patients is, ‘I’m sorry you’ve had to wait so long.’ On Saturday night there was a 12 hour wait to see a doctor,” he said.

“It’s all about elective procedures. But those of us in accident and emergency feel really demoralised. We are drowning.”

“I’m looking after people in the corridors in A&E. What kind of treatment is that? How can I examine someone’s abdomen or listen to their chest or ask them really sensitive questions in the corridor? We need an immediate plan for the winter surge.”

Targets matter – but they cannot do full justice to the health inequality that is baked into the system, Dr Alom said. For example, the poorest and most affluent areas have a 19-year gap in healthy life expectancy in England.

“Health inequalities must be addressed across the board, in every department, in every mission board,” he said. “They relate to living standards, to opportunity, to everything.”

Cutting crime

Previously Labor has pledged to “take back our streets”. One of the pledges in tomorrow’s plan for change will revolve around cutting crime, though the exact measure is as yet unclear.

If the manifesto is anything to go by, it could involve a police recruitment drive.

“Labour will introduce a new Neighbourhood Policing Guarantee, restoring patrols to our town centres by recruiting thousands of new police officers, police and community support officers, and special constables,” the policy document pledged.  

The government has come under fire for the prison capacity crisis: but a report out from the National Audit Office this morning blames the failures of the previous Conservative government.

The parliamentary spending watchdog attributed the current lack of places as “the result of previous governments’ failure to ensure that the number of prison places was aligned with criminal justice policies.”

Spreading opportunity

“Spreading opportunity” is perhaps the vaguest of the government’s five missions. In the plan for change, Starmer will hone in on early years education, setting a target to increase the proportion of four-year-olds and five-year-olds who are fully ready to start school (socially and educationally) from 60% to 75%. That’s around 40,000 children.

The government will do this by increasing early years provision, hiring 6,500 new teachers creating 3,000 new and expanded school-based nurseries. Ministers have already earmarked £2.3bn for this.

It’s a welcome initiative, Baz Ramaih, head of policy at the Center for Education.

“We know that investment in a free, universal, high quality early years offer can have a huge impact on children’s lives,” he said.

The target is “doable” – but only with an understanding of the barriers that stymy early years education uptake. For example, many kids had their language development stunted by the pandemic. A meaningful strategy would focus on hiring more speech and language specialists.

“Are the barriers predominantly social and financial? Are they primarily emotional barriers, are they related to foundations in literacy and numeracy, or speech and communication?” Ramaih said.

“It’s key that the government has, like a plan that’s grounded in, like, what those current barriers are, rather than, you know, very abstract one about getting about trying to get children school ready in a very broad sense.”

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