Prime Minister Keir Starmer will warn Thursday that Britain’s state-run National Health Service must “reform or die” after an independent report said the venerated institution was in a “critical condition”.

Starmer, whose Labour party was elected by a landslide in July, will promise “the biggest reimagining” of the NHS since it was founded 76 years ago in a speech in central London.

The address follows the publication of a 142-page investigation into the service which found that the health of Britons had deteriorated over the past 15 years.

The report’s author, Ara Darzi, an unaffiliated Lord in parliament’s upper chamber, said the NHS had fallen into “disrepair” because of a lack of investment, top-down reorganisation and the coronavirus pandemic.

“What we need is the courage to deliver long-term reform — major surgery not sticking plaster solutions,” Starmer was due to say, according to excerpts of his speech released to reporters.

“The NHS is at a fork in the road, and we have a choice about how it should meet these rising demands.

“Raise taxes on working people to meet the ever-higher costs of ageing population — or reform to secure its future.

“We know working people can’t afford to pay more, so it’s reform or die,” Starmer was expected to say.

Labour dumped the Conservatives out of power on July 4 in part on a pledge to “fix” the NHS, accusing the Tories of having “broken” it during their 14 years in power.

Darzi’s report notes that the NHS is seeing a surge in patients suffering multiple long-term illnesses such as diabetes and high blood pressure.

It says the UK has higher cancer rates than other countries and is lagging behind in its treatment of major conditions.

It also notes that waiting lists have swelled to 7.6 million and that a tenth of patients at accident and emergency wards now wait 12 hours or more before being seen.

Darzi said that he was “shocked” by what he discovered in his inquiry but added that the NHS’s vital signs “remain strong”.

Starmer was expected to outline three areas of reform for a 10-year plan to “turn around the NHS”, whose universal model is a source of British pride, despite its shortcomings in meeting demand.

Just over a year ago, his Tory predecessor Rishi Sunak announced a 15-year drive to recruit more than 300,000 staff to deal with a chronic shortage of doctors and nurses.

At the time, it was estimated that the NHS would have a staff shortfall of 360,000 by 2037 because of an ageing population, a lack of domestically trained health workers and difficulties recruiting and retaining staff, in part because of new visa rules.

Starmer’s plan includes moving from an analogue to a digital NHS, shifting care away from hospitals to communities, and focusing on prevention rather than sickness.

“The challenge is clear before us; the change could amount to the biggest reimagining of our NHS since its birth,” the prime minister was set to say.

Starmer, whose mother was an NHS nurse, has spent much of his first two months in power blaming the Tories for leaving Labour a dire inheritance in sectors ranging from health to the economy and prisons.

The Conservatives, whose leader Sunak is the son of an NHS doctor and a pharmacist, accuse him of exaggerating the country’s problems as a way of laying the groundwork for future tax increases.

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